中国南方三个大城市男男性行为者中的肛门人乳头瘤病毒：对人乳头瘤病毒疫苗接种的启示

Anal human papillomavirus among men who have sex with men in three metropolitan cities in southern China: implications for HPV vaccination.

作者信息

Zhou Yiguo, Lin Yi-Fan, Meng Xiaojun, Duan Qibin, Wang Zhenyu, Yang Bin, Zheng Heping, Li Peiyang, Li Meijuan, Lu Yong, Luo Zhenzhou, Zou Huachun

机构信息

School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.

School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China; School of Mathematical and Physical Sciences/Statistics, The University of Newcastle, Callaghan, Australia.

出版信息

Vaccine. 2020 Mar 17;38(13):2849-2858. doi: 10.1016/j.vaccine.2020.02.009. Epub 2020 Feb 20.

DOI:10.1016/j.vaccine.2020.02.009

PMID:32088017

Abstract

INTRODUCTION

Men who have sex with men (MSM), especially those infected with human immunodeficiency virus (HIV), are at disproportionate risk for human papillomavirus (HPV) infection. Data about anal HPV prevalence among MSM in southern China are limited.

METHODS

MSM were recruited between January 1 and August 31, 2017 in three metropolitan cities: Guangzhou, Shenzhen and Wuxi. A self-completed tablet-based questionnaire was used to collect information about socio-demographic/sexual behavioral characteristics, history of sexually transmitted infections (STIs) and recreational drug use. An anal brush was used to collect exfoliated cells for HPV DNA testing and genotyping, and a blood sample was taken for HIV testing. Penile/anal warts were checked by a clinician.

RESULTS

A total of 536 MSM were enrolled, including 39 HIV-positive and 497 HIV-negative individuals. Compared with HIV-negative MSM, prevalence of any HPV genotype (79.5% vs 46.7%), any high-risk genotype (64.1% vs 36.6%) and any nonavalent vaccine-preventable genotype (53.9% vs 31.6%) was significantly higher in HIV-positive MSM, with all P < 0.01. HIV infection (adjusted odds ratio [AOR], 4.28; 95% confidence interval [CI], 1.87-9.80), using recreational drugs (AOR, 1.87; 95% CI, 1.22-2.87), having ≥ 3 years of sexual experience (AOR, 1.52; 95% CI, 1.01-2.28), having ≥ 6 lifetime male partners (AOR, 1.92; 95% CI, 1.29-2.86), and engaging receptive anal intercourse (AOR, 2.30; 95% CI, 1.48-3.57) were associated with higher anal HPV prevalence. Any HPV prevalence increased with age, from 24.5% at < 20 years to 55.8% at ≥ 40 years.

CONCLUSIONS

Anal HPV prevalence was high among MSM in southern China, significantly associated with HIV status and sexual experience. HPV prevalence increased with age among MSM. A targeted HPV vaccination program for teenage MSM might be necessary. Our findings will inform targeted HPV modelling among MSM in China.

摘要

引言

男男性行为者（MSM），尤其是感染人类免疫缺陷病毒（HIV）的男男性行为者，感染人乳头瘤病毒（HPV）的风险极高。中国南方地区男男性行为者肛门HPV感染率的数据有限。

方法

2017年1月1日至8月31日期间，在广州、深圳和无锡三个大城市招募男男性行为者。采用基于平板电脑的自填问卷收集社会人口学/性行为特征、性传播感染（STIs）病史和娱乐性药物使用情况等信息。使用肛门刷收集脱落细胞进行HPV DNA检测和基因分型，并采集血样进行HIV检测。由临床医生检查阴茎/肛门疣。

结果

共纳入536名男男性行为者，其中39名HIV阳性，497名HIV阴性。与HIV阴性的男男性行为者相比，HIV阳性的男男性行为者中任何HPV基因型（79.5%对46.7%）、任何高危基因型（64.1%对36.6%）和任何九价疫苗可预防基因型（53.9%对31.6%）的感染率均显著更高，所有P<0.01。HIV感染（调整比值比[AOR]，4.28；95%置信区间[CI]，1.87 - 9.80）、使用娱乐性药物（AOR，1.87；95% CI，1.22 - 2.87）、有≥3年性经验（AOR，1.52；95% CI，1.01 - 2.28）、一生中男性性伴侣≥6个（AOR，1.92；95% CI，1.29 - 2.86）以及进行肛交（AOR，2.30；95% CI，1.48 - 3.57）与肛门HPV感染率较高相关。任何HPV感染率随年龄增长而升高，从<20岁时的24.5%升至≥40岁时的55.8%。