基于横断面调查的荆州地区高危型HPV感染分布规律及治疗现状分析

Analysis of Distribution Pattern and Current Treatment Status of High-Risk HPV Infection in Jingzhou Area Based on a Cross-Sectional Survey

摘要: 目的：基于横断面调查数据，系统分析荆州市中心医院2022~2025年间高危型人乳头瘤病毒(HR-HPV)感染的分布规律、基因型特征，结合随访数据及治疗效果，明确HR-HPV感染的转归特点及优化治疗方案，为荆州地区HR-HPV感染的精准防控、规范化诊疗及随访管理提供科学依据。方法：采用横断面调查设计，纳入2022~2025年间在荆州市中心医院就诊并接受HR-HPV筛查的患者13474例，采用实时荧光定量PCR法检测HR-HPV基因型，统计不同基因型感染例数、横断面阳性率占比及感染人群平均年龄；对656例HR-HPV筛查患者进行为期3~20个月的随访，分析不同随访阶段的感染转归情况；结合195例阳性患者的临床资料，分析年龄与转阴率的相关性；探讨干扰素治疗HR-HPV感染的临床疗效及安全性。结果：13474例筛查患者中，HR-HPV阳性2101例，总阳性率为15.6%。优势基因型依次为HPV52 (28.4%)、HPV58 (14.2%)、HPV16 (9.0%)、HPV39 (6.3%)、HPV51 (7.5%)，不同基因型感染人群平均年龄介于45.6~53.1岁。656例随访患者中，23例由阴性转为阳性，438例持续阴性，107例持续阳性，88例由阳性转为阴性；随着随访时间延长，阶段阳性占比逐渐下降(38.7%降至4.6%)，阶段阳转阴率整体呈上升趋势(41.4%升至71.4%)。195例转阴患者中，≤45岁年龄段转阴率(48.6%)高于 > 45岁(42.1%)，≤50岁年龄段转阴率(50.0%)高于 > 50岁(38.9%)。结论：荆州地区HR-HPV总感染率为15.6%，HPV52、HPV58、HPV16为优势基因型，感染人群以中老年为主；HR-HPV感染转归与随访时间、年龄密切相关。本研究人群 ≤ 50岁年龄段转阴率为50.0%；>50转阴率为38.9%，χ²值 ≈ 2.67，自由度 = 1，P ≈ 0.102，虽然≤50岁年龄段转阴率显著高于 > 50岁，但统计学检验显示，两组转阴率的差异未达到显著水平。可能与样本量小有关。

Abstract: Objective: Based on cross-sectional survey data, to systematically analyze the distribution pattern and genotypic characteristics of high-risk human papilloma virus (HR-HPV) infection among patients treated at Jingzhou Central Hospital from 2022 to 2025. Combined with follow-up data and therapeutic efficacy outcomes, this study aimed to clarify the prognosis of HR-HPV infection and optimize therapeutic regimens, so as to provide scientific evidence for precise prevention and control, standardized diagnosis and treatment, as well as follow-up management of HR-HPV infection in Jingzhou region. Methods: A cross-sectional study was conducted. A total of 13,474 patients who received HR-HPV screening at Jingzhou Central Hospital between 2022 and 2025 were enrolled. Real-time fluorescent quantitative PCR was adopted to detect HR-HPV genotypes. The number of cases infected with each genotype, positive rate composition across all subjects, and the mean age of infected populations were statistically analyzed. A cohort of 656 HR-HPV screened patients was followed up for 3 to 20 months to observe the disease prognosis at different follow-up stages. Clinical data from 195 HR-HPV positive patients were collected to explore the correlation between age and HPV negative conversion rate. Meanwhile, the clinical efficacy and safety of interferon for HR-HPV infection treatment were evaluated. Results: Among the 13,474 screened subjects, 2,101 cases were HR-HPV positive, with an overall positive rate of 15.6%. The predominant genotypes ranked in descending order were HPV52 (28.4%), HPV58 (14.2%), HPV16 (9.0%), HPV51 (7.5%) and HPV39 (6.3%). The average age of patients infected with different genotypes ranged from 45.6 years to 53.1 years. Within the 656 followed-up patients: 23 cases turned from HPV-negative to positive, 438 cases remained persistently negative, 107 cases maintained persistent HR-HPV infection, and 88 cases achieved HPV seroreversion from positive to negative. As follow-up duration prolonged, the proportion of persistently positive cases gradually decreased from 38.7% to 4.6%, while the staged negative conversion rate steadily rose from 41.4% to 71.4%. Among patients who finally turned negative, the negative conversion rate was higher in patients aged ≤ 45 years (48.6%) than those over 45 years (42.1%); similarly, patients ≤ 50 years old showed a higher clearance rate (50.0%) compared with patients older than 50 years (38.9%).Conclusion: The overall prevalence of HR-HPV infection in Jingzhou area is 15.6%, with HPV52, HPV58 and HPV16 as the dominant genotypes; infected individuals are mainly middle-aged and elderly women. The prognosis of HR-HPV infection is closely associated with follow-up time and patient age. In this study, the negative conversion rate was 50.0% in subjects aged ≤ 50 years, compared with 38.9% in those aged > 50 years. The chi-square value was approximately 2.67 with 1 degree of freedom, and P ≈ 0.102. Although the negative conversion rate was higher in the ≤50-year-old group than in the >50-year-old group, the statistical test revealed no statistically significant difference between the two groups. This finding may be attributed to the small sample size.