Meta-analysis Of Factors Associated With Persistent Infection Of High-risk HPV In Chinese Women

Objectives:To explore the related factors of persistent infection of high-risk HPV in Chinese women,deepen the understanding of persistent infection of HR-HPV,and hope to provide guidance for clinical work in the future.Methods:Chinese and English databases,such as Pub Med,Medline,Web of Science and Wanfang,CNKI and CBM,were used to search for relevant articles on the analysis of the influencing factors of persistent HR-HPV infection in Chinese women’s cervix.At the same time,references of the articles were consulted and the authors were asked for help to search for relevant literatures and studies.Formulate corresponding retrieval strategy,literature retrieval through two steps,according to include and exclude standards determine ultimately meet the requirements of 18 articles,15 Chinese literature,3 articles English literature(study population for the Chinese),a total of 6588 cases,it can be divided into two groups,HR-HPV persistent infection group 2173 cases,HR-not persistent infection of HPV group4415 cases.For different related factors,they were further subdivided into HPV type and viral load,single/multiple severe infection,and genital tract inflammation.Age,number of pregnancies,menopause,method of contraception,age of menarche,age of first sex,smoking.Meta-analysis was performed using Rev Man 5.3.Main results:1.Correlation between personal factors and HR-HPV persistent infection:(1)Compared with non-menopause,menopause was correlated with HR-HPV persistent infection(OR=2.76,95%CI[2.33,3.28]);(2)The number of pregnancies>2 was associated with persistent HR-HPV infection(OR=2.26,95%CI[1.91,2.67]);(3)Condoms were not prone to persistent HR-HPV infection(OR=0.52,95%CI[0.34,0.81]);(4)Smoking was associated with persistent HR-HPV infection(OR=1.40,95%CI[1.09,1.79]);(5)The persistent HR-HPV infection was associated with > 35 years old(OR=3.50,95%CI[2.11,5.81]).(6)The age of first sexual life≤20 years(OR=1.30,95%CI[1.03,1.66])was correlated with persistent HR-HPV infection.2.Correlation between clinical features and HR-HPV persistent infection:(1)HPV16 and HPV18 were correlated with HR-HPV persistent infection(OR=4.49,95%CI[2.11,9.56];OR=2.47,95%CI[1.37,4.46]);HPV52(OR=0.59,95%CI[0.36,0.98]),HPV45(OR=0.44,95%CI[0.23,0.85]),HPV68(OR=0.11,95%CI[0.02,0.53]),HPV66(OR=0.20,95%CI[0.07,0.58]),HPV35(OR=0.44,95%CI[0.21,0.94]),HPV59(OR=0.11,95%CI[0.21,0.94]),95%CI[0.03,0.46])was not likely to cause persistent HPV infection;(2)The persistence of HR-HPV was not easily induced by single virus infection(OR=0.45,95%CI[0.34,0.59]);(3)Viral load ≥100(OR=4.17,95%CI[3.08,5.56])was associated with persistent HR-HPV infection compared with viral load 1-99(OR=0.32,95%CI[0.24,0.42]);(4)Inflammation of reproductive tract was associated with persistent HR-HPV infection(OR=2.10,95%CI[1.25,3.52]).3.The age of menarche ≤14 years old(P=0.23),HPV58(P=0.23),HPV51(P=0.24),HPV33(P=0.54),HPV31(P=0.09)and HPV56(P=0.59)had no statistical significance,but there were few data included,and a large number of studies are still needed for further verification.Conclusion:1.HPV typing,viral load,reproductive tract inflammatory diseases,single/multiple infections and other disease history were closely related to HR-HPV persistent infection;Combined with the specific HPV infection type,load and other related factors of the patient has a positive effect on the development of appropriate treatment measures.2.Personal factors such as the number of pregnancies,age of first sexual intercourse,condom contraception,age,menopause and smoking were closely related to HR-HPV persistent infection.It is very important to strengthen the knowledge of prevention and treatment of cervical diseases and to advocate healthy living habits to prevent cervical diseases3.There was no significant correlation between age of menarche and persistent HR-HPV infection.