Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville.
J Infect Dis. 2013 Dec 1;208(11):1768-75. doi: 10.1093/infdis/jit374. Epub 2013 Aug 1.
Carcinogenic human papillomaviruses (HPVs) cause a large proportion of anal cancers. Human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) are at increased risk of HPV infection and anal cancer compared with HIV-negative men. We evaluated risk factors for HPV infection and anal precancer in a population of HIV-infected MSM.
Our study included 305 MSM at an HIV/AIDS clinic in the Kaiser Permanente Northern California Health Maintenance Organization. Logistic regression was used to estimate associations of risk factors comparing men without anal HPV infection; men with anal HPV infection, but no precancer; and men with anal precancer.
Low CD4 count (<350 cells/mm(3)) and previous chlamydia infection were associated with an increased risk of carcinogenic HPV infection (odds ratio [OR], 3.65; 95% confidence interval [CI], 1.28-10.40 and OR, 4.24; 95% CI, 1.16-15.51, respectively). History of smoking (OR, 2.71 95% CI, 1.43-5.14), duration, recency, and dose of smoking increased the risk of anal precancer among carcinogenic HPV-positive men but had no association with HPV infection.
We found distinct risk factors for anal HPV infection and anal precancer. Risk factors for HPV infection and anal precancer are similar to established risk factors for cervical cancer progression.
致癌型人类乳头瘤病毒（HPV）导致了很大一部分肛门癌的发生。与 HIV 阴性男性相比，感染人类免疫缺陷病毒（HIV）的男男性行为者（MSM）HPV 感染和肛门癌的风险更高。我们评估了 HIV 感染的 MSM 人群中 HPV 感染和癌前病变的风险因素。
我们的研究纳入了 Kaiser Permanente 北加利福尼亚医疗保健组织 HIV/AIDS 诊所的 305 名 MSM。使用逻辑回归来估计无肛门 HPV 感染、肛门 HPV 感染但无癌前病变和肛门癌前病变的男性之间的风险因素的关联。
低 CD4 计数（<350 个细胞/mm(3)）和先前的衣原体感染与致癌型 HPV 感染的风险增加相关（比值比 [OR]，3.65；95%置信区间 [CI]，1.28-10.40 和 OR，4.24；95% CI，1.16-15.51）。吸烟史（OR，2.71；95% CI，1.43-5.14）、吸烟持续时间、最近吸烟情况和吸烟量增加了致癌型 HPV 阳性男性的肛门癌前病变风险，但与 HPV 感染无关。
我们发现了肛门 HPV 感染和肛门癌前病变的不同风险因素。HPV 感染和肛门癌前病变的风险因素与宫颈癌进展的既定风险因素相似。
