HIV感染男性肛门人乳头瘤病毒感染的患病率、清除率和发病率：HIPVIRG队列研究

Prevalence, clearance, and incidence of anal human papillomavirus infection in HIV-infected men: the HIPVIRG cohort study.

作者信息

de Pokomandy Alexandra, Rouleau Danielle, Ghattas George, Vézina Sylvie, Coté Pierre, Macleod John, Allaire Guy, Franco Eduardo L, Coutlée François

机构信息

Département de Microbiologie et Infectiologie, Hôpital Notre-Dame du Centre Hospitalier de l'Université de Montréal, Département de Médecine Familiale, Faculté de Médecine, Université de Montréal, Montreal, Quebec, Canada.

出版信息

J Infect Dis. 2009 Apr 1;199(7):965-73. doi: 10.1086/597207.

DOI:10.1086/597207

PMID:19239366

Abstract

BACKGROUND

Human immunodeficiency virus (HIV)-seropositive men who have sex with men (MSM) are at higher risk of human papillomavirus (HPV) infection. This study was conducted to better understand the natural history of type-specific HPV infection in the anus.

METHODS

A cohort study was conducted among HIV-seropositive MSM in Montreal to investigate acquisition and loss of anal HPV infection. Participants were followed up every 6 months for 3 years for risk behaviors, HIV-related parameters, and HPV testing.

RESULTS

HPV DNA was detected in 97.9% of the 247 participants at baseline (median, 5 HPV types). The most common types were HPV-16 (38.2%) and HPV-6 (35.3%). Prevalent HPV-16 infections had the lowest clearance rate (12.2 cleared episodes per 1000 person-months [95% confidence interval {CI}, 8.5-17.7]) and a mean retention time of 36 months (95% CI, 32.7-38.8). The highest incidence rates were found for HPV-16 (10.8 new cases per 1000 person-months [95% CI, 8.0-14.7]), HPV-52 (10.8 new cases per 1000 person-months [95% CI, 8.2-14.1]), and HPV-53 (9.8 new cases per 1000 person-months [95% CI, 7.4-13.0]), with cumulative incidences at 36 months of approximately 30%.

CONCLUSIONS

Multiple HPV types were common in the anal canals of HIV-seropositive MSM. Incidence and clearance rates were not similar among HPV types. Ongoing surveillance of this cohort will help our understanding of the determinants of HPV persistence and progression to lesions.

摘要

背景

与男性发生性关系的人类免疫缺陷病毒（HIV）血清阳性男性感染人乳头瘤病毒（HPV）的风险更高。开展本研究是为了更好地了解肛门部位特定类型HPV感染的自然史。

方法

在蒙特利尔对HIV血清阳性男男性行为者开展一项队列研究，以调查肛门HPV感染的获得和清除情况。对参与者随访3年，每6个月进行一次风险行为、HIV相关参数及HPV检测。

结果

247名参与者在基线时97.9%检测到HPV DNA（中位数为5种HPV类型）。最常见的类型为HPV-16（38.2%）和HPV-6（35.3%）。HPV-16感染的清除率最低（每1000人月12.2次清除事件[95%置信区间{CI}，8.5 - 17.7]），平均持续时间为36个月（95% CI，32.7 - 38.8）。HPV-16、HPV-52（每1000人月10.8例新病例[95% CI，8.0 - 14.7]）和HPV-53（每1000人月9.8例新病例[95% CI，7.4 - 13.0]）的发病率最高，36个月时的累积发病率约为30%。