男男性行为者中的人乳头瘤病毒DNA：型特异性流行率、危险因素及对疫苗接种策略的影响
Human papillomavirus DNA in men who have sex with men: type-specific prevalence, risk factors and implications for vaccination strategies.
作者信息
King E M, Gilson R, Beddows S, Soldan K, Panwar K, Young C, Prah P, Jit M, Edmunds W J, Sonnenberg P
机构信息
Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK.
1] Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK [2] The Mortimer Market Centre, Central and North West London NHS Foundation Trust, London WC1E 6JB, UK.
出版信息
Br J Cancer. 2015 Apr 28;112(9):1585-93. doi: 10.1038/bjc.2015.90. Epub 2015 Mar 19.
BACKGROUND
Human papillomavirus (HPV) vaccination of girls will have relatively little effect on HPV-related disease in men who have sex with men (MSM). We determined HPV prevalence and risk factors in MSM to inform the potential effectiveness of vaccinating MSM.
METHODS
Cross-sectional study of 522 MSM aged 18-40 attending a London sexual health clinic who completed a computer-assisted self-interview. Urine and two swabs (anal and penile/scrotal/perianal) were collected and tested using an in-house Luminex-based HPV genotyping system.
RESULTS
Prevalence of DNA of the vaccine-preventable HPV types in ano-genital specimens of men was 87/511 (17.0%), 166/511 (32.5%) and 232/511 (45.4%) for the bivalent (HPV16/18), quadrivalent (HPV6/11/16/18) and nonavalent (HPV6/11/16/18/31/33/45/52/58) vaccine types, respectively. A total of 25.1% had one of the quadrivalent types, and 7.4% had 2+ types. Median age at first anal sex was 19 (IQR 17-23) and at first clinic attendance was 24 (IQR 20-27). The increase in the odds of any HPV infection per year of age was 4.7% (95% CI 1.2-8.4).
CONCLUSIONS
On the basis of the current infection status, most MSM, even among a high-risk population attending a sexual health clinic, are not currently infected with the vaccine-type HPV. A targeted vaccination strategy for MSM in the UK could have substantial benefits.
背景
对女孩进行人乳头瘤病毒（HPV）疫苗接种对男男性行为者（MSM）的HPV相关疾病影响相对较小。我们测定了MSM中的HPV流行率及风险因素，以了解对MSM进行疫苗接种的潜在效果。
方法
对522名年龄在18至40岁、前往伦敦一家性健康诊所就诊并完成计算机辅助自我访谈的MSM进行横断面研究。收集尿液及两份拭子样本（肛门拭子和阴茎/阴囊/肛周拭子），并使用基于Luminex的内部HPV基因分型系统进行检测。
结果
在男性的肛门生殖器标本中，二价疫苗型（HPV16/18）、四价疫苗型（HPV6/11/16/18）和九价疫苗型（HPV6/11/16/18/31/33/45/52/58）的可预防HPV类型的DNA流行率分别为87/511（17.0%）、166/511（32.5%）和232/511（45.4%）。共有25.1%的人感染了一种四价疫苗型，7.4%的人感染了两种及以上疫苗型。首次肛交的中位年龄为19岁（四分位间距17 - 23岁），首次就诊的中位年龄为24岁（四分位间距20 - 27岁）。年龄每增加一岁，任何HPV感染几率增加4.7%（95%置信区间1.2 - 8.4）。
结论
基于目前的感染状况，大多数MSM，即使是在前往性健康诊所就诊的高危人群中，目前也未感染疫苗型HPV。在英国针对MSM的有针对性的疫苗接种策略可能会带来巨大益处。
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