美国成年男性人群中生殖器人乳头瘤病毒感染和人乳头瘤病毒疫苗接种率的流行情况：2013-2014 年国家健康和营养检查调查（NHANES）。
Prevalence of Genital Human Papillomavirus Infection and Human Papillomavirus Vaccination Rates Among US Adult Men: National Health and Nutrition Examination Survey (NHANES) 2013-2014.
机构信息
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Womack Army Medical Center, Fort Bragg, North Carolina.
Department of Clinical Investigation, Womack Army Medical Center, Fort Bragg, North Carolina.
出版信息
JAMA Oncol. 2017 Jun 1;3(6):810-816. doi: 10.1001/jamaoncol.2016.6192.
IMPORTANCE
Human papillomavirus (HPV) is a common sexually transmitted infection that is a major cause of noncervical anogenital and oropharyngeal cancers. Prophylactic HPV vaccine is available for primary prevention. However, the population prevalence data for male genital HPV infection is not well known, while the HPV vaccination coverage is low in the United States.
OBJECTIVES
To estimate the prevalence of genital HPV infection and the HPV vaccination rate in the United States among adult men and to examine potential risk factors for HPV infection.
DESIGN, SETTING, AND PARTICIPANTS: The National Health and Nutrition Examination Survey (NHANES) samples a representative cross-section of the US population. Men aged 18 to 59 years were examined in mobile examination centers during the NHANES 2013-2014. DNA was extracted from self-collected penile swab specimens, and HPV genotyping was performed by polymerase chain reaction amplification. Demographic and vaccination information was gathered via self-report during home-based standardized interviews. Binary multivariable logistic regression was used to estimate the odds of HPV infection.
MAIN OUTCOMES AND MEASURES
The prevalence of genital HPV infection and the HPV vaccination coverage rate among adult men.
RESULTS
During the NHANES 2013-2014, a total of 1868 men aged 18 to 59 years were examined. The overall genital HPV infection prevalence was 45.2% (95% CI, 41.3%-49.3%). The infection prevalence with at least 1 high-risk HPV subtype defined by DNA testing was 25.1% (95% CI, 23.0%-27.3%). In vaccine-eligible men, the prevalence of infection with at least 1 HPV strain targeted by the HPV 4-valent vaccine and HPV 9-valent vaccine was 7.1% (95% CI, 5.1%-9.5%) and 15.4% (95% CI, 11.7%-19.6%), respectively. Among vaccine-eligible men, the HPV vaccination coverage was 10.7% (95% CI, 7.8%-14.6%).
CONCLUSIONS AND RELEVANCE
Among men aged 18 to 59 years in the United States, the overall prevalence of genital HPV infection was 45.2% (95% CI, 41.3%-49.3%). The overall genital HPV infection prevalence appears to be widespread among all age groups of men, and the HPV vaccination coverage is low.
重要性
人乳头瘤病毒（HPV）是一种常见的性传播感染，是导致非宫颈肛门生殖器和口咽癌的主要原因。预防性 HPV 疫苗可用于初级预防。然而，美国男性生殖器 HPV 感染的人群流行率数据并不清楚，而 HPV 疫苗接种率很低。
目的
估计美国成年男性生殖器 HPV 感染的流行率和 HPV 疫苗接种率，并探讨 HPV 感染的潜在危险因素。
设计、地点和参与者：国家健康和营养检查调查（NHANES）样本是美国人口的代表性横断面。18 至 59 岁的男性在 NHANES 2013-2014 年期间在移动检查中心接受检查。从自我采集的阴茎拭子标本中提取 DNA，并通过聚合酶链反应扩增进行 HPV 基因分型。通过家庭为基础的标准化访谈中的自我报告收集人口统计学和疫苗接种信息。使用二元多变量逻辑回归估计 HPV 感染的几率。
主要结果和措施
成年男性生殖器 HPV 感染的流行率和 HPV 疫苗接种率。
结果
在 NHANES 2013-2014 年期间，共检查了 1868 名 18 至 59 岁的男性。总生殖器 HPV 感染流行率为 45.2%（95%CI，41.3%-49.3%）。至少有一种 DNA 检测定义的高危 HPV 亚型的感染流行率为 25.1%（95%CI，23.0%-27.3%）。在可接种疫苗的男性中，至少有一种 HPV 4 价疫苗和 HPV 9 价疫苗针对的 HPV 株感染的流行率分别为 7.1%（95%CI，5.1%-9.5%）和 15.4%（95%CI，11.7%-19.6%）。在可接种疫苗的男性中，HPV 疫苗接种率为 10.7%（95%CI，7.8%-14.6%）。
结论和相关性
在美国 18 至 59 岁的男性中，生殖器 HPV 感染的总流行率为 45.2%（95%CI，41.3%-49.3%）。所有年龄段男性的总生殖器 HPV 感染流行率似乎都很普遍，而 HPV 疫苗接种率很低。
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