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意大利北部一个多民族地区,宫颈癌高发,为研究 HIV 阴性男性中沙眼衣原体和 HPV 共同感染情况。

Chlamydia trachomatis and HPV co-infections in HIV negative men from a multi-ethnic area of Northern Italy at high prevalence of cervical malignancies.

机构信息

Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.

University of Trieste, Trieste, Italy.

出版信息

J Med Virol. 2017 Sep;89(9):1654-1661. doi: 10.1002/jmv.24811. Epub 2017 Apr 26.

Abstract

Chlamydia trachomatis and HPV coinfections in the male population are often a disregarded issue. We performed a study to evaluate the prevalence of such infections in heterosexual HIV negative men from a Northern Italy multi-ethnic area at high prevalence for cervical malignancies. Urethral swabs (US) or first-voided urine were evaluated retrospectively from 1317 patients attending Sexually Transmitted Infections (STI) clinic and from 3388 outpatients attending private clinics. Informations about participants' demographic characteristics and attributes of C. trachomatis, including chronic infection, and HPV genotypes testing, were collected. Exact Fisher test, bivariate, and multivariate logistic regressions were carried out. The prevalence of C. trachomatis was 1.7% in the outpatients and 16.9% in the STI group (P < 0.0001) in which the highest frequency was observed in men of age ≤25 years. Among patients with C. trachomatis, asymptomatic HPV co-infection was detected in 33% of men from the STI clinic and in 2% of the outpatients. Out of all coinfections, 56% were due to single HPV, with a prevalence of 73% in young STI men. The distribution of HPV genotypes confirmed the increased circulation of LR-HPV42, HR-HPV51, HR-HPV52 and prHR-HPV82, and the decreasing of HR-HPV16. African nationalities and leucorrhea were significantly associated risk factors, while the regular condom use offered an effective protection. This study highlights the high prevalence of C. trachomatis and HPV asymptomatic co-infection in young HIV negative men attending the STI clinic, representing a reservoir of new HPV genotypes with potential oncogenic risk.

摘要

沙眼衣原体和 HPV 合并感染在男性人群中通常被忽视。我们进行了一项研究,以评估意大利北部一个多民族地区高宫颈癌发病率的 HIV 阴性异性恋男性中这些感染的流行率。回顾性评估了 1317 名性传播感染 (STI) 门诊患者和 3388 名私人诊所门诊患者的尿道拭子 (US) 或首次排空尿液。收集了参与者的人口统计学特征和沙眼衣原体信息,包括慢性感染和 HPV 基因型检测。进行了确切 Fisher 检验、双变量和多变量逻辑回归。门诊患者中沙眼衣原体的患病率为 1.7%,STI 组为 16.9%(P<0.0001),其中≤25 岁男性的发病率最高。在患有沙眼衣原体的患者中,在 STI 门诊的 33%男性和门诊的 2%男性中检测到无症状 HPV 合并感染。在所有合并感染中,56%是由于单一 HPV 引起的,在年轻的 STI 男性中,其患病率为 73%。HPV 基因型的分布证实了 LR-HPV42、HR-HPV51、HR-HPV52 和 prHR-HPV82 的循环增加,以及 HR-HPV16 的减少。非洲国籍和白带是明显的相关危险因素,而定期使用避孕套提供了有效的保护。本研究强调了在 STI 门诊就诊的 HIV 阴性年轻男性中沙眼衣原体和 HPV 无症状合并感染的高患病率,这是具有潜在致癌风险的新 HPV 基因型的潜在传染源。

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