| ObjectiveHuman papillomavirus(HPV)causes a variety of cancers,but cervical cancer is the“classic”cancer of HPV.At present,there are 4-valent HPV vaccine in China mainland,but the HPV infection rate and genotype distribution vary greatly in different regions.The purpose of this study is to investigate the prevalence and distribution of HPV in Qingdao,and to analyze the relationship between the prevalence of HPV infection and age,season and year.Investigating the prevalence and distribution of local HPV genotypes will be benefit for HPV vaccination recommendations and cervical cancer prevention.MethodsThis study enrolled 10589 women performed HPV genotyping at Qingdao Women and Children’s Hospital between 2018 and 2020.HPV genotypes were identified via multiplex real-time PCR assay combined with flow-through hybridization technique.This assay can identify 27 types of HPV,including 17 high-risk types(16,18,26,31,33,35,39,45,51,52,53,56,58,59,66,68 and 82)and 10 low-risk types(6,11,40,42,43,44,55,61,81 and 83).The descriptive statistics were used to describe the frequency and proportion SPSS v.25.0 was used for further analysis.For comparisons among different age groups,season groups or years groups,the categorical variables were compared by using the Pearsonχ~2test.All the reported P values were made on the basis of two-sided tests with a significance level of 0.05.Results(1)The overall detectable HPV infection rate was 25.05%(2653/10589)in this study,of which 68.90%(1828/2653)were only high-risk-HPV positive,11.99%(318/2653)positive for mixed high-risk and low-risk HPV and 19.11%(507/2653)positive only low-risk HPV.(2)We found that single HPV infections was the most common in the local population 74.26%(1970/2653).Two HPV genotypes(double infection)were the most common in the multiple HPV infection distributions,with an overall rate of19.64%(521/2653).Three HPV genotypes(triple infection)and four or more detectable HPV genotypes were followed,with overall prevalences of 4.15%and 1.43%,respectively.Five or more HPV genotypes were reared with an overall prevalence less than 1%.(3)In all the 10589 subjects,the highest overall prevalence of HPV was found in women≤20 years old(43.66%,31/71),while the lowest prevalence of HPV was in women aged 31 to 40 years old(23.21%,1128/4861).The overall prevalence of HPV in women aged≥61 years was(32.61%,60/184).The difference was statistically significant among the different age groups(P<0.05).(4)Local HPV infection was also seasonally-specific with the highest infection rate in autumn(P<0.05).(5)From 2018 to 2020,the HPV infection rate increased significantly.(6)Of the reported high-risk HPV genotypes,the top five were HPV16(16.36%),HPV52(15.15%),HPV58(12.45%),HPV53(7.91%)and HPV56(7.35%).The top three low-risk HPV genotypes were HPV61(23.70%),HPV81/43(13.84%)and HPV6(13.73%).(7)In different cervical lesions,the top three genotypes of HPV infection were HPV16,HPV58 and HPV52.The infection rate of high-risk HPV genotypes is substantially increased with the degree of cervical lesions,but the multiple infection rate did not increase with the degree of cervical lesions.(8)The 9-valent vaccine covers 46.55%genotypes in Qingdao,which is much lower than the HPV vaccination coverage(85.72%)in other regions.Conclusion(1)The infection rate of cervical HPV in females in Qingdao is relatively high,which is correlated with season and age.From 2018 to 2020,the HPV infection rate showed an upward trend.(2)The infection is diversified,mainly monogenotype infection,and high-risk HPV infection is the most common.HPV16,58,and 52 are the main HR-HPVs that causing cervical lesions.HPV16 is a genotype closely associated with cervical lesions.Polygenotypice infection is not associated with the grade of cervical lesions.(3)The nine-valent vaccine with wider coverage should be vaccinated to prevent cervical cancer,and more suitable vaccines can be developed according to the regional characteristics to prevent HPV infection. |
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