摘要目的 调查人类免疫缺陷病毒(HIV)阳性妇女人乳头状瘤病毒(HPV)的感染状况,分析高危型HPV感染的危险因素.方法 收集178例自愿接受宫颈癌筛查的HIV阳性已婚妇女作为研究组,另选取122例HIV阴性妇女为对照组.所有受检患者填写调查问卷,检测HIV阳性妇女的CD4+T细胞计数和HIV RNA载量,使用PCR方法检测HPV亚型.采用SPSS 16.0软件进行统计分析,并用Logistic回归分析HPV感染的危险因素.结果 研究组HPV阳性者、高危型及多重HPV感染者分别是68例(38.2%)、63例(35.4%)和24例(13.5%),而对照组分别为15例(12.3%)、10例(8.2%)和4例(3.3%),两组比较差异有统计学意义(x2分别为24.77、29.08和8.91,P值均＜0.05).两组常见高危型HPV感染亚型相似,以HPV 16、52、58和HPV18亚型常见.Logistic回归分析表明,CD4+T细胞计数＜350个/μL,配偶HIV阳性及性途径感染HIV为高危型HPV感染的危险因素.结论 HIV阳性妇女宫颈HPV感染率高,高危型和多重HPV感染常见.高危型HPV感染与HIV阳性妇女的免疫状态、HIV感染途径及配偶HIV状态有关.

abstractsObjective To evaluate the prevalence and risk factors of human papillomaviruses (HPV)infection among human immunodeficiency virus(HIV)-positive women.Methods Totally 178HIV-positive and 122 HIV-negative women were enrolled.Structured interviews,peripheral CD4 + T cells counts and cervical specimens were obtained.Polymerase chain reaction(PCR)assay was used to identify HPV types. SPSS 16.0 was used for statistical analysis,and logistic regression was used to identify independent prognostic factors for high-risk HPV infection. Results HPV positive rate,high-risk and multiple HPV infection rates were 38.2% vs.12.3% ,35.4% vs.8.2% ,and 13.5% vs.3.3% in HIVpositive women and HIV-negative women,respectively,and the differences were of statistical significance (x2 =24.77,29.08 and 8.91,P ＜0.05).The common types of high-risk HPV were similar between HIV-positive and HIV-negative women(HPV16,52,58 and 18).CD4 + T count ＜ 350/pL,HIV-positive in husband,and HIV infection through sexual contact were risk factors for high-risk HPV infection in HIV-positive women.Conclusion sThe prevalence of HPV infection in HIV-infected women is high,especially for high-risk HPV infection and multiple infection.High-risk HPV infection usually occurs in HIV-positive women with low immune status,HIV infection through sexual contact and HIV-positive husband.