2.1 The prevalence of HPV infection among individuals overall.
There were 2828 HPV positive individuals overall, and the positive rate was 20.3% (Table 1). The HPV single genotype group had 2100 cases, accounting for 74.3% of the positive individuals; the HPV double genotype group had 520 cases, accounting for 18.4% of the positive individuals; and the HPV triple genotype group had 208 cases, accounting for 7.4% of the positive individuals.
Table 1
Prevalence of the different HPV genotypes among the included individuals.
Sorts
Genotypes
|
HPV positive
(ratio)
|
Single type
(ratio)
|
Double types
(ratio)
|
Triple types
(ratio)
|
Total
|
HPV 16
|
542 (19.7%)
|
331(15.9%)
|
143 (27.5%)
|
68 (43.6%)
|
13933
|
HPV 18
|
192 (7.0%)
|
115 (5.5%)
|
48 (9.2%)
|
29 (18.6%)
|
13933
|
HPV 31
|
131 (4.8%)
|
67 (3.2%)
|
41 (7.9%)
|
23 (14.7%)
|
13933
|
HPV 33
|
117 (4.2%)
|
54 (2.6%)
|
37 (7.1%)
|
26 (16.7%)
|
13933
|
HPV 35
|
92 (3.3%)
|
36 (1.7%)
|
29 (5.6%)
|
27 (17.3%)
|
13933
|
HPV 39
|
266 (9.6%)
|
148 (7.1%)
|
79 (15.2%)
|
39 (25.0%)
|
13933
|
HPV 45
|
57 (2.07%)
|
18 (0.9%)
|
23 (4.4%)
|
16 (10.3%)
|
13933
|
HPV 51
|
314 (11.4%)
|
178 (8.6%)
|
80 (15.4%)
|
56 (35.9%)
|
13933
|
HPV 52
|
704 (25.5%)
|
437(21.0%)
|
165 (31.7%)
|
102(65.4%)
|
13933
|
HPV 56
|
220 (8.0%)
|
106 (5.1%)
|
71 (13.7%)
|
43 (27.6%)
|
13933
|
HPV 58
|
443 (16.1%)
|
262(12.6%)
|
113 (21.7%)
|
68 (43.6%)
|
13933
|
HPV 59
|
170 (6.2%)
|
83 (4.0%)
|
40 (7.7%)
|
47 (30.1%)
|
13933
|
HPV 66
|
235 (8.5%)
|
120 (5.8%)
|
65 (12.5%)
|
50(32.05%)
|
13933
|
HPV 68
|
198 (7.2%)
|
92 (4.4%)
|
63 (12.1%)
|
43 (27.6%)
|
13933
|
HPV 82
|
70 (2.5%)
|
27 (1.3%)
|
28 (5.4%)
|
15 (9.6%)
|
13933
|
HPV6/11
|
79 (2.8%)
|
35 (1.7%)
|
23 (4.4%)
|
21 (10.1%)
|
2573
|
Total
|
2828
|
2100
|
520
|
208
|
13972
|
The ratio is calculated by (the HPV−genotype s positive individual) divided (the total HPV positive, the single HPV positive individual, double HPV positive individual or triple HPV positive individual) respectively. |
In the statistics (Table 1), the top fifth prevalent HPV genotypes were HPV52 (5.1% of the total individuals), HPV16 (3.9%), HPV58 (3.2%), HPV51 (2.2%) and HPV39 (1.9%). The top fifth single infection types were HPV52 (21.0% of the HPV single type individuals), HPV16 (15.9%), HPV58 (12.6%), HPV51 (8.6%) and HPV39 (7.1%); The top fifth double infection types were HPV52 (31.7% of the HPV double types individuals), HPV16 (27.5%), HPV58 (21.7%), HPV51 (15.4%) and HPV39 (15.2%); The top fifth triple infection types were HPV52 (65.4% of the HPV triple types individuals), HPV16 (43.6%), HPV58 (43.6%), HPV51 (35.9%) and HPV39 (35.9%).
2.2 Correlation analysis of HPV prevalence with ages
The HPV infection prevalence in each group was shown in Table 2. There were 467 HPV-positive patients among 21–25 years old, which was the largest age group. The youngest age group present the highest HPV infection rate (40.5% of the age-specified individuals), and single HPV infection attributed the mainly type (22.9%). The age-specific HPV prevalence analysis showed that the overall HPV positive rate decreased before 30 years old, and decreased again after 60 years old (Fig. 2.A). HPV infection types analysis showed that the single HPV infection proportion was stable before 55 years old (Fig. 2.B). The double and triple HPV infection rates increased with age overall (Fig. 2. C and D).
Table 2
The age-specific prevalence of the 13972 individuals
Genotypes
Age(Y)
|
HPV positive
(No. Ratio)
|
Single type
(No. Ratio)
|
Double types
(No. Ratio)
|
Triple types
(No. Ratio)
|
Total
(No.)
|
≤ 20
|
53
|
40.5%
|
30
|
22.9%
|
11
|
8.4%
|
12
|
9.2%
|
131
|
21–25
|
379
|
26.0%
|
253
|
17.3%
|
89
|
6.1%
|
37
|
2.5%
|
3824
|
26–30
|
608
|
17.6%
|
467
|
13.5%
|
101
|
2.9%
|
40
|
1.2%
|
3463
|
31–35
|
724
|
18.9%
|
554
|
14.5%
|
123
|
3.2%
|
47
|
1.2%
|
1461
|
36–40
|
396
|
19.4%
|
306
|
15.0%
|
70
|
3.4%
|
20
|
1.0%
|
2039
|
41–45
|
218
|
20.8%
|
172
|
16.4%
|
34
|
3.2%
|
12
|
1.1%
|
1050
|
46–50
|
148
|
20.6%
|
113
|
15.7%
|
26
|
3.6%
|
9
|
1.3%
|
719
|
51–55
|
135
|
22.5%
|
103
|
17.2%
|
24
|
4.0%
|
8
|
1.3%
|
599
|
56–60
|
88
|
24.2%
|
58
|
16.0%
|
19
|
5.2%
|
11
|
3.0%
|
363
|
> 60
|
67
|
25.7%
|
36
|
13.8%
|
21
|
8.1%
|
10
|
3.8%
|
261
|
Unknown
|
12
|
18.8%
|
8
|
12.5%
|
2
|
3.1%
|
2
|
3.1%
|
62
|
Total
|
2828
|
20.2%
|
2100
|
15.0%
|
520
|
3.7%
|
208
|
1.5%
|
13972
|
The age−specific prevalence are calculated by (the total HPV positive,the single HPV positive individual, double HPV positive individual or triple HPV positive individual) divided ( total age−specific people ) respectively. |
2.3 The relationship between HPV infection and gynecological diseases
Among the tested individuals, we analyzed the HPV prevalence among individuals with common gynecological diseases. Data from individuals got bacterial vaginitis (744 cases), cervicitis (531 cases), cervical lesions (352 cases), fungal vaginitis (268 cases), and pelvic inflammatory disease (184 cases) were sorted and analyzed, and individuals who underwent physical examinations (310 cases) were selected as the reference group. The prevalence of HPV infection is significant popular among fungal vaginitis (P = 0.010; χ2 = 6.61) and cervical lesions (P = 0.000; χ2 = 1069.60). The infection genotype analysis showed that the prevalence of single HPV infection single fungal vaginitis (P < 0.001) and cervical lesions (P < 0.001) were significantly popular (Fig. 3. A, B, C and D)
The HPV infection genotypes among the individuals with five common gynecological diseases are presented in Fig. 4. The main HPV genotypes popular among physical examinations group were HPV16 (4.1% of the total individuals in the group), HPV52 (4.0%), HPV58 (3.2%), HPV51 (2.0%) and HPV18 (1.7%); the top fifth prevalent HPV genotypes among individuals with cervicitis were HPV52 (3.7%), HPV16 (2.7%), HPV66 (1.8%), HPV56 (1.4%) and HPV58 (1.4%); the top fifth prevalent HPV genotypes among individuals with pelvic inflammation were HPV52 (6.2%), HPV58 (5.4%), HPV16 (4.6%), HPV31 (2.08%), HPV39 (2.08%) and HPV66 (2.08%); the top fifth prevalent HPV genotypes among individuals with bacterial vaginitis were HPV52 (7.1%), HPV16 (4.7%), HPV58 (4.5%), HPV66 (2.4%), and HPV56 (2.06%); the top fifth prevalent HPV genotypes among individuals with fungal vaginitis were HPV52 (5.8%), HPV58 (4.2%), HPV16 (3.6%) and HPV39 (2.3%); and the top fifth prevalent HPV genotypes among individuals with cervical lesions were HPV52 (9.7%), HPV16 (9.5%), HPV58 (7.3%), HPV66 (4.6%) and HPV56 (3.7%).
2.4 The HPV prevalence among the pregnant women.
To investigate the rate of HPV infections of pregnant women, we analyzed HPV infection of early pregnant women, middle-late pregnant women and abortion women. The quantity of HPV positivity is 82, 492 and 666 sequential. The early pregnant women, middle-late pregnant women HPV positive ration was lower than routine health checks HPV infection rate, especially the triple genotype infection rate (Table 3). The top fifth prevalent genotypes in women with HPV infections were the same as those of the women undergoing routine health checks.
Table 3. HPV prevalence in early, middle-late pregnant and abortion women
HPV infection types
|
Early
|
Middle -late
|
Abortion
|
HPV positive
|
14 (17.1%)
|
96 (19.5%)
|
158 (23.7%)
|
|
Single genotype
|
11 (13.4%)
|
82 (16.7%)
|
116 (17.4%)
|
Double genotypes
|
3 (3.7%)
|
13 (2.6%)
|
32 (4.8%)
|
Triple genotypes
|
0 (0.0%)
|
1 (0.2%)
|
10 (1.5%)
|
|
HPV52
|
5 (6.1%)
|
21 (4.3%)
|
32 (4.8%)
|
HPV16
|
3 (3.7%)
|
19 (3.9%)
|
22 (3.3%)
|
HPV51
|
2 (2.4%)
|
11 (2.2%)
|
23 (3.5%)
|
HPV39
|
2 (2.4%)
|
11 (2.2%)
|
22 (3.3%)
|
HPV6/11
|
0 (0.0%)
|
3 (0.6%)
|
3 (0.5%)
|
Total
|
82
|
492
|
666
|
The ratio are calculated by (the positive women) divided ( the number HPV−checked women under different pregnancy states ) respectively. |
Table 4
The different HPV genotype combinations among women with HPV infections
|
16
|
18
|
31
|
33
|
35
|
39
|
45
|
51
|
52
|
56
|
58
|
59
|
66
|
68
|
82
|
6+
11
|
HPV16
|
-
|
16
|
8
|
18
|
13
|
24
|
7
|
25
|
60
|
16
|
43
|
25
|
20
|
19
|
7
|
15
|
HPV18
|
|
-
|
6
|
7
|
3
|
11
|
6
|
14
|
13
|
10
|
12
|
6
|
9
|
4
|
1
|
13
|
HPV31
|
|
|
-
|
4
|
3
|
6
|
2
|
7
|
16
|
5
|
13
|
2
|
7
|
7
|
2
|
2
|
HPV33
|
|
|
|
-
|
3
|
6
|
4
|
7
|
15
|
10
|
3
|
4
|
6
|
8
|
1
|
2
|
HPV35
|
|
|
|
|
-
|
4
|
2
|
5
|
15
|
6
|
15
|
2
|
12
|
6
|
2
|
1
|
HPV39
|
|
|
|
|
|
-
|
5
|
16
|
31
|
10
|
19
|
15
|
11
|
16
|
2
|
6
|
HPV45
|
|
|
|
|
|
|
-
|
3
|
6
|
4
|
5
|
5
|
4
|
3
|
14
|
1
|
HPV51
|
|
|
|
|
|
|
|
-
|
46
|
16
|
23
|
18
|
16
|
14
|
9
|
8
|
HPV52
|
|
|
|
|
|
|
|
|
-
|
29
|
65
|
30
|
34
|
30
|
11
|
12
|
HPV56
|
|
|
|
|
|
|
|
|
|
-
|
18
|
3
|
35
|
14
|
3
|
3
|
HPV58
|
|
|
|
|
|
|
|
|
|
|
-
|
17
|
21
|
16
|
4
|
8
|
HPV59
|
|
|
|
|
|
|
|
|
|
|
|
-
|
6
|
14
|
3
|
4
|
HPV66
|
|
|
|
|
|
|
|
|
|
|
|
|
-
|
9
|
3
|
1
|
HPV68
|
|
|
|
|
|
|
|
|
|
|
|
|
|
-
|
2
|
2
|
HPV82
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
-
|
1
|
HPV6/11
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
-
|
Total
|
541
|
192
|
131
|
117
|
92
|
266
|
57
|
314
|
704
|
220
|
443
|
190
|
234
|
198
|
70
|
79
|
2.5 The prevalence of HPV combinations infection types overall.
To investigate the HPV genotype coupled among multiplied HPV infections individuals, The HPV genotype coupled infected individual was statistically analyzed (Table 4). The most common types of infection were HPV52: HPV58 (65 cases, 4.7% of the total combinations cases); HPV16: HPV52 (60 cases, 4.4%); HPV51: HPV52 (46 cases, 3.4%); HPV16: HPV58 (43 cases, 3.1%); and HPV56: HPV66 (35 cases, 2.6%), of which HPV52 had the highest frequency in combination infections.