Department of Pathology, School of Medicine, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21287, USA.
AIDS. 2012 Jul 31;26(12):1555-65. doi: 10.1097/QAD.0b013e328353b83c.
High-risk human papillomavirus (HR-HPV) infection is the most common sexually transmitted infection. Penile and cervical cancer rates are highest in sub-Saharan Africa. However, little is known about the impact of HIV infection on HR-HPV acquisition and clearance among heterosexual men.
HR-HPV incidence and clearance were evaluated in 999 men (776 HIV-negative and 223 HIV-positive) aged 15-49 years who participated in male circumcision trials in Rakai, Uganda.
Penile swabs were tested for HR-HPV by Roche HPV Linear Array. A Poisson multivariable model was used to estimate adjusted incidence rate ratios (adjIRRs) and clearance risk ratios (adjRRs).
HR-HPV incidence was 66.5/100 person-years in HIV-positive men and 32.9/100 person-years among HIV-negative men [IRR=2.02, 95% confidence interval (CI) 1.67-2.44]. Incidence was higher in the unmarried men (adjIRR=1.73, 95% CI 1.19-2.52), and decreased with age (adjIRR for men >35 years=0.64, 95% CI 0.43-0.94) and male circumcision (adjIRR=0.70, 95% CI 0.55-0.89). HR-HPV clearance was 114.7/100 person-years for HIV-positive men and 170.2/100 person-years for HIV-negative men (risk ratio=0.67, 95% CI 0.59-0.77). HR-HPV clearance in HIV-negative men increased with circumcision (adjRR=1.48, 95% CI 1.26-1.74), HSV-2 infection (adjRR=1.20, 95% CI 1.01-1.44), and symptoms of urethral discharge (adjRR=1.35, 95% CI 1.06-1.73). Clearance of HR-HPV was significantly lower for unmarried men (adjRR 0.76, 95% CI 0.59-0.98).
HR-HPV is common among heterosexual Ugandan men, particularly the HIV-infected. HIV infection increases HR-HPV acquisition and reduces HR-HPV clearance. Promotion of male circumcision and additional prevention measures, such as HPV vaccination, is critical in sub-Saharan Africa.
高危型人乳头瘤病毒（HR-HPV）感染是最常见的性传播感染。撒哈拉以南非洲的阴茎癌和宫颈癌发病率最高。然而，对于 HIV 感染对异性恋男性中 HR-HPV 感染和清除的影响知之甚少。
对参加乌干达拉凯男性包皮环切试验的 999 名年龄在 15-49 岁的男性（776 名 HIV 阴性和 223 名 HIV 阳性）进行了 HR-HPV 发病率和清除率评估。
通过罗氏 HPV 线性阵列检测阴茎拭子中的 HR-HPV。使用泊松多变量模型估计调整后的发病率比值比（adjIRR）和清除风险比（adjRR）。
HIV 阳性男性的 HR-HPV 发病率为 66.5/100 人年，HIV 阴性男性为 32.9/100 人年[发病率比（IRR）=2.02，95%置信区间（CI）1.67-2.44]。未婚男性的发病率更高（adjIRR=1.73，95%CI 1.19-2.52），且随年龄增长而降低（年龄>35 岁男性的 adjIRR=0.64，95%CI 0.43-0.94）和男性包皮环切术（adjIRR=0.70，95%CI 0.55-0.89）。HIV 阳性男性的 HR-HPV 清除率为 114.7/100 人年，HIV 阴性男性为 170.2/100 人年（风险比=0.67，95%CI 0.59-0.77）。HIV 阴性男性的 HR-HPV 清除率随着包皮环切术（adjRR=1.48，95%CI 1.26-1.74）、单纯疱疹病毒 2 感染（adjRR=1.20，95%CI 1.01-1.44）和尿道分泌物症状（adjRR=1.35，95%CI 1.06-1.73）而增加。未婚男性的 HR-HPV 清除率明显降低（adjRR 0.76，95%CI 0.59-0.98）。
HR-HPV 在乌干达异性恋男性中很常见，尤其是 HIV 感染者。HIV 感染增加了 HR-HPV 的感染，降低了 HR-HPV 的清除率。在撒哈拉以南非洲，推广男性包皮环切术和其他预防措施（如 HPV 疫苗接种）至关重要。
