Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
AIDS. 2012 Nov 13;26(17):2211-22. doi: 10.1097/QAD.0b013e328358d908.
Human papillomavirus (HPV), one of the commonest sexually transmitted infections, may be a cofactor in HIV acquisition. We systematically reviewed the evidence for an association of HPV infection with HIV acquisition in women, heterosexual men and men who have sex with men (MSM).
: Systematic review and meta-analysis.
Studies meeting inclusion criteria in Pubmed, Embase and conference abstracts up to 29 July 2011 were identified. Random effects meta-analyses were performed to calculate summary hazard ratios (HR). Publication bias and statistical heterogeneity were evaluated and population attributable fractions (PAFs) calculated.
Eight articles were included, with previously unpublished data from five authors. Seven studies found an association between prevalent HPV and HIV acquisition. Risk of HIV acquisition in women doubled with prevalent HPV infection with any genotype [HR = 2.06 (95% CI = 1.44-2.94), I = 0%], although adjustment for confounders was often inadequate. The effect was similar for high-risk [HR = 1.99 (95% CI = 1.54-2.56), I = 8.4%] and low-risk [HR = 2.01 (95% CI = 1.27-3.20), I = 0%] HPV genotypes with weak evidence of publication bias (P = 0.06). Two studies in men were identified: both showed an association between HPV infection and HIV acquisition. Unpublished data from one of two studies in women indicated an association between genotypes targeted by HPV vaccines and HIV acquisition. PAFs for HIV attributable to infection with any HPV genotype ranged between 21 and 37%.
If further studies validate the association between HPV infection and HIV acquisition, HPV vaccines may reduce HIV incidence in high HPV prevalence populations, in addition to preventing cervical cancer. HIV surveillance studies during implementation of HPV vaccine programmes are warranted.
人乳头瘤病毒（HPV）是最常见的性传播感染之一，可能是 HIV 获得的协同因素。我们系统地审查了 HPV 感染与女性、异性恋男性和男男性接触者（MSM）中 HIV 获得之间关联的证据。
系统综述和荟萃分析。
在 Pubmed、Embase 和会议摘要中，我们检索了截至 2011 年 7 月 29 日符合纳入标准的研究。我们进行了随机效应荟萃分析，以计算综合危害比（HR）。评估了发表偏倚和统计异质性，并计算了人群归因分数（PAF）。
共纳入 8 篇文章，其中包括 5 位作者的未发表数据。有 7 项研究发现 HPV 现患与 HIV 获得之间存在关联。有任何基因型的 HPV 现患感染的女性 HIV 获得风险增加了一倍[HR = 2.06（95%CI = 1.44-2.94），I = 0%]，尽管经常对混杂因素进行调整，但效果相似。高危型[HR = 1.99（95%CI = 1.54-2.56），I = 8.4%]和低危型[HR = 2.01（95%CI = 1.27-3.20），I = 0%]HPV 基因型也有类似的效果，存在发表偏倚的微弱证据（P = 0.06）。在男性中确定了两项研究：两者均表明 HPV 感染与 HIV 获得之间存在关联。一项女性研究的未发表数据表明，HPV 疫苗针对的基因型与 HIV 获得之间存在关联。归因于任何 HPV 基因型感染的 HIV 的人群归因分数（PAF）在 21%至 37%之间。
如果进一步的研究验证了 HPV 感染与 HIV 获得之间的关联，那么 HPV 疫苗除了预防宫颈癌外，还可能降低高 HPV 流行人群的 HIV 发病率。在实施 HPV 疫苗计划期间，需要进行 HIV 监测研究。
