根据性取向和 HIV 状况划分的男性特定型别人类乳头瘤病毒感染率：系统文献复习和荟萃分析。

Type-Specific Anal Human Papillomavirus Prevalence Among Men, According to Sexual Preference and HIV Status: A Systematic Literature Review and Meta-Analysis.

机构信息

Department of Infectious Diseases, Public Health Service Amsterdam, the Netherlands.

International Agency for Research on Cancer, Lyon, France.

出版信息

J Infect Dis. 2019 Jan 29;219(4):590-598. doi: 10.1093/infdis/jiy556.

DOI:10.1093/infdis/jiy556

PMID:30239749

Abstract

BACKGROUND

Anal human papillomavirus (HPV) infection, most notably HPV16, the central cause of anal cancer, is increased by anal sexual intercourse and worsened by human immunodeficiency virus (HIV)-positivity.

METHODS

A systematic review and meta-analysis of type-specific anal HPV prevalence in men, compared according to sexual preference, HIV status, and, when available, anal cytopathology.

RESULTS

Seventy-nine eligible studies included: 1805 HIV-negative men who have sex with women (MSW), 924 HIV-positive MSW, 8213 HIV-negative men who have sex with men (MSM), and 12758 HIV-positive MSM. Irrespective of anal cytopathology, HPV16 prevalence was significantly higher in MSM than MSW, both among HIV-negative (14% vs 3%; prevalence ratio (PR) 4.7; 95% confidence interval [CI] 2.5-8.9) and HIV-positive men (30% vs 11%; PR = 2.8; 95% CI, 1.9-4.1). Likewise, HPV16 was significantly higher in HIV-positive than HIV-negative men, both among MSW (PR = 3.5; 95% CI, 1.6-7.7) and MSM (PR = 2.1; 95% CI, 1.8-2.5). Anal HPV16 prevalence was similar between HIV-positive MSW and HIV-negative MSM. For MSM, anal HPV16 prevalence was significantly higher from studies with anal cytopathology, suggesting population sampling effects.

CONCLUSION

Sexual preference and HIV infection are independent strong determinants of male anal HPV16 infection, confirming HIV-positive MSM as priorities for anal cancer prevention.

摘要

背景

肛门人乳头瘤病毒（HPV）感染，尤其是肛门癌的主要病因 HPV16，因肛门性行为而增加，并因人类免疫缺陷病毒（HIV）阳性而恶化。

方法

对男性特定型别肛门 HPV 流行率进行了系统回顾和荟萃分析，根据性取向、HIV 状态以及在可行的情况下，根据肛门细胞学病理进行了比较。

结果

79 项符合条件的研究包括：1805 名 HIV 阴性的与女性发生性行为的男性（MSW）、924 名 HIV 阳性的 MSW、8213 名 HIV 阴性的与男性发生性行为的男性（MSM）和 12758 名 HIV 阳性的 MSM。无论肛门细胞学病理如何，MSM 中 HPV16 的流行率均明显高于 MSW，在 HIV 阴性男性中（14%对 3%；流行率比（PR）4.7；95%置信区间 [CI]2.5-8.9）和 HIV 阳性男性中（30%对 11%；PR=2.8；95%CI，1.9-4.1）。同样，在 HIV 阳性男性中，HPV16 的流行率明显高于 HIV 阴性男性，在 MSW 中（PR=3.5；95%CI，1.6-7.7）和 MSM 中（PR=2.1；95%CI，1.8-2.5）。HIV 阳性的 MSW 与 HIV 阴性的 MSM 之间的肛门 HPV16 流行率相似。对于 MSM，有肛门细胞学病理的研究中，肛门 HPV16 流行率明显较高，表明人群抽样效应。