Persistent human papillomavirus (HPV) infection is a key factor for the development and progression of cervical cancer. We sought to identify the type-specific HPV prevalence by cervical cytology and assess disease progression risk based on high-risk persistent HPV infection in South Korea. To investigate the HPV prevalence by Pap results, we searched seven literature databases without any language or date restrictions until July 17, 2019. To estimate the risk of disease progression by HPV type, we used the Korea HPV Cohort study data. The search included the terms “HPV” and “Genotype” and “Korea.” Studies on Korean women, type-specific HPV distribution by cytological findings, and detailed methodological description of the detection assay were included. We assessed the risk of disease progression according to the high-risk HPV type related to the nonavalent vaccine and associated persistent infections in 686 HPV-positive women with atypical squamous cells of uncertain significance or low-grade squamous intraepithelial lesions from the Korea HPV Cohort Study. Type-specific HPV prevalence was the proportion of women positive for a specific HPV genotype among all HPV-positive women tested for that genotype in the systematic review. We included 23 studies in our review. HPV-16 was the most prevalent, followed by HPV-58, -53, -70, -18, and -68. In women with high-grade squamous intraepithelial lesions, including cancer, HPV-16, -18, and -58 were the most prevalent. In the longitudinal cohort study, the adjusted hazard ratio of disease progression from atypical squamous cells of uncertain significance to high-grade squamous intraepithelial lesions was significantly higher among those with persistent HPV-58 (increase in risk: 3.54–5.84) and HPV-16 (2.64–5.04) infections. While HPV-16 was the most prevalent, persistent infections of HPV-16/58 increased the risk of disease progression to high-grade squamous intraepithelial lesions. Therefore, persistent infections of HPV-16 and -58 are critical risk factors for cervical disease progression in Korea. Our results suggest that equal attention should be paid to HPV-58 and -16 infections and provide important evidence to assist in planning the National Immunization Program in Korea.

中文翻译：

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韩国女性持续感染 HPV-16/58 导致疾病进展加剧：系统评价和韩国 HPV 队列研究

人乳头瘤病毒（HPV）持续感染是宫颈癌发生和发展的关键因素。我们试图通过宫颈细胞学来确定特定类型的 HPV 患病率，并根据韩国高危持续性 HPV 感染评估疾病进展风险。为了通过巴氏涂片结果调查 HPV 患病率，我们检索了截至 2019 年 7 月 17 日为止的七个没有任何语言或日期限制的文献数据库。为了根据 HPV 类型估计疾病进展的风险，我们使用了韩国 HPV 队列研究数据。搜索包括术语“HPV”、“基因型”和“韩国”。包括对韩国女性的研究、细胞学结果的特定类型 HPV 分布以及检测分析的详细方法学描述。我们根据韩国 HPV 队列研究中与非有效疫苗相关的高危 HPV 类型和相关持续感染，评估了 686 名具有不确定意义的非典型鳞状细胞或低度鳞状上皮内病变的 HPV 阳性女性的疾病进展风险。 。特定型 HPV 患病率是指在系统评价中检测出特定 HPV 基因型的所有 HPV 阳性女性中，该基因型呈阳性的女性所占的比例。我们的综述中纳入了 23 项研究。HPV-16 最常见，其次是 HPV-58、-53、-70、-18 和 -68。在患有高级鳞状上皮内病变（包括癌症）的女性中，HPV-16、-18 和 -58 最为常见。在纵向队列研究中，持续性HPV-58（风险增加：3.54-5.84）和HPV-16患者从意义不明的非典型鳞状细胞进展为高级鳞状上皮内病变的调整后风险比显着更高(2.64–5.04) 感染。虽然 HPV-16 是最常见的，但 HPV-16/58 的持续感染会增加疾病进展为高级鳞状上皮内病变的风险。因此，HPV-16和-58的持续感染是韩国宫颈疾病进展的关键危险因素。我们的研究结果表明，应同等重视 HPV-58 和 -16 感染，并为协助规划韩国国家免疫计划提供重要证据。