H Lee Moffitt Cancer Center, Tampa, FL, USA. anna.giuliano@moffi tt.org
Lancet. 2011 Mar 12;377(9769):932-40. doi: 10.1016/S0140-6736(10)62342-2. Epub 2011 Feb 28.
Human papillomaviruses (HPVs) cause genital warts and cancers in men. The natural history of HPV infection in men is largely unknown, and that information is needed to inform prevention strategies. The goal in this study was to estimate incidence and clearance of type-specific genital HPV infection in men, and to assess the associated factors.
Men (aged 18-70 years), residing in Brazil, Mexico, and the USA, who were HIV negative and reported no history of cancer were recruited from the general population, universities, and organised health-care systems. They were assessed every 6 months for a median follow-up of 27·5 months (18·0-31·2). Specimens from the coronal sulcus, glans penis, shaft, and scrotum were obtained for the assessment of the status of HPV genotypes.
In 1159 men, the incidence of a new genital HPV infection was 38·4 per 1000 person months (95% CI 34·3-43·0). Oncogenic HPV infection was significantly associated with having a high number of lifetime female sexual partners (hazard ratio 2·40, 1·38-4·18, for at least 50 partners vs not more than one partner), and number of male anal-sexual partners (2·57, 1·46-4·49, for at least three male partners vs no recent partners). Median duration of HPV infection was 7·52 months (6·80-8·61) for any HPV and 12·19 months (7·16-18·17) for HPV 16. Clearance of oncogenic HPV infection decreased in men with a high number of lifetime female partners (0·49, 0·31-0·76, for at least 50 female partners vs not more than one partner), and in men in Brazil (0·71, 0·56-0·91) and Mexico (0·73, 0·57-0·94) compared with the USA. Clearance of oncogenic HPV was more rapid with increasing age (1·02, 1·01-1·03).
The data from this study are useful for the development of realistic cost-effectiveness models for male HPV vaccination internationally.
National Cancer Institute.
人乳头瘤病毒（HPV）可导致男性生殖器疣和癌症。男性 HPV 感染的自然史在很大程度上尚不清楚，而这些信息对于制定预防策略是必要的。本研究的目的是估计男性特定类型的生殖器 HPV 感染的发生率和清除率，并评估相关因素。
从一般人群、大学和有组织的医疗保健系统中招募了年龄在 18-70 岁之间、HIV 阴性且无癌症病史的男性。他们每 6 个月评估一次，中位随访时间为 27.5 个月（18.0-31.2）。从冠状沟、阴茎头、阴茎干和阴囊采集标本，以评估 HPV 基因型的状态。
在 1159 名男性中，新发生殖器 HPV 感染的发生率为每 1000 人月 38.4 例（95%CI 34.3-43.0）。致癌 HPV 感染与一生中性伴侣数量较多显著相关（风险比 2.40，1.38-4.18，伴侣数至少 50 人与不超过 1 个伴侣相比），与男性肛交性伴侣数量较多也显著相关（2.57，1.46-4.49，最近至少有 3 个性伴侣与无最近性伴侣相比）。任何 HPV 的中位感染持续时间为 7.52 个月（6.80-8.61），HPV16 的中位感染持续时间为 12.19 个月（7.16-18.17）。具有较多性伴侣的男性（伴侣数至少 50 人与不超过 1 个伴侣相比，0.49，0.31-0.76）和来自巴西（0.71，0.56-0.91）和墨西哥（0.73，0.57-0.94）的男性中，致癌 HPV 感染的清除率降低。HPV 感染的清除率随着年龄的增加而加快（1.02，1.01-1.03）。
本研究的数据对于国际上制定男性 HPV 疫苗的成本效益模型非常有用。
美国国立癌症研究所。
