An inverse relationship between age and human papillomavirus (HPV) prevalence has been reported in many developed countries, but information on this relationship is scarce in many other parts of the world. We carried out a cross-sectional study of sexually active women from the general population of 15 areas in 4 continents. Similar standardised protocols for women's enrolment, cervical specimen collection and PCR-based assays for HPV testing were used. HPV prevalence in different age groups was compared by study area. 18,498 women aged 15-74 years were included. Age-standardised HPV prevalence varied more than 10-fold between populations, as did the shape of age-specific curves. HPV prevalence peaked below age 25 or 35, and declined with age in Italy, the Netherlands, Spain, Argentina, Korea and in Lampang, Thailand and Ho Chi Minh, Vietnam. This was not the case in Songkla, Thailand nor Hanoi, Vietnam, where HPV prevalence was low in all age groups. In Chile, Colombia and Mexico, a second peak of HPV prevalence was detected among older women. In the poorest study areas in Asia (Shanxi, China and Dindigul, India), and in Nigeria, HPV prevalence was high across all age groups. The substantial differences observed in age-specific curves of HPV prevalence between populations may have a variety of explanations. These differences, however, underline that great caution should be used in inferring the natural history of HPV from age-specific prevalences.

译文

在许多发达国家,已经报道了年龄与人乳头瘤病毒 (HPV) 患病率之间的反比关系,但是在世界许多其他地区,有关这种关系的信息很少。我们对来自4大洲15个地区的普通人群的性活跃女性进行了横断面研究。使用了类似的标准化方案,用于女性入组,宫颈标本收集和基于PCR的HPV检测方法。按研究区域比较了不同年龄组的HPV患病率。包括18,498名15-74岁的妇女。年龄标准化的HPV患病率在人群之间的变化超过10倍,年龄特定曲线的形状也是如此。HPV的患病率在25岁或35岁以下达到峰值,在意大利,荷兰,西班牙,阿根廷,韩国以及泰国南邦和越南胡志明市,随着年龄的增长而下降。泰国宋卡和越南河内的情况都不是这样,那里所有年龄组的HPV患病率都很低。在智利,哥伦比亚和墨西哥,在老年妇女中发现了HPV患病率的第二个高峰。在亚洲最贫困的研究地区 (中国山西和印度Dindigul) 和尼日利亚,HPV的患病率在所有年龄组中都很高。在人群之间HPV患病率的年龄特异性曲线中观察到的实质性差异可能有多种解释。然而,这些差异强调,在从年龄特异性患病率推断HPV的自然史时应格外小心。

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