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核苷类似物治疗宫颈人乳头瘤病毒感染的疗效

Nucleoside analogues therapy for cervical high-risk HPV infection

来源期刊: 广州医药 | 11-16 发布时间:2021-11-25 收稿时间:2025/11/13 18:11:15 阅读量:9
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关键词:
持续性高危型人乳头瘤病毒富马酸丙酚替诺福韦宫颈上皮内瘤变阴道镜Reid评分
Persistent high-risk human papilloma virus (HR-HPV)Tenofovir alafenamideCervical Intraepithelial neoplasiaReid colposcopic index
DOI:
10.3969/j.issn.1000-8535.2021.02.003
收稿时间:
2020-10-10 
修订日期:
 
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引用总数:
0  
目的 评价口服核苷类似物富马酸丙酚替诺福韦治疗宫颈持续性高危型人乳头瘤感染患者的疗效。方法 本回顾性研究中,将同一亚型高危型人乳头瘤病毒感染超过1年患者随机分为两组,治疗组给予口服富马酸丙酚替诺福韦,25 mg,每天一次,连续3个月;对照组给予宣教说明,无特殊处理。于入组后第3个及第6个月随诊。检测患者宫颈人乳头瘤病毒感染的变化,同时观察宫颈细胞学、阴道镜Reid评分及宫颈组织病理学变化。结果 宫颈持续性高危型人乳头瘤病毒感染者共82例,分为两组:治疗组42例,对照组40例。均完成随访。在治疗结束时、治疗结束后3个月,治疗组清除人乳头瘤病毒的有效率分别为 52.38% 和 61.90%,优于对照组20.00%(P<0.05)和30.00% (P<0.05);治疗结束时、治疗结束后3个月,治疗组细胞学异常的缓解率分别为66.67%和77.78%,优于对照组22.22%(P<0.05)和33.33%(P<0.05);治疗组中Reid评分3分及其以上者例数较对照组少(2 vs 10,P<0.05),且Reid评分较基线明显下降(P<0.05),对照组Reid评分无显著变化(P>0.05)。6个月时治疗组中宫颈上皮内瘤变I级者组织学缓解率优于对照组(72.72% vs 35.00%,P<0.05)。随访期间无严重不良反应。结论 口服富马酸丙酚替诺福韦可有效清除宫颈持续性高危型人乳头瘤病毒感染,且安全、临床可行。
Objective To investigate the clinical efficacy of nucleoside analogues Tenofovir Alafenamide (TAF) therapy for cervical high-risk HPV (HR-HPV) infection. Methods In this prospective study, a total of 82 patients with persistent cervical HR-HPV infection were randomly divided into two groups. The treatment group (42 patients) administered orally TAF (25mg, once daily, 3 months). The control group (40 patients) received no treatment. All patients were followed up for 6 months. HPV testing, ThinPrep cytology test (TCT), and Reid colposcopic index (RCI) grading were performed for both groups. Results HR-HPV remission rates were 52.38% and 61.9% in the treatment group at the 3-and 6-month follow-up, respectively, whereas 20% and 30% in the control group at the 3-and 6-month follow-up visits. Conversion rates of abnormal TCT results were 66.67% and 77.78% in the treatment group at two follow-up visits. In contrast, the control group showed remission rates at 22.2% and 33.3%, respectively. There were 2 and 10 patients with grade of 3-4 or higher at the treatment group and the control group at the 6-month visit, respectively. RCI scoring was declining obviously at 6 months in the treatment group (P<0.05), whereas the control group showed no significantly difference. 16 of 22 (72.72%) patients with CINⅠin the treatment group were alleviated at 6-month visit compared to 35% in the control group(P<0.05). No serious adverse events happened during the treatment and follow up. Conclusion Tenofovir alafenamide is an effective, safe and accessible treatment for cervical HR-HPV infection.
1、 陶泽宇,徐志,冯连顺,等. 治疗慢性乙型肝炎病毒感染药物的研究进展[J]. 国外医药(抗生素分册), 2018, 39(4): 308-319. 陶泽宇,徐志,冯连顺,等. 治疗慢性乙型肝炎病毒感染药物的研究进展[J]. 国外医药(抗生素分册), 2018, 39(4): 308-319.
2、 YANGW,SONG Y,LU Y L. Increased expression of programmed death (PD)-1 and its ligand PD-L1 correlates with impaired cell-mediated immunity in high-risk human papillomavirus-related cervical intraepithelial neoplasia[J].Immunology,2013,139(4):513-522. YANGW,SONG Y,LU Y L. Increased expression of programmed death (PD)-1 and its ligand PD-L1 correlates with impaired cell-mediated immunity in high-risk human papillomavirus-related cervical intraepithelial neoplasia[J].Immunology,2013,139(4):513-522.
3、 魏雪敏,隋龙. HPV感染后宫颈局部免疫环境改变及NO的作用[J].国际妇产科学杂志,2011,38(1):37-40. 魏雪敏,隋龙. HPV感染后宫颈局部免疫环境改变及NO的作用[J].国际妇产科学杂志,2011,38(1):37-40.
4、 SNOECK R, NOEL J C, MULLER C, et al. Cidofovir, a new approach for the treatment of cervix intraepithelial neoplasia grade III (CIN III)[J]. J Med Virol, 2000, 60(2): 205-209. SNOECK R, NOEL J C, MULLER C, et al. Cidofovir, a new approach for the treatment of cervix intraepithelial neoplasia grade III (CIN III)[J]. J Med Virol, 2000, 60(2): 205-209.
5、 KABAN I, CENGIZ H, KABAN A, et al. Agreement between colposcopy results using the Reid Colposcopic Index and histopathology[J]. Ginekologiapolska, 2015, 86(7): 537-540. KABAN I, CENGIZ H, KABAN A, et al. Agreement between colposcopy results using the Reid Colposcopic Index and histopathology[J]. Ginekologiapolska, 2015, 86(7): 537-540.
6、 LIN C, QIU J, WANG C, et al. Topical imiquimod treatment for human papillomavirus infection in patients with and without cervical/vaginal intraepithelial neoplasia[J]. Taiwan J Obstet Gynecol, 2012, 51(4): 533-538. LIN C, QIU J, WANG C, et al. Topical imiquimod treatment for human papillomavirus infection in patients with and without cervical/vaginal intraepithelial neoplasia[J]. Taiwan J Obstet Gynecol, 2012, 51(4): 533-538.
7、 HAMPSON L, MARTIN-HIRSCH P, HAMPSON I N, et al. An overview of early investigational drugs for the treatment of human papilloma virus infection and associated dysplasia[J]. Expert OpinInvestig Drugs, 2015, 24(12): 1529-1537. HAMPSON L, MARTIN-HIRSCH P, HAMPSON I N, et al. An overview of early investigational drugs for the treatment of human papilloma virus infection and associated dysplasia[J]. Expert OpinInvestig Drugs, 2015, 24(12): 1529-1537.
8、 刘嵘,祝达,李天,等. 二黄栓治疗高危型H PV持续阳性宫颈病变的临床疗效观察及机制探讨[J]. 华中科技大学学报(医学版), 2018, 47(3):325-328. 刘嵘,祝达,李天,等. 二黄栓治疗高危型H PV持续阳性宫颈病变的临床疗效观察及机制探讨[J]. 华中科技大学学报(医学版), 2018, 47(3):325-328.
9、 赵健,廖秦平,谢红,等. 保妇康栓治疗人乳头瘤病毒感染的临床观察[J]. 实用妇产科杂志, 2015, 31(1): 45-48. 赵健,廖秦平,谢红,等. 保妇康栓治疗人乳头瘤病毒感染的临床观察[J]. 实用妇产科杂志, 2015, 31(1): 45-48.
10、 HILLEMANNS P, PETRY K U, SOERGEL P, et al. Efficacy and safety of hexaminolevulinate photodynamic therapy in patients with low-grade cervical intraepithelial neoplasia[J]. Lasers Surg Med, 2014, 46(6): 456-461. HILLEMANNS P, PETRY K U, SOERGEL P, et al. Efficacy and safety of hexaminolevulinate photodynamic therapy in patients with low-grade cervical intraepithelial neoplasia[J]. Lasers Surg Med, 2014, 46(6): 456-461.
11、 KYRGIOU M, KOLIOPOULOS G, MARTIN-HIRSCH P, et al. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis[J]. Lancet, 2006, 367(9509): 489-498. KYRGIOU M, KOLIOPOULOS G, MARTIN-HIRSCH P, et al. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis[J]. Lancet, 2006, 367(9509): 489-498.
12、 INSINGA R P, DASBACH E J, ELBASHA E H, et al. Progression and regression of incident cervical HPV 6, 11, 16 and 18 infections in young women[J]. Infect Agent Cancer,2007(2): 15. INSINGA R P, DASBACH E J, ELBASHA E H, et al. Progression and regression of incident cervical HPV 6, 11, 16 and 18 infections in young women[J]. Infect Agent Cancer,2007(2): 15.
13、 FU Y, BAO Y, HUI Y, et al. Topical photodynamic therapy with 5-aminolevulinic acid for cervical high-risk HPV infection[J]. Photodiagnosis Photodyn Ther, 2016,(13): 29-33. FU Y, BAO Y, HUI Y, et al. Topical photodynamic therapy with 5-aminolevulinic acid for cervical high-risk HPV infection[J]. Photodiagnosis Photodyn Ther, 2016,(13): 29-33.
14、 van PACHTERBEKE C, BUCELLA D, ROZENBERG S, et al. Topical treatment of CIN 2+ by cidofovir: results of a phase II, double-blind, prospective, placebo-controlled study[J]. Gynecol Oncol, 2009, 115(1): 69-74. van PACHTERBEKE C, BUCELLA D, ROZENBERG S, et al. Topical treatment of CIN 2+ by cidofovir: results of a phase II, double-blind, prospective, placebo-controlled study[J]. Gynecol Oncol, 2009, 115(1): 69-74.
15、 韩芳,陆巧妮,徐力昆,等. 西多福韦对人宫颈癌细胞CaSki内人乳头瘤病毒16抑制作用研究[J]. 中国医药生物技术, 2014(5): 347-352. 韩芳,陆巧妮,徐力昆,等. 西多福韦对人宫颈癌细胞CaSki内人乳头瘤病毒16抑制作用研究[J]. 中国医药生物技术, 2014(5): 347-352.
16、 de CLERCQ E. In search of a selective therapy of viral infections[J]. Antiviral Res, 2010, 85(1): 19-24. de CLERCQ E. In search of a selective therapy of viral infections[J]. Antiviral Res, 2010, 85(1): 19-24.
17、 European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection[J]. J Hepatol, 2017, 67(2): 370-398. European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection[J]. J Hepatol, 2017, 67(2): 370-398.
18、 TERRAULT N A, LOK A, MCMAHON B J, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance[J]. Hepatology, 2018, 67(4): 1560-1599. TERRAULT N A, LOK A, MCMAHON B J, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance[J]. Hepatology, 2018, 67(4): 1560-1599.
19、 HILDESHEIM A, HERRERO R, WACHOLDER S, et al. Effect of human papillomavirus 16/18 L1 viruslike particle vaccine among young women with preexisting infection: a randomized trial[J]. JAMA, 2007, 298(7): 743-753. HILDESHEIM A, HERRERO R, WACHOLDER S, et al. Effect of human papillomavirus 16/18 L1 viruslike particle vaccine among young women with preexisting infection: a randomized trial[J]. JAMA, 2007, 298(7): 743-753.
20、 CASTLE P E, RODRIGUEZ A C, BURK R D, et al. Short term persistence of human papillomavirus and risk of cervical precancer and cancer: population based cohort study[J]. BMJ, 2009, 339: b2569. CASTLE P E, RODRIGUEZ A C, BURK R D, et al. Short term persistence of human papillomavirus and risk of cervical precancer and cancer: population based cohort study[J]. BMJ, 2009, 339: b2569.
21、 EBISCH R, KETELAARS P, van der SANDEN W, et al. Screening for persistent high-risk HPV infections may be a valuable screening method for young women: A retrospective cohort study[J]. PLoS One, 2018, 13(10): e206219. EBISCH R, KETELAARS P, van der SANDEN W, et al. Screening for persistent high-risk HPV infections may be a valuable screening method for young women: A retrospective cohort study[J]. PLoS One, 2018, 13(10): e206219.
22、 ZHOU H L, ZHANG W, ZHANG C J, et al. Prevalence and distribution of human papillomavirus genotypes in Chinese women between 1991 and 2016: a systematic review[J]. J Infect, 2018, 76(6): 522-528. ZHOU H L, ZHANG W, ZHANG C J, et al. Prevalence and distribution of human papillomavirus genotypes in Chinese women between 1991 and 2016: a systematic review[J]. J Infect, 2018, 76(6): 522-528.
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