High Burden of Human Papillomavirus (HPV) Infection among Young Women in KwaZulu-Natal, South Africa

Objectives
HPV infection causes cervical cancer, yet information on prevalence and risk factors for HPV in Africa remain sparse. This study describes the prevalence of HPV genotypes and risk factors associated with HPV among young women ≤ 30 years of age in KwaZulu-Natal (KZN), South Africa.
Methods
Cervicovaginal lavage samples were tested for HPV genotypes in 224 women enrolled in a prospective cohort study. Clinical, behavioural and demographic data were collected. We measured prevalence of HPV genotypes and using logistic regression, examined for factors associated with HPV.
Results
Median age of participants was 21 years [interquartile range (IQR):18–23]. The overall prevalence of HPV was 76.3% (171/224) with multiple and single genotypes prevalent in 56.3% and 20.1% of women respectively. Proportion of women with high-risk genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56 and 58) was 54.5%. Women not living with their partner [adjusted odds ratio (aOR)] = 3.42 95% CI1.22–9.60; p = 0.019), was significantly associated with HPV infection and high-risk HPV genotype infection.
Conclusion
The high burden of HPV and associated risk behaviours highlight the need to intensify behavioural interventions to prevent HPV acquisition in young women. The large scale delivery of HPV vaccine should be prioritised to prevent HPV acquisition and reduce HPV-related morbidity.

研究目标
人乳头瘤病毒（Human Papillomavirus, HPV）感染可引发子宫颈癌，但目前非洲地区关于HPV流行率及其危险因素的相关研究数据仍较为匮乏。本研究旨在描述南非夸祖鲁-纳塔尔省（KwaZulu-Natal, KZN）≤30岁青年女性中HPV基因型的流行情况，以及与HPV感染相关的危险因素。

研究方法
本研究对纳入一项前瞻性队列研究的224名女性的宫颈阴道灌洗液样本进行HPV基因型检测，并收集了受试者的临床、行为学及人口统计学资料。本研究统计了HPV基因型的流行率，并采用logistic回归分析探讨与HPV感染相关的危险因素。

研究结果
受试者的中位年龄为21岁[四分位数间距（interquartile range, IQR）：18~23岁]。HPV总体流行率为76.3%（171/224），其中多重基因型感染与单一基因型感染的女性占比分别为56.3%和20.1%。高危型HPV基因型（16、18、31、33、35、39、45、51、52、56及58型）的感染占比为54.5%。未与伴侣共同居住与HPV感染及高危型HPV基因型感染显著相关，校正比值比（adjusted odds ratio, aOR）为3.42，95%置信区间为1.22~9.60，P=0.019。

研究结论
本次研究显示当地HPV感染负担沉重且伴随相关危险行为，因此亟需强化行为干预措施，以预防青年女性感染HPV。应优先推广HPV疫苗的大规模接种，以预防HPV感染并降低HPV相关疾病的发病率。