HIV 阳性男男性行为者中特定型别肛门人乳头瘤病毒感染的发生率和危险因素。
Incidence of and risk factors for type-specific anal human papillomavirus infection among HIV-positive MSM.
机构信息
aDepartment of Medicine, University of California, San Francisco, San Francisco bSchool of Public Health, Department of Epidemiology, University of California, Berkeley, Berkeley, California cCenter for Health Disparities Research and Department of Public Health, Brody School of Medicine, Greenville, North Carolina dDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
出版信息
AIDS. 2014 Jun 1;28(9):1341-9. doi: 10.1097/QAD.0000000000000254.
OBJECTIVE
HIV-positive MSM are at increased risk of anal human papillomavirus (HPV) infection compared with men in the general population, and little is known about the natural history of anal HPV infection in this population. The objective of this study was to determine the incidence of and risk factors for anal type-specific HPV infection.
DESIGN
Prospective cohort study.
METHODS
HIV-positive MSM were evaluated for anal HPV DNA, lifestyle factors, and sexual risk behaviors every 6 months for at least 2 years.
RESULTS
The overall incidence rate of detectable type-specific anal HPV infection was 21.3 per 100 person-years [95% confidence interval (CI) 17.7-25.4] and was 13.3/100 person-years (10.5-16.6) for oncogenic HPV types. The most common incident infections were HPV 18 (3.7/100 person-years) and HPV 16 (3.5/100 person-years). An increased number of recent partners with whom the participant was the receptive partner [odds ratio (OR) 2.9 (1.6-5.1) 8+ partners vs. 0-1], an increased number of new partners in which the participant was the receptive partner [OR 1.03 (1.01-1.1) per partner], an increased number of new oral-anal contact partners in which the participant was the receptive partner [OR 1.1 (1.03-1.1) per partner], and the frequency of receptive anal intercourse [OR 1.1 (1.03-1.1) per act] all significantly increased the odds of incident HPV infection (P ≤ 0.05).
CONCLUSION
HIV-positive MSM have a high incidence of oncogenic anal HPV infection. Recent receptive anal sexual behaviors, including receptive anal intercourse and receptive oral-anal contact, are the most important risk factors for incident anal HPV infection.
目的
与普通人群中的男性相比，HIV 阳性男男性接触者（MSM）肛门人乳头瘤病毒（HPV）感染的风险增加，而对于该人群中肛门 HPV 感染的自然史知之甚少。本研究旨在确定肛门 HPV 感染的特定类型的发生率和危险因素。
设计
前瞻性队列研究。
方法
HIV 阳性 MSM 每 6 个月评估一次肛门 HPV DNA、生活方式因素和性行为风险，至少持续 2 年。
结果
可检测的特定类型肛门 HPV 感染的总体发生率为 21.3/100 人年[95%置信区间（CI）17.7-25.4]，致癌 HPV 类型为 13.3/100 人年（10.5-16.6）。最常见的新发感染是 HPV 18（3.7/100 人年）和 HPV 16（3.5/100 人年）。最近的性伴侣数量增加[比值比（OR）2.9（1.6-5.1）8+伴侣与 0-1 个伴侣]、作为接受方的新伴侣数量增加[OR 1.03（1.01-1.1）每个新伴侣]、作为接受方的新口交肛交伴侣数量增加[OR 1.1（1.03-1.1）每个新伴侣]和接受肛交的频率增加[OR 1.1（1.03-1.1）每次肛交]均显著增加 HPV 感染的几率（P≤0.05）。
结论
HIV 阳性 MSM 肛门 HPV 感染的发生率较高。最近的接受性肛门性行为，包括接受性肛交和接受性口交肛交，是肛门 HPV 感染的最重要危险因素。
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