National Institute of Infectious Diseases, FIOCRUZ, Rio de Janeiro, Brazil.
San Francisco Department of Public Health, San Francisco, CA, USA.
J Int AIDS Soc. 2021 Mar;24(3):e25691. doi: 10.1002/jia2.25691.
INTRODUCTION: As the leading sexually transmitted infection worldwide, human papillomavirus (HPV) may disproportionately affect transwomen. We aimed to estimate anal HPV prevalence, especially focusing on high-risk (hr)-HPV types and evaluate their associated factors among transwomen living in Rio de Janeiro, Brazil. METHODS: Transwomen enrolled in a respondent-driven sampling (RDS)-based survey conducted between August 2015 and January 2016 self-collected anal samples, which were promptly stored at minus 80°C. After DNA extraction, HPV detection and genotyping were performed using the PapilloCheck test. We estimated HPV prevalences and evaluated the correlates of anal hr-HPV infection using a regression logistic model. RESULTS: Out of 345 transwomen, 272 (78.8%) were included in this analysis (122 [44.9%] HIV-positive). No participant had ever received HPV vaccination. Among participants enrolled, 212 (77.9%) were positive for any anal HPV type and 165 (60.7%) for hr-HPV. Most common hr-HPV were as follows: HPV16 (17.6%), HPV68 (14.7%), HPV39 (14.3%), HPV56 (12.5%), HPV51 (11.4%) and HPV52 (11.0%). HIV-positive transwomen had three times the odds of having an hr-HPV compared to HIV-negative transwomen. Participants who had a current rectal Neisseria gonorrhoeae infection had 3.7 times the odds of being coinfected with hr-HPV. Among HIV-positive transwomen, neither antiretroviral therapy use, undetectable viral load, current and nadir CD4 counts were associated with anal hr-HPV infection. CONCLUSIONS: Brazilian transwomen in our study exhibit some of the highest population-specific rates of HPV and hr-HPV. There is an urgent need to elucidate the burden of HPV infection, prevalence of HPV-related diseases and access to and uptake of HPV vaccination among transwomen, especially from low- and middle-income settings.
简介:人乳头瘤病毒(HPV)是全球主要的性传播感染病原体,可能会对跨性别女性造成不成比例的影响。我们旨在估计巴西里约热内卢跨性别女性的肛门 HPV 流行率,特别是关注高危(hr)-HPV 类型,并评估其相关因素。
方法:参与这项研究的跨性别女性通过基于应答者驱动抽样(RDS)的调查进行自我招募,于 2015 年 8 月至 2016 年 1 月期间收集肛门样本,并立即储存在零下 80°C。提取 DNA 后,使用 PapilloCheck 检测法检测和分型 HPV。我们使用回归逻辑模型估计 HPV 流行率,并评估肛门高危 HPV 感染的相关因素。
结果:在 345 名跨性别女性中,有 272 名(78.8%)符合纳入标准(122 名[44.9%]HIV 阳性)。没有参与者曾接受过 HPV 疫苗接种。在入组的参与者中,212 名(77.9%)检测到任何类型的肛门 HPV,165 名(60.7%)检测到高危 HPV。最常见的高危 HPV 包括 HPV16(17.6%)、HPV68(14.7%)、HPV39(14.3%)、HPV56(12.5%)、HPV51(11.4%)和 HPV52(11.0%)。与 HIV 阴性的跨性别女性相比,HIV 阳性的跨性别女性感染高危 HPV 的可能性是其三倍。当前患有直肠淋病奈瑟菌感染的参与者感染高危 HPV 的可能性是其三倍。在 HIV 阳性的跨性别女性中,抗逆转录病毒治疗的使用、不可检测的病毒载量、当前和最低 CD4 计数均与肛门高危 HPV 感染无关。
结论:在我们的研究中,巴西的跨性别女性具有一些最高的特定人群 HPV 和高危 HPV 流行率。迫切需要阐明 HPV 感染负担、HPV 相关疾病的流行率以及跨性别女性获得和接受 HPV 疫苗接种的情况,特别是在中低收入国家。
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