HIV阴性和HIV感染的男男性行为者口腔HPV感染的12个月发病率及清除情况：H2M队列研究
Twelve-month incidence and clearance of oral HPV infection in HIV-negative and HIV-infected men who have sex with men: the H2M cohort study.
作者信息
van Aar Fleur, Mooij Sofie H, van der Sande Marianne A B, Meijer Chris J L M, King Audrey J, Verhagen Dominique W M, Heijman Titia, Coutinho Roel A, Schim van der Loeff Maarten F
机构信息
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), PO Box 1, 3720BA, Bilthoven, The Netherlands.
Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands.
出版信息
BMC Infect Dis. 2014 Dec 31;14:668. doi: 10.1186/s12879-014-0668-z.
BACKGROUND
Our aim was to compare the 12-month incidence and clearance of oral high-risk HPV infection between HIV-infected men who have sex with men (MSM) and HIV-negative MSM.
METHODS
MSM aged 18 years or older were recruited in Amsterdam, the Netherlands. Questionnaire data and oral-rinse and gargle samples were collected at baseline, and after 6 and 12 months. HPV DNA was genotyped using the SPF10-PCR & DEIA-LiPA25 system (version 1). Determinants of oral HPV incidence and clearance were explored using Cox and logistic regression analyses respectively.
RESULTS
433 HIV-negative and 290 HIV-infected MSM were included in these analyses. The median follow-up time per participant was 12 months (range 3-15). During follow-up, 114 incident oral high-risk HPV infections were observed. The incidence rate of HPV-16 was 3.5/1000 person-months (PM) in HIV-infected and 0.9/1000 PM in HIV-negative MSM (IRR 4.1; 95% CI 1.3-13.2). The incidence rates of other high-risk HPV types ranged between 1.3-3.5/1000 PM in HIV-infected and 0.0-1.1/1000 PM in HIV-negative MSM. In multivariable analyses, HIV infection (adjusted hazard ratio [aHR] 3.8; 95% CI 2.3-6.2) and a higher number of recent oral sex partners (aHR 2.4 for ≥8 partners compared to ≤2; 95% CI 1.4-4.2) were associated with HPV incidence. Of the 111 baseline oral high-risk infections, 59 (53.2%) were cleared. In multivariable analyses, only a higher number of recent oral sex partners was associated with HPV clearance (adjusted odds ratio 3.4 for ≥8 compared to ≤2 partners; 95% CI 1.3-9.0).
CONCLUSIONS
The incidence rate of oral high-risk HPV infection was higher in HIV-infected MSM and in those with a higher number of recent oral sex partners. Just over half of the oral high-risk HPV infections at baseline were cleared after 12 months, with a higher likelihood of clearance among MSM reporting higher numbers of recent oral sex partners, but no difference by HIV status.
背景
我们的目的是比较男男性行为者（MSM）中感染人类免疫缺陷病毒（HIV）者与未感染HIV者口腔高危型人乳头瘤病毒（HPV）感染的12个月发病率及清除率。
方法
在荷兰阿姆斯特丹招募18岁及以上的MSM。在基线时、6个月后和12个月后收集问卷数据以及口腔冲洗和漱口样本。使用SPF10-PCR & DEIA-LiPA25系统（第1版）对HPV DNA进行基因分型。分别使用Cox回归分析和逻辑回归分析探索口腔HPV感染发病率及清除率的决定因素。
结果
433名未感染HIV的MSM和290名感染HIV的MSM纳入了这些分析。每位参与者的中位随访时间为12个月（范围3 - 15个月）。随访期间，观察到114例新发口腔高危型HPV感染。HPV-16的发病率在感染HIV的MSM中为3.5/1000人月（PM），在未感染HIV的MSM中为0.9/1000 PM（发病率比[IRR] 4.1；95%置信区间[CI] 1.3 - 13.2）。其他高危型HPV的发病率在感染HIV者中为1.3 - 3.5/1000 PM，在未感染HIV者中为0.0 - 1.1/1000 PM。在多变量分析中，HIV感染（校正风险比[aHR] 3.8；95% CI 2.3 - 6.2）以及近期有更多口交性伴侣（≥8个伴侣与≤2个伴侣相比，aHR为2.4；95% CI 1.4 - 4.2）与HPV感染发病率相关。在111例基线口腔高危感染中，59例（53.2%）被清除。在多变量分析中，只有近期有更多口交性伴侣与HPV清除相关（≥8个伴侣与≤2个伴侣相比，校正比值比为3.4；95% CI 1.3 - 9.0）。
结论
感染HIV的MSM以及近期有更多口交性伴侣者的口腔高危型HPV感染发病率更高。基线时超过一半的口腔高危型HPV感染在12个月后被清除，近期有更多口交性伴侣的MSM清除的可能性更高，但与HIV感染状态无关。
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