Objective: To investigate the effect of red blood cell folate on the prognosis of high-risk human papillomavirus (HR-HPV) infection. Methods: A total of 564 participants with low-grade cervical intraepithelial neoplasias (CINⅠ) were selected from the community-based married women cohort established in 2014. The general baseline information and factors related to HPV infection were collected. Meanwhile, HPV genotyping and levels of folate were measured. The subjects were divided into different levels of exposure group according to the folate levels and followed up for 24 months to observe the changes of HR-HPV infection status. There were four changes, including persistent infection, infection turned negative, from negative to positive and constant negative by comparing HR-HPV infection status at baseline and follow-up to 24 months. Results: 483 participators completed 24 months of follow-up observation, with a follow-up rate of 85.64% (483/564). The rates of persistent infection, infection turned negative, from negative to positive, and the constant negative were 52.45% (75/143), 47.55% (68/143), 19.71% (67/340), 80.29% (273/340), respectively. Our results demonstrated that the risk of persistent infection (aRR=2.50, 95%CI: 1.55-4.02) and from negative to positive (aRR=4.55, 95%CI: 2.52-8.23) in the low level of folate were significantly higher than that in the high level of folate, especially the risk of homotype persistent infection (aRR=2.72, 95%CI: 1.51-4.90). The risk of persistent infection (trend χ2=20.62, P<0.001), from negative to positive (trend χ2=31.76, P<0.001), persistent homotypic infection (trend χ2=20.09, P<0.001) increased with the decrease of red blood cell folate level. On the contrary, no similar results were found in persistent heterotypic infection. Conclusions: A low level of red blood cell folate could increase the risk of HR-HPV persistent infection and from negative to positive. In women with HR-HPV infection, the risk of persistent homotypic infection is higher.
目的： 探讨红细胞叶酸对高危型人乳头瘤病毒（HR-HPV）感染转归的影响。 方法： 从课题组于2014年在山西省建立的已婚女性自然人群队列中，选择经病理学确诊的低度宫颈上皮内瘤变（CINⅠ）患者564名为研究对象。采用前瞻性队列研究的方法，在基线收集研究对象一般人口学特征、HPV感染相关因素的同时，利用化学发光免疫分析法进行红细胞叶酸水平的测定，依此将研究对象分为不同水平暴露组并在第24个月对其进行随访。应用导流杂交技术对研究对象基线及随访结束时的宫颈脱落细胞进行HPV感染状况检测，依据其变化情况判定HR-HPV持续感染、由阳转阴、由阴转阳和持续阴性4种不同结局，探讨红细胞叶酸对HR-HPV感染转归的影响。采用SPSS 22.0软件进行资料分析。 结果： 483名女性完成了24个月的随访观察，随访率为85.64%（483/564），HR-HPV持续感染率为52.45%（75/143），由阳转阴率为47.55%（68/143），由阴转阳率为19.71%（67/340），持续阴性率为80.29%（273/340）。红细胞叶酸低水平组发生持续感染（aRR=2.50，95%CI：1.55~4.02）及由阴转阳（aRR=4.55，95%CI：2.52~8.23）的风险高于高水平组，特别是同型持续感染的发生风险（aRR=2.72，95%CI：1.51~4.90）较高。随着红细胞叶酸水平的降低，HR-HPV持续感染（趋势检验χ²=20.62，P<0.001）、由阴转阳（趋势检验χ²=31.76，P<0.001）和同型持续感染（趋势检验χ²=20.09，P<0.001）的发生风险呈升高趋势，在异型持续感染中未见类似结果。 结论： 红细胞叶酸低水平可增加HR-HPV持续感染和由阴转阳的风险，特别是HR-HPV感染女性，发生同型持续感染的危险性更大。.