尖锐湿疣亚临床感染HPV分型与预后的关系

摘要

Objective To investigate the relationship between human papillomavirus (HPV) classification and prognosis in subclinical infection of patients with condyloma acuminatum (CA). Methods Specimens of local warts from 158 cases of typical CA (typical group) and 108 cases of subclinical CA infection (subclinical group) in Depart-ment of Rheumatology-Dermatology, Meizhou People's Hospital from April 2015 to December 2016 were detected for of HPV genotype. The infection type of HPV-DNA and infection status in subclinical group were observed, and com-pared with those in the typical group. At the same time, the intractable recurrence of subclinical infection with different types of HPV was analyzed. Results ①A total of 108 cases of HPV-DNA were detected in subclinical group, mostly HPV 6 (55 cases, 50.9％), followed by HPV 11 (18 cases, 16.7％). There were 86 cases (79.6％) of low-risk HPV and 22 cases (20.4％) of high-risk HPV. There was no significant difference in the constituent ratio of each HPV type between the subclinical group and the typical group (P>0.05). ② The rate of single infection in the typical group was 60.8％, which was significantly lower than 75.0％of the subclinical group. The rate of multiple infection (three and above three) was 15.8％, which was significantly higher than 3.7％of the subclinical group (P<0.05).③A total of 14 cases suffered no less than 3 times of relapse in subclinical group, accounting for 13.0％, including 4 cases of HPV16+18, 3 cases of HPV16+52, 3 cases of HPV16, 2 cases of HPV18, 1 case of HPV6+11, and 1 case of HPV43. Conclusion Subclinical infections are dominated by HPV 6 and are mainly single infection. The recurrence rate was high among patients with multiple infections.%目的 探讨尖锐湿疣(CA)亚临床感染乳头瘤空泡病毒(HPV)分型以及分型与预后的关系.方法 对2015年4月至2016年12月期间梅州市人民医院风湿皮肤科收治的158例典型CA(典型组)和108例CA亚临床感染者(亚临床组)的局部疣体标本进行HPV基因型检测,观察亚临床组感染HPV-DNA类型以及感染情况,并与经典组进行对比.同时分析亚临床感染不同类型HPV出现顽固性复发情况.结果 ①亚临床组患者共检出各类型HPV-DNA合计108个,其中以HPV 6型最高,共55个(50.9％),其次为HPV 11型,共18个(16.7％);低危HPV型共86个(79.6％),高危HPV型22个(20.4％),各型构成比与典型组比较,差异均无统计学意义(P>0.05);②典型组单一感染率为60.8％,明显低于亚临床组的75.0％,三重以及三重以上感染率为15.8％,明显高于亚临床组的3.7％,差异均有统计学意义(P<0.05);③亚临床组感染复发次数高达3次以及3次以上的患者共14例,占13.0％,包括HPV16+18型4例、HPV16+52型3例、HPV16型3例、HPV18型2例、HPV6+11型1例、HPV43型1例.结论 亚临床感染主要亚型为HPV 6型,并以单一感染为主,多种感染者复发率较高.