Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta.
Synergy America, Inc., Duluth.
Clin Infect Dis. 2019 Aug 30;69(6):1011-1018. doi: 10.1093/cid/ciy1002.
Differences in human papillomavirus (HPV) seroprevalence by sex have been observed, likely due to differences in the anatomic site of HPV exposure. Seroconversion may be more likely after exposure at nonkeratinized (mucosal) compared to keratinized epithelium. We compared seroprevalence among self-identified gay/bisexual men who have sex with men (MSM) and females, 2 groups more likely exposed at mucosal epithelium, and men who only have sex with women (MSW), a group likely exposed primarily at keratinized epithelium, using data from the National Health and Nutrition Examination Survey from 2003 to 2010.
HPV 6/11/16/18 serum antibody was detected using a multiplexed, competitive luminex immunoassay. Weighted seroprevalence was estimated among unvaccinated, sexually experienced 18-59 year-old MSM, MSW, and females, overall and by demographic and sexual behavior characteristics. Seroprevalences were compared using prevalence ratios adjusted for sexual behavior (aPRs).
Overall, seroprevalence in MSM, MSW, and females was 42.6%, 13.2%, and 37.1%, respectively. Seroprevalence in MSM was comparable to females (aPR: 0.85, 95% confidence interval [CI]: 0.68-1.08) and higher than MSW (aPR: 2.72, 95% CI: 2.19-3.38). MSW had a significantly lower seroprevalence than females (aPR: 0.31, 95% CI: 0.28-0.34). Similar associations were seen in all sociodemographic subgroups. Seroprevalence increased with number of lifetime sex partners in all groups.
In this population-based survey, HPV seroprevalence among groups likely exposed at mucosal epithelium (MSM, females) was comparable; seroprevalence in both groups was higher than in MSW. Future research could explore whether differences in seropositivity following infection result in differential protection from future infection.
已观察到 HPV 血清阳性率在性别上存在差异，这可能归因于 HPV 暴露部位的解剖学差异。与角化上皮相比，非角化（黏膜）部位的 HPV 暴露后更可能发生血清转化。我们比较了自认为是男男性行为者（MSM）和女性的 HPV 血清阳性率，这两组人群更有可能在黏膜上皮暴露，以及只与女性发生性行为的男性（MSW），后者更有可能主要在角化上皮暴露，数据来自 2003 年至 2010 年的全国健康与营养调查。
使用多重竞争 Luminex 免疫分析检测 HPV 6/11/16/18 血清抗体。在未接种疫苗、有性行为经验的 18-59 岁 MSM、MSW 和女性中，按人口统计学和性行为特征，对 HPV 血清阳性率进行加权估计。采用性行为调整的优势比（aPRs）比较血清阳性率。
总体而言，MSM、MSW 和女性的血清阳性率分别为 42.6%、13.2%和 37.1%。MSM 的血清阳性率与女性相当（aPR：0.85，95%置信区间 [CI]：0.68-1.08），高于 MSM（aPR：2.72，95% CI：2.19-3.38）。MSW 的血清阳性率明显低于女性（aPR：0.31，95% CI：0.28-0.34）。在所有社会人口统计学亚组中均观察到类似的关联。在所有组中，血清阳性率随终生性伴侣数量的增加而增加。
在这项基于人群的调查中，黏膜上皮暴露（MSM、女性）可能性较大的人群的 HPV 血清阳性率相似；两组的血清阳性率均高于 MSM。未来的研究可以探索感染后血清阳性率的差异是否导致对未来感染的保护作用不同。
