Rettig Eleni Marie, Fakhry Carole, Rositch Anne F, Burke Anne E, Chang Kathryn, Silver Michelle I, Viscidi Raphael, Gravitt Patti
From the *Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; †Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of ‡Gynecology and Obstetrics and §Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD; and ¶Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, NM.
Sex Transm Dis. 2016 Apr;43(4):231-7. doi: 10.1097/OLQ.0000000000000426.
Human papillomavirus (HPV) causes oropharyngeal and cervical cancers. Oropharyngeal cancer primarily affects whites, but cervical cancer is more common among blacks. Reasons for this distinct epidemiology are unclear.
Serum was collected from women aged 35 to 60 years in the HPV in Perimenopause cohort and evaluated for antibodies to 8 HPV types. Demographic and behavioral data were collected by telephone questionnaire. Associations between sexual behaviors, race, age, HPV serostatus, and strength of serologic response to HPV were evaluated.
There were 781 women in this analysis, including 620 white (79%) and 161 (21%) black women. Whites were less likely to report 5+ vaginal sex partners (prevalence ratio [PR], 0.86; 95% confidence interval [CI], 0.77-0.97), but more likely to report 5+ oral sex partners (PR, 2.38; 95% CI, 1.62-3.49) compared with blacks. Seropositivity to most individual HPV types and at least 3 types was significantly lower in whites than in blacks (PR, 0.62; 95% CI, 0.47-0.80). Human papillomavirus seropositivity was independently associated with younger age among blacks, but with sexual exposures among whites. Furthermore, strength of serologic response to most HPV types significantly decreased with older age among blacks, but not among whites.
Racial differences in immune markers of HPV exposure and the epidemiology of HPV-related cancers may be linked to differences in patterns of sexual behaviors.
人乳头瘤病毒(HPV)可引发口咽癌和宫颈癌。口咽癌主要影响白人,但宫颈癌在黑人中更为常见。这种独特流行病学现象的原因尚不清楚。
从围绝经期HPV队列研究中35至60岁的女性中收集血清,并评估其针对8种HPV类型的抗体。通过电话问卷收集人口统计学和行为数据。评估性行为、种族、年龄、HPV血清学状态以及对HPV血清学反应强度之间的关联。
本分析纳入781名女性,其中620名(79%)为白人,161名(21%)为黑人女性。与黑人相比,白人报告有5个以上阴道性伴侣的可能性较小(患病率比[PR],0.86;95%置信区间[CI],0.77 - 0.97),但报告有5个以上口交性伴侣的可能性较大(PR,2.38;95% CI,1.62 - 3.49)。白人对大多数单一HPV类型以及至少3种类型的血清阳性率显著低于黑人(PR,0.62;95% CI,0.47 - 0.80)。HPV血清阳性在黑人中与较年轻的年龄独立相关,但在白人中与性接触相关。此外,黑人中对大多数HPV类型的血清学反应强度随年龄增长显著降低,但白人中并非如此。
HPV暴露免疫标志物的种族差异以及HPV相关癌症的流行病学可能与性行为模式的差异有关。