印度男性包皮环切术与HIV-1及其他性传播感染的风险

Male circumcision and risk of HIV-1 and other sexually transmitted infections in India.

作者信息

Reynolds Steven J, Shepherd Mary E, Risbud Arun R, Gangakhedkar Raman R, Brookmeyer Ronald S, Divekar Anand D, Mehendale Sanjay M, Bollinger Robert C

机构信息

Division of Infectious Diseases, Johns Hopkins University Medical School, Ross 1150, 720 Rutland Avenue, Baltimore, Maryland 21205, USA.

出版信息

Lancet. 2004 Mar 27;363(9414):1039-40. doi: 10.1016/S0140-6736(04)15840-6.

DOI:10.1016/S0140-6736(04)15840-6

PMID:15051285

Abstract

Circumcised men have a lower risk of HIV-1 infection than uncircumcised men. Laboratory findings suggest that the foreskin is enriched with HIV-1 target cells. However, some data suggest that circumcision could simply be a marker for low-risk behaviours. In a prospective study of 2298 HIV-uninfected men attending sexually transmitted infection clinics in India, we noted that circumcision was strongly protective against HIV-1 infection (adjusted relative risk 0.15; 95% CI 0.04-0.62; p=0.0089); however, we noted no protective effect against herpes simplex virus type 2, syphilis, or gonorrhoea. The specificity of this relation suggests a biological rather than behavioural explanation for the protective effect of male circumcision against HIV-1.

摘要

包皮环切术男性感染HIV-1的风险低于未行包皮环切术的男性。实验室研究结果表明，包皮富含HIV-1靶细胞。然而，一些数据表明，包皮环切术可能仅仅是低风险行为的一个标志。在一项对2298名在印度性传播感染诊所就诊的未感染HIV男性的前瞻性研究中，我们注意到包皮环切术对HIV-1感染具有很强的保护作用（调整后的相对风险为0.15；95%可信区间为0.04-0.62；p=0.0089）；然而，我们未发现其对2型单纯疱疹病毒、梅毒或淋病有保护作用。这种关系的特异性表明，男性包皮环切术对HIV-1的保护作用是生物学原因而非行为原因。