School of Public Health, Makerere University, Kampala, Uganda.
J Infect Dis. 2010 May 15;201(10):1463-9. doi: 10.1086/652185.
In Rakai, Uganda, human immunodeficiency virus (HIV)-positive men were randomized to undergo either immediate circumcision (intervention arm) or delayed circumcision (control arm). Penile swab samples were assayed for high-risk human papillomavirus (HR-HPV) by Roche HPV Linear Array at enrollment and at 24 months (intervention arm, 103 subjects; control arm, 107 subjects). Rate ratios (RRs) of HR-HPV were estimated by Poisson regression. At 24 months, HR-HPV prevalence was found in 57 (55.3%) of 103 subjects in the intervention arm and in 77 (71.7%) of 107 subjects in the control arm (RR, 0.77; 95% confidence interval [CI], 0.62-0.97). Multiple HR-HPV infections were found in 19 (22.4%) of 85 subjects in the intervention arm and in 45 (42.5%) of 106 subjects in the control arm (RR, 0.53; 95% CI, 0.33-0.83). New HR-HPV genotypes were acquired by 34 (42.0%) of 81 subjects in the intervention arm and by 53 (57.0%) 85 subjects in the control arm (RR, 0.74; 95% CI, 0.54-1.01; P = .06). Multiple new HR-HPV genotypes were acquired by 8 (9.9%) of 81 subjects in the intervention arm and by 23 (24.7%) of 93 subjects in the control arm (RR, 0.40; 95% CI, 0.19-0.84; P = .01). Circumcision did not affect the acquisition of single HR-HPV infections (RR, 1.00; 95% CI 0.65-1.53) or clearance of HR-HPV infections (RR, 1.09; 95% CI 0.94-1.27). Circumcision of HIV-positive men reduced the prevalence and incidence of multiple HR-HPV infections.
ClinicalTrials.gov identifier: NCT00124878 .
在乌干达的 Rakai，将 HIV 阳性男性随机分为立即行包皮环切术（干预组）或延迟行包皮环切术（对照组）。在入组时和 24 个月时，用罗氏 HPV 线性阵列对阴茎拭子样本进行高危型人乳头瘤病毒（HR-HPV）检测。通过泊松回归估计 HR-HPV 的率比（RR）。24 个月时，干预组 103 例患者中有 57 例（55.3%）和对照组 107 例患者中有 77 例（71.7%）患者 HR-HPV 阳性（RR，0.77；95%可信区间[CI]，0.62-0.97）。干预组 85 例患者中有 19 例（22.4%）和对照组 106 例患者中有 45 例（42.5%）发生多重 HR-HPV 感染（RR，0.53；95%CI，0.33-0.83）。干预组 81 例患者中有 34 例（42.0%）和对照组 85 例患者中有 53 例（57.0%）新感染 HR-HPV 基因型（RR，0.74；95%CI，0.54-1.01；P =.06）。干预组 81 例患者中有 8 例（9.9%）和对照组 93 例患者中有 23 例（24.7%）发生多重新 HR-HPV 基因型感染（RR，0.40；95%CI，0.19-0.84；P =.01）。包皮环切术并未影响 HR-HPV 单一感染的获得（RR，1.00；95%CI，0.65-1.53）或 HR-HPV 感染的清除（RR，1.09；95%CI，0.94-1.27）。HIV 阳性男性行包皮环切术可降低多重 HR-HPV 感染的发生率和患病率。
ClinicalTrials.gov 标识符：NCT00124878 。
