Analysis Of Human Papillomavirus Genotype Distribution In 904 Patients With Condyloma Acuminatum

Objective:Condyloma Acuminatum(CA),also known as anogenital warts,is a verruciform benign proliferative disease mainly caused by infection of Human Papillomavirus(HPV),which is one of the most common sexually transmitted diseases in clinic.Anogenital warts are usually asymptomatic,but some patients occasionally feel pain or itching,mainly occur in the genitals,perineum,vagina,urethra,anal perianal skin,and cervix,etc.Sexual contact is the main way of transmission,and a small number of people can be infected through close contact with non-sexually contact.Anogenital warts can cause great burden to patients and Health-care providers because of its high recurrence rate and strong contagion.More than 200 types of human papillomavirus(HPV)have been identified,and at least 40 of them can infect the genital area.HPVs can be divided into two subtypes based on their different pathogenicity,including high-risk HPV subtype and low-risk HPV subtype.The low-risk HPV infection often causes benign verrucous proliferation of skin and mucous membrane,such as genital warts;whereas high-risk HPV infection can causes precancers,atypical hyperplasia and cancers,such as cervical cancer,penile cancer,etc.Based on the retrospective analysis of the results of HPV genotyping in 904 cases of condyloma acuminatum in Tianjin Union Medical Center from 2014 to 2017,we preliminarily discussed the HPV subtypes distribution in patients with condyloma acuminatum.Methods:The study was carried out in Tianjin Union Medical Center,which included 904 patients(281 are female patients and 623 are male patients)with anogenital warts,from January 2014 to December 2017.The initial diagnosis of anogenital warts was made by the outpatient dermatology clinic of Tianjin Union Medical Center through clinical feature,epidemiological contact history and acetic acid white test.The results of HPV genotyping in 904 cases of condyloma acuminatum in the Hospital were retrospectively analyzed.In this study,HPV genotypes were determined and analyzed by using Liferiver papillomavirus(HPV)nucleic acid assay kit(PCR fluorescence method).The kit can detect 15 HPV subtypes(including 2 Low-risk HPV type of 6/11 and 13 high-risk HPV types of 16,18,31,33,35,39,45,51,52,56,58,59,68).The data was processed statistically by SPSS 19.0,and P<0.05 was considered statistically significant.Results: 1.The 904 patients with condyloma acuminatum aged 11 to 87,the interquartile range of patients' age was 32.00(26.00,42.00),which most of the patients were between 20 and 49 years old.Among the 904 cases,680 samples tested positive for HPV,with a positive rate of 75.22%(680/904).2.The positive rate of HPV subtypes in descending order was HPV6/11,6,52,51,58,56,31,18,59,39,35,33,68,45.Among them,HPV6/11 positive rate was the highest(64.5%,579/904),accounting for 85.14%(59/680).The positive rate of HPV16 was the highest in high-risk HPV infection,accounting for 11.32%(77/680).3.Among the 680 HPV positive cases,579 cases were positive for HPV6/11,and the difference percentage of HPV6/11 in 4 years was not statistically significant(P>0.05).4.Among the 680 HPV positive cases,the infection rate of high-risk HPV in male was 42.49%(201/473),while in female was 54.11%(112/207);the infection rate of low-risk HPV in male was 90.06%(426/473),while in female was 73.91%(153/207).The difference of infection between men and women in high-risk and low-risk HPV types was statistically significant(P<0.05).5.Among the 904 cases of condyloma acuminatum,the positive rate of HPV detection in male was 75.92%(473/623),and the rate in female was 73.66%(207/281).There was no statistically significant difference in the positive rate of HPV detection between male and female(P>0.05).6.313 of the 680 positive patients infected with at least one high-risk HPV genotype,accounting for 46.03%(313/680).There were 367 patients infected with pure low-risk HPV(HPV6/11),with a percentage of 53.97%(367/680).There were 101 patients infected with pure high-risk HPV,accounting for 14.85%(101/680).And there were 212 patients simultaneously infected with low-risk and high-risk HPV,accounting for 31.18%(212/680).7.Among the 904 patients with condyloma acuminatum,312 samples were tested by RPR and TPPA,and the results showed that 7 cases were positive for RPR and TPPA,including RPR titer of 6 cases were greater than or equal to 1:4.24 patients were tested for Mycoplasma urealytium DNA and 10 cases among them were positive.20 patients were tested for chlamydia trachomatis DNA and 9 cases among them were positive;15 patients were tested for HSV-Ig G and 13 cases among them were positive.In 2014,there were 242 patients with condyloma acuminata,which 66 patients among them were tested for HIV and 3 were positive for HIV.Conclusions: In 904 patients with condyloma acuminatum,interquartile range of patients' age was 32.00(26.00,42.00),and the positive rate was 75.22%(680/904).The positive rate of HPV subtypes in descending order was HPV6/11,6,52,51,58,56,31,18,59,39,35,33,68,45.Among the HPV subtypes,HPV6/11 positive rate was the highest,accounting for 85.14%(59/680),and there was no statistical difference about percentage of HPV6/11 in 4 years.The positive rate of high-risk HPV was 46.03%(313/680).There were 212 cases of mixed infection with low-risk and high-risk HPV,with a percentage of 31.18%(212/680).The positive rate for human papillomavirus was no statistically significance between men and women,but the infection between men and women in high-risk and low-risk HPV types was statistically significance.In addition,patients with condyloma acuminata were susceptible to other sexually transmitted diseases,so medical history should be carefully scrutinized and the related laboratory examinations should be actively completed.