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HIV阴性和HIV感染男男性行为者中肛门和阴茎高危型人乳头瘤病毒的流行情况

Anal and penile high-risk human papillomavirus prevalence in HIV-negative and HIV-infected MSM.

作者信息

van Aar Fleur, Mooij Sofie H, van der Sande Marianne A B, Speksnijder Arjen G C L, Stolte Ineke G, Meijer Chris J L M, Verhagen Dominique W M, King Audrey J, de Vries Henry J C, Schim van der Loeff Maarten F

机构信息

aEpidemiology & Surveillance Department, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven bCluster of Infectious Diseases, Public Health Service Amsterdam cDepartment of Internal Medicine, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam dJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht eDepartment of Pathology, Vrije Universiteit-University Medical Center (VUmc) fDepartment of Internal Medicine, Jan van Goyen Medical Center gDepartment of Dermatology, Academic Medical Center, Amsterdam, the Netherlands. *Fleur Van Aar and Sofie H. Mooij contributed equally to the writing of the article.

出版信息

AIDS. 2013 Nov 28;27(18):2921-31. doi: 10.1097/01.aids.0000432541.67409.3c.

DOI:10.1097/01.aids.0000432541.67409.3c

PMID:23921617

Abstract

OBJECTIVE

Anal and penile high-risk human papillomavirus (HPV) infection is associated with anogenital cancer, which is especially common in HIV-infected MSM. We assessed HPV prevalence and determinants in MSM.

DESIGN

Analysis of baseline data from a prospective cohort study.

METHODS

MSM aged 18 years or older were recruited in Amsterdam, the Netherlands. Participants completed risk-factor questionnaires. HPV DNA was analyzed in anal and penile shaft self-swabs and genotyped using a sensitive PCR and reverse line blot assay (SPF10-PCR-DEIA-LiPA25-system). Multivariable logistic regression analyses were performed to assess determinants of high-risk HPV infection.

RESULTS

MSM (n = 778) were recruited in 2010-2011, of whom 317 (41%) were HIV-infected. Prevalence of anal high-risk HPV infection was 45% in HIV-negative versus 65% in HIV-infected MSM (P <0.001). HPV-16 was the most frequently detected type and was more common in HIV-infected MSM (13% in HIV-negative and 22% in HIV-infected MSM; P = 0.001). Prevalence of penile high-risk HPV infection was 16% in HIV-negative and 32% in HIV-infected MSM (P <0.001). In multivariable analyses, HIV infection remained associated with anal [adjusted odds ratio (aOR) 2.2; 1.8-2.7] and penile (aOR 2.0; 1.4-2.9) high-risk HPV infection. Higher number of lifetime male sex partners was significantly associated with anal and penile high-risk HPV in HIV-negative, but not HIV-infected MSM. Receptive anal intercourse was associated with anal high-risk HPV in HIV-infected MSM.

CONCLUSION

Anal and penile high-risk HPV infections are very common in MSM. HIV infection is a strong and independent determinant for anal and penile high-risk HPV infection. Determinants for HPV infection appear to differ between HIV-negative and HIV-infected MSM.

摘要

目的

肛门和阴茎高危型人乳头瘤病毒（HPV）感染与肛门生殖器癌相关，这在感染HIV的男男性行为者（MSM）中尤为常见。我们评估了MSM中HPV的流行率及其决定因素。

设计

对一项前瞻性队列研究的基线数据进行分析。

方法

在荷兰阿姆斯特丹招募18岁及以上的MSM。参与者完成风险因素问卷。对肛门和阴茎体的自我拭子进行HPV DNA分析，并使用灵敏的聚合酶链反应和反向线印迹分析（SPF10-PCR-DEIA-LiPA25系统）进行基因分型。进行多变量逻辑回归分析以评估高危型HPV感染的决定因素。

结果

2010年至2011年招募了778名MSM，其中317名（41%）感染了HIV。HIV阴性的MSM中肛门高危型HPV感染率为45%，而感染HIV的MSM中为65%（P<0.001）。HPV-16是最常检测到的类型，在感染HIV的MSM中更常见（HIV阴性者中为13%，感染HIV的MSM中为22%；P=0.001）。HIV阴性的MSM中阴茎高危型HPV感染率为16%，感染HIV的MSM中为32%（P<0.001）。在多变量分析中，HIV感染仍与肛门（校正比值比[aOR]2.2；1.8-2.7）和阴茎（aOR 2.0；1.4-2.9）高危型HPV感染相关。在HIV阴性但非感染HIV的MSM中，终身男性性伴侣数量较多与肛门和阴茎高危型HPV显著相关。接受肛交与感染HIV的MSM中的肛门高危型HPV相关。