传染病信息

目的 中国人类免疫缺陷病毒（human immunodeficiency virus, HIV）感染育龄期女性的宫颈癌防控尚未得到足够重视，宫颈癌筛查未纳入艾滋病抗病毒治疗门诊常规检查项目。本研究旨在通过Meta分析系统评价中国HIV感染育龄期女性的人乳头瘤病毒（human papilloma virus, HPV）感染及宫颈病变现状，为制定针对性宫颈癌筛查策略提供循证依据。方法 系统检索中国知网、万方、维普、Pubmed等数据库中关于中国HIV感染育龄期女性宫颈癌筛查的病例对照研究。提取并分析HIV感染女性（观察组）与HIV阴性女性（对照组）高危型HPV感染、低危型HPV感染、多重HPV感染、宫颈低度病变及宫颈高度病变的发病率。采用STATA 15.0软件进行统计分析，Begg's test检验评估发表偏倚。结果 共纳入16篇文献（中文14篇，英文2篇）。观察组高危型HPV感染、低危型HPV感染、多重HPV感染、宫颈低度病变及宫颈高度病变发病率分别为34.34%、14.20%、19.54%、14.00%及9.46%；对照组高危型HPV感染、低危型HPV感染、多重HPV感染、宫颈低度病变和宫颈高度病变发病率分别为17.42%、8.15%、5.24%、4.11%及2.64%。Meta分析显示：高危型HPV感染（OR=3.78,95%CI:2.36～3.36,P<0.05）、多重HPV感染和宫颈高度病变采用随机效应模型进行计算，95%置信区间分别为2.82(2.36～3.36)、3.78(1.99～7.18)和3.15(1.51～6.58)，且统计学P值均<0.05，差异有统计学意义。低危型HPV感染采用随机效应模型进行计算，95%置信区间为1.62(0.97～2.69)，但统计学P值>0.05，差异无统计学意义。宫颈低度病变选择固定效应进行分析，95%置信区间为2.94(2.05～4.22)，差异无统计学意义（P=0.08）。结果显示，HIV感染可以明显增加中国女性的高危型HPV感染、多重HPV感染和宫颈高度病变的患病风险，HIV感染的中国女性的低危型HPV感染和宫颈低度病变的患病风险有升高趋势，但差异无统计学意义。结论 HIV感染可以明显增加中国女性的高危型HPV感染、多重HPV感染和宫颈高度病变的患病风险。

Objective Cervical cancer prevention and control among Chinese women of childbearing age infected with human immunodeficiency virus(HIV) have not received sufficient attention, and cervical cancer screening has not been incorporated into routine check-up items in HIV antiretroviral therapy clinics. This study aims to systematically evaluate the current status of human papillomavirus(HPV) infection and cervical lesions in Chinese HIV-infected women of childbearing age through meta-analysis, providing evidence-based data for developing targeted cervical cancer screening strategies. Methods Case-control studies on cervical cancer screening among Chinese HIV-infected women of childbearing age were systematically retrieved from databases such as CNKI, Wanfang, VIP, and PubMed. The incidence rates of high-risk HPV infection, low-risk HPV infection, multiple HPV infections, cervical low-grade lesions, and cervical high-grade lesions were extracted and analyzed for HIV-infected women(observation group) and HIV-negative women(control group). Statistical analysis was performed using STATA 15.0 software, and publication bias was assessed using Begg's test. Results A total of 16 articles(14 in Chinese and 2 in English) were included. The incidence rates of high-risk HPV infection, low-risk HPV infection, multiple HPV infections, cervical low-grade lesions, and cervical high-grade lesions in the observation group were 34.34%, 14.20%, 19.54%, 14.00%, and 9.46%, respectively. In the control group, the incidence rates were 17.42%, 8.15%, 5.24%, 4.11%, and 2.64%, respectively. Meta-analysis showed that high-risk HPV infection(OR=3.78, 95% CI: 2.36–3.36, P<0.05), multiple HPV infections, and cervical high-grade lesions were calculated using a random-effects model, with 95% confidence intervals of 2.82(2.36–3.36), 3.78(1.99–7.18), and 3.15(1.51–6.58), respectively, and the statistical P-values were all < 0.05, indicating significant differences. Low-risk HPV infection was calculated using a random-effects model, with a 95% confidence interval of 1.62(0.97–2.69), but the statistical P-value was > 0.05, indicating no significant difference. Cervical low-grade lesions were analyzed using a fixed-effects model, with a 95% confidence interval of 2.94(2.05–4.22), and the difference was not statistically significant(P=0.08). The results indicate that HIV infection can significantly increase the risk of high-risk HPV infection, multiple HPV infections, and cervical high-grade lesions in Chinese women. Although the risk of low-risk HPV infection and cervical low-grade lesions appears elevated in HIV-infected Chinese women, the differences are not statistically significant. Conclusion HIV infection can significantly increase the risk of high-risk HPV infection, multiple HPV infections, and cervical high-grade lesions in Chinese women.