Understanding the Epidemiology of Genital Human Papillomavirus Infection in Woman: Importance of Data on Type-specific Infections

婦女感染人類乳突瘤病毒之流行病學特徵：區分不同型別感染之重要性

孫建安(Chien-An Sun) ； 朱堂元(Tang-Yuan Chu) ； 楊智如(Chih-Ju Yang) ； 吳德敏(Der-Min Wu) ； 游山林(San-Lin You) ； 謝長堯(Chang-You Hsieh) ； 余慕賢(Mu-Hsien Yu)

《Journal of Medical Sciences》 20卷9期 (2000/12) Pp. 470-480

摘要

婦女感染高危險型別之人類乳突瘤病毒是其罹患子宮頸癌前病變和子宮頸癌的最主要致病因子，因此瞭解婦女感染不同型別（包括高危險型別和低危險型別）之人類乳突瘤病毒的流行病學特徵有助於掌握預防子宮頸癌的方向。根據研究報告的結果顯示，感染高危險型別之人類乳突瘤病毒較易造成持續性的感染，而低危險型別之人類乳突瘤病毒感染則較易造成短暫的感染。另外，不同類型之性行為亦與感染不同型別的人類乳突瘤病毒有關。具體而言，低危險型別之人類乳突瘤病毒感染與最近之性接觸的性伴侶數有密切的相關，而高危險型別之人類乳突瘤病毒感染則與長期之性接觸的性伴侶數有顯著的相關。近年來的流行病學研究也發現不同地理區域的婦女族群呈現顯著不同類型的年齡別人類乳突瘤病毒感染率。本論文藉由回顧流行病學的研究文獻，指出區分不同型別之人類乳突瘤病毒感染在洞悉感染自然史、性行為危險因子類型以及不同地理區域婦女族群之不同類型的年齡別人類乳突瘤病毒感染率的重要性。

關鍵字

人類乳突瘤病毒 ； 型別感染 ； 自然史 ； 性行為危險因子

並列摘要

This paper reviews recent epidemiological data available from the literature to illustrate the importance of data on type-specific infections of human papillomavirus (HPV) for understanding the epidemiology of genital HPV infection in women. It has been well recognized that infections with certain high-risk HPV types have a central etiologic role in the development of cervical intraepithelial neoplasia and cervical cancer. Therefore, understanding the epidemiology of cervical infection with high-risk and low-risk HPVs would provide a promising lead for primary prevention of cervical cancer. Based on available research data, it is noted that infection with high risk HPVs tend to be of a longer duration and infection with low-risk HPV types is of a more transient nature. Moreover, different HPV types might result from different degrees of transmissibility by the sexual route. In conclusion, this epidemiological review provides research evidence indicating the importance of data on type-specific infections in assessing the natural history, sexual risk factor profiles, and age patterns of cervical HPV infection. More specifically, infection with high-risk HPVs tend to be of a longer duration and infection with low-risk HPV types is of a more transient nature. Furthermore, high-risk HPV infection correlates more closely to lifetime sexual exposure measurements, while low-risk HPV infection seems to correlate only with recent sexual activity. Future studies should more fully characterize the distribution of type-specific HPV infections in women living in distinct geographical areas in order to gain more insight into the unique age patterns of HPV infection in women residing in different parts of the world.

並列關鍵字

human papillomavirus ； type-specific infections ； natural history ； sexual risk factor profiles