Sexual Behaviour and HPV Infections in 18 to 29 Year Old Women in the Pre-Vaccine Era in the Netherlands 英文参考文献.docVIP

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Sexual Behaviour and HPV Infections in 18 to 29 Year Old Women in the Pre-Vaccine Era in the Netherlands 英文参考文献.doc

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Sexual Behaviour and HPV Infections in 18 to 29 Year Old Women in the Pre-Vaccine Era in the Netherlands 英文参考文献

SexualBehaviourandHPVInfectionsin18to29YearOld WomeninthePre-VaccineEraintheNetherlands CharlotteH.Lenselink1*,WillemJ.G.Melchers2,WimG.V.Quint3,AnneliesM.J.Hoebers2,JanC.M. Hendriks4,LeonF.A.G.Massuger1,RuudL.M.Bekkers1 1Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands, 2Department of Medical Microbiology, NijmegenUniversityCentreforInfectiousDiseases,Nijmegen,theNetherlands,3DDLDiagnosticLaboratory,Voorburg,theNetherlands,4DepartmentofEpidemiology andBiostatistics,RadboudUniversityNijmegenMedicalCentre,Nijmegen,theNetherlands Abstract Background: Infection with Human Papillomavirus (HPV) is a necessary event in the multi-step process of cervical carcinogenesis.LittleisknownaboutthenaturalhistoryofHPVinfectionamongunscreenedyoungadults.Asprophylactic vaccinesarebeingdevelopedtopreventspecificallyHPV16and18infections,shiftsinprevalenceinthepostvaccineera may be expected. This study provides a unique opportunity to gather baseline data before changes by nationwide vaccinationoccur. MethodsandPrincipalFindings:Thiscross-sectionalstudyispartofalargeprospectiveepidemiologicstudyperformed among2065unscreenedwomenaged18to29years.Womenreturnedaself-collectedcervico-vaginalspecimenandfilled outaquestionnaire.AllHPVDNA-positivesamples(bySPF10DEIA)weregenotypedusingtheINNO-LiPAHPVgenotyping assay.HPVpointprevalenceinthissamplewas19%.LowandhighriskHPVprevalencewas9.1%and11.8%,respectively.A singleHPV-typewasdetectedin14.9%ofallwomen,whilemultipletypeswerefoundin4.1%.HPV-types16(2.8%)and18 (1.4%)werefoundconcomitantlyinonly3women(0.1%).TherewasanincreaseinHPVprevalencetill22years.Multivariate analysisshowedthatnumberoflifetimesexualpartnerswasthemostpowerfulpredictorofHPVpositivity,followedbytype ofrelationship,frequencyofsexualcontact,age,andnumberofsexualpartnersoverthepast6months. Conclusions and Significance: This study shows that factors independently associated with HPV prevalence are mainly related to sexua