Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA.
Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
J Infect Dis. 2021 Apr 23;223(8):1400-1409. doi: 10.1093/infdis/jiaa519.
Oropharyngeal cancers associated with high-risk human papillomavirus (HR-HPV) infection are increasing in the United States, especially among men. We evaluated the prevalence and predictors of concurrent (genital and oral) and concordant (same-type) HR-HPV infections in the United States.
We used the National Health and Nutrition Examination Survey from 2009 to 2016. Predictors were assessed via multivariable logistic regression.
Among 10 334 respondents, 172 (2.1%) had concurrent infections (109 [3.5%] men and 63 [0.76%] women]. Ninety-three (1.0%) had concordant infections (54 [1.6%] men and 39 [0.5%] women). Predictors of concurrence in men included the following: no longer married versus married (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.3-4.9), living with a partner versus married (3.0; 1.2-7.5), and having 2-5 lifetime oral sex partners (3.0; 1.2-7.5). In women they included the following: no longer married versus married (3.6; 1.3-10.3), ≥2 recent sex partners (4.6; 1.4-15.6 for 2-5 partners and 3.9; 1.1-14.3 for ≥6 partners), and marijuana use (2.2; 1.0-4.5). The predictor of concordance in men and women was no longer married versus married (3.5; 1.2-9.9 in men and 3.2; 1.1-9.4 in women).
Concurrent and concordant HR-HPV infections occur at a high rate, especially among men, and are associated with behavioral factors. This underscores the importance of HPV vaccination, screening, and education in men.
与高危型人乳头瘤病毒（HR-HPV）感染相关的口咽癌在美国的发病率不断上升，尤其是在男性中。我们评估了美国同时（生殖器和口腔）和一致（同型）HR-HPV 感染的流行率和预测因素。
我们使用了 2009 年至 2016 年的全国健康和营养调查数据。通过多变量逻辑回归评估了预测因素。
在 10334 名受访者中，172 人（2.1%）同时患有感染（109 名男性[3.5%]和 63 名女性[0.76%]）。93 人（1.0%）患有一致感染（54 名男性[1.6%]和 39 名女性[0.5%]）。男性同时感染的预测因素包括：与已婚相比，未婚（比值比[OR]，2.3；95%置信区间[CI]，1.3-4.9），与伴侣同居而非已婚（3.0；1.2-7.5），以及有 2-5 个终生口腔性伴侣（3.0；1.2-7.5）。在女性中，这些因素包括：与已婚相比，未婚（3.6；1.3-10.3），最近有≥2 个性伴侣（2-5 个性伴侣为 4.6；1.4-15.6，≥6 个性伴侣为 3.9；1.1-14.3），以及使用大麻（2.2；1.0-4.5）。男性和女性一致感染的预测因素是与已婚相比，未婚（男性为 3.5；1.2-9.9，女性为 3.2；1.1-9.4）。
同时和一致的 HR-HPV 感染发生率很高，尤其是在男性中，且与行为因素有关。这突显了 HPV 疫苗接种、筛查和男性教育的重要性。
