Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
Sex Transm Infect. 2013 May;89(3):262-6. doi: 10.1136/sextrans-2012-050633. Epub 2012 Oct 30.
Male circumcision reduces penile high-risk human papillomavirus (HR-HPV) prevalence in randomised trials. The goal of this study was to examine the effect of circumcision on HPV viral load among HPV-infected men in a randomised trial of male circumcision.
In a randomised trial to assess the efficacy of circumcision on HIV acquisition in Rakai, Uganda, HIV-negative men were randomised to immediate (intervention) or delayed (control) circumcision and followed over 24 months. We performed quantitative-PCR HPV viral load assays on penile swabs which tested positive by Linear Array (LA) for six HR-HPV genotypes and estimated viral load in the remaining types by LA signal strength.
At 24 months, circumcision intervention arm men infected with one of the six selected HR-HPV genotypes had a lower viral load and significantly reduced HR-HPV high LA band intensity (PRR=0.61, 95% CI 0.43 to 0.86) compared to infected men in the control arm of the trial. The decreased viral load associated with circumcision was seen among HPV infections acquired after enrolment but not among infections that persisted from trial enrolment to 24 months (p=0.80).
The decreased penile HR-HPV shedding observed among HPV-infected circumcised men may help to explain the protective association observed between circumcision and reduced acquisition of HR-HPV in female partners.
随机试验表明，男性包皮环切术可降低阴茎高危型人乳头瘤病毒（HR-HPV）的流行率。本研究旨在通过随机包皮环切术试验，研究包皮环切术对 HPV 感染男性 HPV 病毒载量的影响。
在乌干达 Rakai 进行的一项随机试验中，评估了包皮环切术对 HIV 感染的效果，将 HIV 阴性男性随机分为立即（干预）或延迟（对照）包皮环切组，并随访 24 个月。我们对线性阵列（LA）检测到六种 HR-HPV 基因型阳性的阴茎拭子进行了定量 PCR HPV 病毒载量检测，并根据 LA 信号强度估计了其余类型的病毒载量。
在 24 个月时，与试验对照组中感染六种选定 HR-HPV 基因型之一的男性相比，包皮环切术干预组中感染一种 HR-HPV 基因型的男性病毒载量较低，HR-HPV 高 LA 带强度显著降低（PRR=0.61，95%CI 0.43 至 0.86）。与从试验入组开始持续存在的 HPV 感染相比，与包皮环切术相关的病毒载量降低见于入组后获得的 HPV 感染（p=0.80）。
在 HPV 感染的包皮环切男性中观察到的阴茎 HR-HPV 脱落减少，可能有助于解释包皮环切术与女性性伴侣中 HR-HPV 感染减少之间观察到的保护关联。
