Nielson Carrie M, Schiaffino Melody K, Dunne Eileen F, Salemi Jason L, Giuliano Anna R
Oregon Health and Science University, Portland, USA.
J Infect Dis. 2009 Jan 1;199(1):7-13. doi: 10.1086/595567.
Male circumcision may lower men's risk of human papillomavirus (HPV) infection and reduce transmission to sex partners. Reported associations between circumcision and HPV infection in men have been inconsistent.
Four hundred sixty-three men in 2 US cities were tested at 6 anogenital sites and in semen for 37 types of HPV. Men were eligible if they reported sex with a woman within the past year, no history of genital warts or penile or anal cancer, and no current diagnosis of a sexually transmitted infection. Participants completed a self-administered questionnaire. Circumcision status was assessed by the study clinician. Logistic regression was used to examine associations between circumcision and HPV detection at each site and in semen, with adjustment for potential confounders.
Seventy-four men (16.0%) were uncircumcised. Adjusted odds ratios (AORs) for any HPV genotype and circumcision were 0.53 (95% confidence interval [CI], 0.28-0.99) for any anatomic site/specimen, 0.17 (95% CI, 0.05-0.56) for the urethra, 0.44 (95% CI, 0.23-0.82) for the glans/corona, and 0.53 (95% CI, 0.28-0.99) for the penile shaft. AORs were <1.0 but not statistically significant for the scrotum, semen, anal canal, and perianal area.
Circumcision may be protective against HPV infection of the urethra, glans/corona, and penile shaft.
男性包皮环切术可能会降低男性感染人乳头瘤病毒（HPV）的风险，并减少向性伴侣的传播。据报道，包皮环切术与男性HPV感染之间的关联并不一致。
对美国2个城市的463名男性的6个肛门生殖器部位和精液进行了37种HPV检测。如果男性报告在过去一年内与女性发生过性行为、无尖锐湿疣或阴茎或肛门癌病史且目前未诊断出性传播感染，则符合入选条件。参与者完成了一份自我管理的问卷。包皮环切状态由研究临床医生评估。采用逻辑回归分析包皮环切术与每个部位及精液中HPV检测之间的关联，并对潜在混杂因素进行调整。
74名男性（16.0%）未行包皮环切术。任何HPV基因型与包皮环切术的校正比值比（AOR）在任何解剖部位/标本为0.53（95%置信区间[CI]，0.28 - 0.99），尿道为0.17（95%CI, 0.05 - 0.56），龟头/冠状沟为0.44（95%CI, 0.23 - 0.82），阴茎体为0.53（95%CI, 0.28 - 0.99）。阴囊、精液、肛管和肛周区域的AOR<1.0，但无统计学意义。
包皮环切术可能对尿道、龟头/冠状沟和阴茎体的HPV感染具有保护作用。
