Analysis of clinico-demographic characteristics in PCR-confirmed patients with hepatitis B virus, hepatitis C virus, human papillomavirus, and cytomegalovirus infections at a Nepalese Reference Laboratory

Background: Oncogenic viruses are a global public health concern that
mandates focused research. This retrospective study analyzed
clinico-demographic profiles and infection trends of hepatitis B virus
(HBV), hepatitis C virus (HCV), human papillomavirus (HPV), and
cytomegalovirus (CMV) among laboratory visitors from 2021-2024. Methods:
Clinico-demographics (age, gender, specimens, histopathological
assessments) and real-time PCR (DNA/RNA copies/ml, genotypes) data were
collected and analyzed using SPSS version 17.0. Results: Of the tested
patients, 59.22% (706/1192) had HBV infection, 51.45% (160/311) had HCV
infection, 16.52% (57/345) had HPV infection, and 34.87% (83/238) had CMV
infection. The highest risk ratio for HBV (1.63) or HCV (1.76) infection
was among patients aged 20-29, while HPV (1.28) and CMV (2.42) infections
were among those aged 20-29 and <1, respectively. CMV was often
detected in urine (90.36%, 75/83). HBV infections peaked in 2023. HCV and
CMV infection rates decreased over time. HPV infections remained
consistent. Females and adults or elderly with HBV or HCV infections had a
low viral load (<50 and <25 copies/ml, respectively), while
males and adults had a high viral load (>1,000,000 copies/ml).
Low-risk HPV genotypes were often detected (70.18%, 40/57) than HPV-16
(26.32%, 15/57) and HPV-18 (21.05%, 12/57). Abnormal squamous cells of
undetermined importance (ASC-US) (54.54%, 6/11) was the most common
histological abnormality among females with HPV infection. Conclusions:
HBV or HCV infections were more common in adult males, HPV in adult
females, and CMV in infants. HBV infections rose over time, while those of
HCV and CMV reduced. Low-risk HPV was often diagnosed in conjunction with
ASC-US.

背景：致瘤病毒（oncogenic viruses）是一类全球范围内备受关注的公共卫生问题，亟需开展针对性研究。本回顾性研究分析了2021至2024年间，实验室就诊人群中乙型肝炎病毒（hepatitis B virus, HBV）、丙型肝炎病毒（hepatitis C virus, HCV）、人乳头瘤病毒（human papillomavirus, HPV）及巨细胞病毒（cytomegalovirus, CMV）的临床人口学特征与感染流行趋势。方法：研究收集了临床人口学资料（年龄、性别、标本类型、组织病理学评估结果）及实时荧光定量PCR（real-time PCR）检测数据（DNA/RNA拷贝数/ml、基因型），并采用SPSS 17.0软件进行统计分析。结果：纳入检测的研究对象中，乙型肝炎病毒感染率为59.22%（706/1192），丙型肝炎病毒感染率为51.45%（160/311），人乳头瘤病毒感染率为16.52%（57/345），巨细胞病毒感染率为34.87%（83/238）。乙型肝炎病毒（相对危险度1.63）与丙型肝炎病毒（相对危险度1.76）感染的最高风险人群均为20~29岁年龄段人群；而人乳头瘤病毒感染（相对危险度1.28）与巨细胞病毒感染（相对危险度2.42）的最高风险人群分别为20~29岁及<1岁婴幼儿。巨细胞病毒检出率最高的标本类型为尿液，占比达90.36%（75/83）。乙型肝炎病毒感染率在2023年达到峰值；丙型肝炎病毒与巨细胞病毒感染率随时间呈下降趋势，而人乳头瘤病毒感染率则保持相对稳定。感染乙型或丙型肝炎病毒的女性及成人/老年群体，其病毒载量分别低于50拷贝/ml与25拷贝/ml；而男性成人的病毒载量则高于1,000,000拷贝/ml。低危型人乳头瘤病毒基因型检出率为70.18%（40/57），高于HPV-16型（26.32%，15/57）与HPV-18型（21.05%，12/57）的检出率。在合并人乳头瘤病毒感染的女性人群中，最常见的组织病理学异常为意义未明确的非典型鳞状上皮细胞（ASC-US），占比达54.54%（6/11）。结论：乙型或丙型肝炎病毒感染更常见于成年男性，人乳头瘤病毒感染多见于成年女性，巨细胞病毒感染则以婴幼儿群体高发。乙型肝炎病毒感染率随时间呈上升趋势，而丙型肝炎病毒与巨细胞病毒感染率则呈下降趋势；低危型人乳头瘤病毒感染常与意义未明确的非典型鳞状上皮细胞合并检出。