【2017年整理】综述 预防性人乳头状瘤病毒疫苗：如何提高目标人群的接种率？.docVIP

预防性人乳头状瘤病毒疫苗：如何提高目标人群的接种率？ 摘要：人乳头状瘤病毒（Human Papillomavirus，HPV）不仅能诱发生殖部位的多种癌症，还可以引发某些类型的头颈部肿瘤以及复发性呼吸道乳头状瘤病等疾病，对人类的健康造成相当大的危害，引起极大的疾病负担。但目前对HPV感染缺乏有效的预防控制措施，而且随着社会上初次性行为年龄的逐步提前，HPV对人类的危害将会越来越大，因为性行为是感染HPV的高危因素。可喜的是，预防性HPV感染的有效疫苗已经研发成功，已在全球100多个国家上市。目前HPV疫苗的三期临床试验正在中国开展，成功后将获得政府的批准。因此本篇综述将总结目前国内外关于HPV疫苗推广的研究，阐述健康教育，医务人员，接种地点，接种次数和价格等五个影响HPV疫苗推广的主要因素,为日后疫苗在中国的推广应用提供依据。 【关键词】：人乳头状瘤病毒，预防性人乳头状瘤病毒疫苗，健康教育，医务人员，接种地点，接种次数，价格 Abstract：Human Papillomavirus infection can induce various kinds of genital cancer as well as some sorts of head and neck tumor and recurrent respiratory papillomatosis，which poses a great threat on human health and results in great burden of disease. However, so far no effective measure has been developed to protect human being from the harmful effect of HPV. Furthermore, along with age of sexual debut has advanced gradually, it can be predicted that HPV will produce more and more harmful effect on human being because sexual behavior is highly related to the infection of HPV. Fortunately, effective prophylactic HPV vaccine has been developed and available in more than one hundred countries around the world. Currently, phase three clinical trials of HPV vaccine is undergoing in China. If it succeeded, HPV vaccine would be introduced into China. Thus, this review will summarize current researches at home and abroad and focus on five factors which affect vaccine promotion most: health education, medical personnel, site of vaccine uptake, doses of vaccine and price in order to provide latest information for the future promotion of HPV vaccine in China. 【Key words】 HPV, HPV vaccine, health education, medical personnel, site of vaccine uptake, dose of vaccine, price 概述： 1.1 人乳头状瘤病毒 人乳头状瘤病毒（Human Papillomavirus，HPV）属于乳多空病毒科，乳头病毒属。病毒基因为双链环状DNA，被主要衣壳蛋白（L1）和次要衣壳蛋白（L2）这两种结构蛋白包被[1]。现已发现HPV有100多个基因型，根据感染部位的不同，分为嗜皮肤性和嗜黏膜性两大类，前者主要感染皮肤，引起各种类型的皮肤疣和疣状表皮发育不良，后者主要感染生殖道和呼吸道黏膜上皮细胞，引起生殖道尖锐湿疣，喉乳头瘤及子宫颈癌[1]，表1说明不同型别的HPV与人类疾病的关系[1]，其中HPV 16和18 与 70%的宫颈癌相关；而HPV 6和11则与90%的