Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada.
J Infect Dis. 2020 Nov 9;222(11):1928-1937. doi: 10.1093/infdis/jiaa302.
Limited evidence indicates greater female-to-male (F-M) transmission of genital infection with human papillomavirus (HPV) relative to male-to-female (M-F). We verified the hypothesis of a differential transmission rate in couple-based studies by conducting a systematic review and meta-analysis.
We searched MEDLINE, EMBASE, Scopus, and Cochrane Library databases for studies published until December 2019. We calculated pooled estimates of F-M and M-F transmission rates and their rate differences per 100 person-months, with 95% confidence intervals (CI), using a random-effects model. We counted occurrences of directionality preponderance for each HPV type.
We identified 7 eligible studies published between 2008 and 2019, providing data for 752 couples. Pooled estimates for F-M and M-F transmission rates were 3.01 (95% CI, 1.19-7.64; I2 = 97%) and 1.60 (95% CI, 0.86-2.98; I2 = 89%), respectively. The overall rate difference was 0.61 (95% CI, -0.27 to 1.49; I2 = 75%). Three studies provided rates by sex and HPV genotype; 2 favored a preponderance of F-M and 1 favored M-F transmission.
There was slight evidence for a differential transmission rate favoring higher F-M than M-F transmission with substantial statistical heterogeneity across studies.
有限的证据表明，与男性向女性（M-F）传播相比，HPV 生殖器感染的女性向男性（F-M）传播更大。我们通过系统评价和荟萃分析验证了基于夫妻的研究中存在差异传播率的假设。
我们在 MEDLINE、EMBASE、Scopus 和 Cochrane Library 数据库中搜索了截至 2019 年 12 月发表的研究。我们使用随机效应模型计算了 F-M 和 M-F 传播率的汇总估计值及其每 100 人月的差异率，置信区间为 95%（CI）。我们计算了每种 HPV 类型的方向性优势发生率。
我们确定了 7 项发表于 2008 年至 2019 年的合格研究，为 752 对夫妇提供了数据。F-M 和 M-F 传播率的汇总估计值分别为 3.01（95% CI，1.19-7.64；I2 = 97%）和 1.60（95% CI，0.86-2.98；I2 = 89%）。总体差异率为 0.61（95% CI，-0.27 至 1.49；I2 = 75%）。三项研究按性别和 HPV 基因型提供了传播率；有 2 项研究倾向于 F-M 传播优势，1 项研究倾向于 M-F 传播。
有轻微证据表明存在差异传播率，F-M 传播率高于 M-F 传播率，但研究之间存在很大的统计异质性。
