Geskus Ronald B, González Cristina, Torres Montserrat, Del Romero Jorge, Viciana Pompeyo, Masiá Mar, Blanco José R, Iribarren Mauricio, De Sanjosé Silvia, Hernández-Novoa Beatriz, Ortiz Marta, Del Amo Julia
aPublic Health Service of AmsterdambAcademic Medical Center, Amsterdam, The NetherlandscNational Center of Epidemiology, Institute of Health Carlos III, MadriddCIBERESPeNational Center of Microbiology, Institute of Health Carlos III. MadridfSanitary Center Sandoval, MadridgVirgen del Rocío University Hospital, SevillahElche University Hospital, AlicanteiSan Pedro -CIBIR Hospital, Logroño, La RiojajXeral de Vigo University Hospital, VigokCatalan Institute of Oncology, BarcelonalRamón y Cajal University Hospital-IRYCIS, Madrid, Spain.*Ronald B. Geskus and Cristina González contributed equally to the writing of this manuscript.†Marta Ortiz and Julia Del Amo are senior authors and have equally contributed to this manuscript.
AIDS. 2016 Jan 2;30(1):37-44. doi: 10.1097/QAD.0000000000000874.
To estimate incidence and clearance of high-risk human papillomavirus (HR-HPV), and their risk factors, in men who have sex with men (MSM) recently infected by HIV in Spain; 2007-2013.
Multicenter cohort. HR-HPV infection was determined and genotyped with linear array. Two-state Markov models and Poisson regression were used.
We analysed 1570 HR-HPV measurements of 612 MSM over 13 608 person-months (p-m) of follow-up. Median (mean) number of measurements was 2 (2.6), median time interval between measurements was 1.1 years (interquartile range: 0.89-1.4). Incidence ranged from 9.0 [95% confidence interval (CI) 6.8-11.8] per 1000 p-m for HPV59 to 15.9 (11.7-21.8) per 1000 p-m for HPV51. HPV16 and HPV18 had slightly above average incidence: 11.9/1000 p-m and 12.8/1000 p-m. HPV16 showed the lowest clearance for both 'prevalent positive' (15.7/1000 p-m; 95% CI 12.0-20.5) and 'incident positive' infections (22.1/1000 p-m; 95% CI 11.8-41.1). More sexual partners increased HR-HPV incidence, although it was not statistically significant. Age had a strong effect on clearance (P-value < 0.001) due to the elevated rate in MSM under age 25; the effect of HIV-RNA viral load was more gradual, with clearance rate decreasing at higher HIV-RNA viral load (P-value 0.008).
No large variation in incidence by HR-HPV type was seen. The most common incident types were HPV51, HPV52, HPV31, HPV18 and HPV16. No major variation in clearance by type was observed, with the exception of HPV16 which had the highest persistence and potentially, the strongest oncogenic capacity. Those aged below 25 or with low HIV-RNA- viral load had the highest clearance.
评估2007 - 2013年西班牙近期感染艾滋病毒的男男性行为者（MSM）中高危型人乳头瘤病毒（HR - HPV）的感染率、清除率及其危险因素。
多中心队列研究。采用线性阵列法对HR - HPV感染进行检测和基因分型。使用双状态马尔可夫模型和泊松回归分析。
在13608人月的随访期内，我们对612名男男性行为者进行了1570次HR - HPV检测。检测次数的中位数（均值）为2次（2.6次），检测之间的时间间隔中位数为1.1年（四分位间距：0.89 - 1.4年）。HPV59的感染率为每1000人月9.0[95%置信区间（CI）6.8 - 11.8]，HPV51为每1000人月15.9（11.7 - 21.8）。HPV16和HPV18的感染率略高于平均水平：分别为11.9/1000人月和12.8/1000人月。HPV16在“既往阳性”（15.7/1000人月；95%CI 12.0 - 20.5）和“新发阳性”感染（22.1/1000人月；95%CI 11.8 - 41.1）中的清除率最低。性伴侣数量增加会使HR - HPV感染率上升，尽管无统计学意义。年龄对清除率有显著影响（P值<0.001），因为25岁以下男男性行为者的清除率较高；HIV - RNA病毒载量的影响较为渐进，随着HIV - RNA病毒载量升高清除率降低（P值0.008）。
未观察到不同HR - HPV类型在感染率上有较大差异。最常见的新发类型为HPV51、HPV52、HPV31、HPV18和HPV16。除HPV16清除率最低、持续时间最长且可能致癌能力最强外，未观察到不同类型在清除率上有较大差异。25岁以下或HIV - RNA病毒载量低的人群清除率最高。
