葡萄牙肛门生殖器疣人乳头瘤病毒的流行病学 - HERCOLES 研究。

Epidemiology of human papillomavirus on anogenital warts in Portugal - The HERCOLES study.

机构信息

Centro de Saúde da Lapa, Consulta DST, Lisboa, Portugal.

Investigador Independente, Lisboa, Portugal.

出版信息

J Eur Acad Dermatol Venereol. 2017 Aug;31(8):1342-1348. doi: 10.1111/jdv.14311. Epub 2017 Jun 6.

DOI:10.1111/jdv.14311

PMID:28485812

Abstract

BACKGROUND

Anogenital warts (AGW) are one of the most prevalent sexually transmitted disease worldwide. Approximately, 90% of AGWs are related to infection by HPV 6 and 11. However, AGW have been associated with infection by multiple genotypes, including HR-HPV, which may be associated with a long-term increased risk of anogenital cancer.

OBJECTIVE

This observational prospective epidemiological study aims to estimate the type-specific HPV distribution on incident AGWs in both genders, and additionally to assess the frequency of anal and oral HPV infection in patients with AGWs.

METHODS

According to defined inclusion criteria, individuals with incident clinical diagnosis of AGWs were recruited in seven Portuguese Centres. HPV genotyping was performed using CLART HPV2 test.

RESULTS

Between November 2012 and March 2014, 162 women and 400 men (mean age: 34 years), were enrolled. After exclusion of patients with unqualified AGW samples, HPV was detected in 95.3% (505/530) AGW patients, 96.8% males and 91.6% females. Among men who have sex with men, HPV was detected in 98.5% patients. HPV 6 and/or HPV 11 were the most frequent genotypes (87.5%), and HPV 16 the most common HR-HPV (9.2%). Infection with HPV 6/11 and any HR-HPV was observed in 35.8% patients. HPV prevalence on the anal canal and oral mucosa was 83.1% and 15.0%, respectively.

CONCLUSION

Incident AGWs were more frequent in males than in females. LR-HPVs were more common among males and HR-HPVs among females. HPV 6 and 11 were the most common genotypes on both genders. However, there was also a high prevalence of HR-HPVs, particularly of HPV 16. AGWs represent a clinical marker of both anal and oral HPV infections, including anal HR-HPV infections in women and men who have sex with men. The HERCOLES study could be a clue to further investigations concerning HPV burden of disease by gender and sexual behaviour.

摘要

背景

肛门生殖器疣（AGW）是全球最常见的性传播疾病之一。大约 90%的 AGW 与 HPV 6 和 11 感染有关。然而，AGW 也与多种基因型感染有关，包括 HR-HPV，这可能与肛门生殖器癌的长期风险增加有关。

目的

本观察性前瞻性流行病学研究旨在估计两性新发 AGW 的 HPV 型别分布，并评估 AGW 患者肛门和口腔 HPV 感染的频率。

方法

根据明确的纳入标准，在七个葡萄牙中心招募了新发临床诊断为 AGW 的个体。使用 CLART HPV2 检测进行 HPV 基因分型。

结果

2012 年 11 月至 2014 年 3 月期间，纳入了 162 名女性和 400 名男性（平均年龄：34 岁）。排除 AGW 样本不合格的患者后，530 例 AGW 患者中 HPV 检出率为 95.3%（505/530），男性为 96.8%，女性为 91.6%。男男性接触者中，HPV 检出率为 98.5%。最常见的基因型为 HPV 6 和/或 HPV 11（87.5%），最常见的 HR-HPV 为 HPV 16（9.2%）。35.8%的患者感染 HPV 6/11 和任何 HR-HPV。肛门和口腔黏膜的 HPV 流行率分别为 83.1%和 15.0%。

结论

新发 AGW 在男性中比女性更常见。LR-HPV 在男性中更常见，而 HR-HPV 在女性中更常见。HPV 6 和 11 是两性中最常见的基因型。然而，HR-HPV 的流行率也很高，尤其是 HPV 16。AGW 是肛门和口腔 HPV 感染的临床标志物，包括女性和男男性接触者的肛门 HR-HPV 感染。HERCOLES 研究可能为进一步研究按性别和性行为划分的 HPV 疾病负担提供线索。