Clinical Study Of High Risk HPV Infection Risk Factors And HIV / AIDS Combined With Perianal Condyloma Acuminatum

Part Ⅰ Study on Cervical High-risk HPV Infection Risk Factors of Gynecological Patients in General HospitalObjective:To investigate risk factors associated with cervical high-risk Human papillomavirus (HPV) infection of gynecological patients in general hospital, and analysis the co-infection of cervical high-risk HPV and common sexually transmitted pathogens.Methods:A cluster sampling was carried for five hundred cases showed positive in cervical high-risk HPV test, while500cases of negative were the negative control group.Both of them were taken enclosed questionnaire. Mycoplasma,chlamydia, gonorrhea, herpes virus antibodies, syphilis, HIV antibody of81cases with cervical high-risk HPV infection were tested. While Mycoplasma, Chlamydia, Gonorrhea of81cases without cervical high-risk HPV infection were tested as control group.Results:Univariate analysis showed that30～50years old, low education level, unsteady job, spouse smoking, age of first delivery<20years, age of first sex<20years, multiple sexual partners, frequency of sexual activity≥4times/week, taking contraceptive, condoms use were associated with cervical high-risk HPV infection. Further line multivariate analysis showed that spouse smoking, multiple sexual partners, age of first sex<20years, sexual frequency≥4times/week, low education level, taking contraceptives were risk factors of cervical high-risk HPV infection,while condoms-use was a protective factor. Mycoplasma infection rate of cervical HPV-positive group was76.5%(62/81), while the rate of negative group was56.8%(46/81).χ2test showed significant difference(P<0.05).HSV-2infection rate of cervical high-risk HPV-positive patients was23.5%(19/81).Conclusion:Sexual health education among women should be strengthened. Promoting the use of condoms, avoiding taking oral contraceptives, avoiding premature sexual life and multiple sexual partners can decrease the risk of HPV infection, while cervical high-risk HPV infection was associated with mycoplasma infection. There were higher HSV-2infection in patients with cervical high-risk HPV infection.PartⅡ Clinical Features and Treatment of Perianal Condyloma Patients with HIV/AIDSObjective:To study clinical features of HIV/AIDS patients with recurrent perianal warts. To discuss clinical efficacy of5-aminolevulinic acid photodynamic therapy combined with electrocautery treating for HIV/AIDS patients with recurrent perianal warts.Methods:To analyze clinical data of nine cases recurrent perianal warts with HIV/AIDS systematically, including education level, marital status, sex partners number, condom use, CD4+T cell count, HARRT treatment, genital warts duration, recurrence times and so on. The number and size of lesions were inspected. Visible genital wart was removed by electrocautery firstly, then photodynamic therapy. The efficacy was observed in6month after treatment.Results:Both of the9patients were MSM, whose number of sexual partners were7-1100, with an average of141. Eight patients discontinuously use condoms, while another patient has not been used condom. Four patients were combined with sysphilis, including3cases of secondary syphilis, another patient with primary syphilis. The CD4+T cell counts were46to460cells/ul of this group, with an average of275cells/ul. Disease course was ranging from3months to1.5years, with an average of1.2years. Recurrence times was4to10, with an average of5times. Lesions number was7to37, with an average were14. Eight patients were cured by photodynamic therapy combined with electrocautery, while another one was recurrent.Conclusions:MSM hold higher risk of perianal warts. For repeated recurrent, extensive areas of anal lesions in male patients, combination of AIDS, syphilis and other sexually transmitted diseases need to be alert at the same time. Considering of poor efficacy of conventional methods, photodynamic therapy combined with electrocautery is an effective way for recurrent perianal warts with HIV/AIDS.