From the Institute of Human Virology.
University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD.
Sex Transm Dis. 2022 Apr 1;49(4):297-303. doi: 10.1097/OLQ.0000000000001587.
Multiple anal human papillomavirus (HPVs) may increase the risk of anal cancer among men who have sex with men (MSM) living with human immunodeficiency virus (HIV). The Jaccard Similarity Index (JSI) was explored as a measure of multiple HPV persistence.
The TRUST/RV368 cohort enrolled MSM living with and without HIV in Abuja and Lagos, Nigeria. Participants with anal swabs at baseline, 3- and 12-month visits were tested for high- and low-risk HPVs using a next-generation sequencing assay. Persistence of the same HPV genotypes over time was calculated using the JSI and categorized into high, medium, and low similarity tertiles. Factors associated with higher versus lower similarity were estimated with multivariable ordinal logistic regression and reported as adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Of the 225 participants, median age was 25 years (interquartile range, 22-29 years), 62% were living with HIV, median HPVs was 3 (interquartile range, 2-5), and HPV6 (28%), HPV16 (26%), HPV11 (23%), and HPV45 (20%) were most prevalent. Fifty-three percent of participants had highly similar HPVs at 3 months, and the similarity was associated with HIV (aOR, 3.11; 95% CI, 1.6-5.9) and recent receptive sex (aOR, 1.9; 95% CI, 1.0-3.5). By 12 months, 20% had highly similar HPVs, and it was associated with 12 years or longer since anal coital debut (aOR, 6.8; 95% CI, 3.1-5.2), self-reported genital warts (aOR, 3.1; 95% CI, 1.5-6.6), and 200 or less CD4 cells/mm3 (aOR, 13.3; 95% CI, 2.7-65.2) for those living with HIV.
Studies evaluating the JSI as a predictor of high-grade intraepithelial lesions would further confirm its applicability as a quantitative measure of multiple HPV persistence.
多重肛门人乳头瘤病毒（HPV）可能会增加感染人类免疫缺陷病毒（HIV）的男男性行为者（MSM）发生肛门癌的风险。Jaccard 相似指数（JSI）被探索作为衡量多重 HPV 持续性的指标。
TRUST/RV368 队列招募了在尼日利亚阿布贾和拉各斯感染和未感染 HIV 的 MSM。基线、3 个月和 12 个月时进行肛门拭子检测，采用下一代测序检测高危和低危 HPV。使用 JSI 计算同一 HPV 基因型随时间的持续性，并分为高、中、低相似性三分位。使用多变量有序逻辑回归估计与较高相似性相比，与较低相似性相关的因素，并报告为调整后的优势比（aOR）和 95%置信区间（CI）。
在 225 名参与者中，中位年龄为 25 岁（四分位间距，22-29 岁），62%感染 HIV，中位 HPV 为 3（四分位间距，2-5），HPV6（28%）、HPV16（26%）、HPV11（23%）和 HPV45（20%）最为常见。53%的参与者在 3 个月时 HPV 高度相似，这种相似性与 HIV（aOR，3.11；95%CI，1.6-5.9）和最近接受性肛交（aOR，1.9；95%CI，1.0-3.5）有关。12 个月时，20%的参与者 HPV 高度相似，与肛交开始 12 年或更长时间（aOR，6.8；95%CI，3.1-5.2）、自述生殖器疣（aOR，3.1；95%CI，1.5-6.6）和 HIV 感染者 200 个或更少的 CD4 细胞/mm3（aOR，13.3；95%CI，2.7-65.2）有关。
评估 JSI 作为高级别上皮内瘤变预测因子的研究将进一步证实其作为多重 HPV 持续性定量测量指标的适用性。
