Pils Sophie, Mlakar Jana, Poljak Mario, Domjanič Grega Gimpelj, Kaufmann Ulrike, Springer Stephanie, Salat Andreas, Langthaler Eva, Joura Elmar A
Department of Obstetrics and Gynaecology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia.
EClinicalMedicine. 2022 Oct 12;54:101702. doi: 10.1016/j.eclinm.2022.101702. eCollection 2022 Dec.
There is limited data on human papillomaviruses (HPV) prevalence in transpeople due to low acceptance rate of screening methods. HPV tests from self-collected urine are gender-neutral, have a high acceptance, and have a comparable accuracy in females to clinician-collected samples. The aim of this study was to evaluate both the HPV prevalence in the urine in a large cohort of 200 transpeople with common risk profiles and the acceptability of such screening method.
The study was conducted at the outpatient clinic for transpeople at the Department of Obstetrics and Gynaecology, Medical University of Vienna, Austria. 200 transpeople have been enrolled between May and October 2021. Inclusion criteria were gender identity dysphoria, age over 18 years, and adequate language skills.Subjects were asked to answer a survey concerning gender identity, established risk factors for HPV infections as well as their preference regarding urine or provider-collected cytology-/HPV-based screening, and to provide a urine sample. Five patients not able to provide urine were excluded. HPV genotyping was performed using a validated multiplex real-time PCR assay, which simultaneously detects 28 HPV genotypes. This trial is registered at ClinicalTrials.gov, NCT04864951.
Overall HPV positivity was 19·0% (37/195), 24·2% in female to male, 11·8% in male to female, 26·3% in genderqueer/non binary/other subjects, 27·9% in subjects currently having a cervix, and 26·0% in subjects born with cervix. Independent of gender reassignment surgery, being born with a cervix was associated with a higher risk of HPV infections ( = 0·008), yet 42·3% (44/104) have never attended cervical cancer screening. Overall, 79·0% (154/195) of transpeople would prefer urine HPV tests to provider-collected HPV screening.
HPV testing in self-collected urine samples provides a unique opportunity for screening of this hard-to-reach population and should be evaluated in further studies.
None.
由于筛查方法的接受率较低，关于跨性别者中人乳头瘤病毒（HPV）流行率的数据有限。自行采集尿液进行HPV检测具有性别中立性，接受度高，在女性中与临床医生采集的样本具有相当的准确性。本研究的目的是评估200名具有常见风险特征的跨性别者大样本队列中尿液中的HPV流行率以及这种筛查方法的可接受性。
该研究在奥地利维也纳医科大学妇产科跨性别者门诊进行。2021年5月至10月招募了200名跨性别者。纳入标准为性别认同障碍、年龄超过18岁以及具备足够的语言能力。受试者被要求回答一份关于性别认同、HPV感染既定风险因素以及他们对尿液或医疗服务提供者采集的基于细胞学/HPV的筛查的偏好的调查问卷，并提供一份尿液样本。排除5名无法提供尿液的患者。使用经过验证的多重实时PCR检测法进行HPV基因分型，该方法可同时检测28种HPV基因型。本试验已在ClinicalTrials.gov注册，注册号为NCT04864951。
总体HPV阳性率为19.0%（37/195），女性向男性转变者中为24.2%，男性向女性转变者中为11.8%，性别酷儿/非二元性别/其他受试者中为26.3%，目前有子宫颈的受试者中为27.9%，出生时即有子宫颈的受试者中为26.0%。与性别重置手术无关，出生时即有子宫颈与HPV感染风险较高相关（P = 0.008），然而42.3%（44/104）的人从未参加过宫颈癌筛查。总体而言，79.0%（154/195）的跨性别者更喜欢尿液HPV检测而非医疗服务提供者采集的HPV筛查。
自行采集尿液样本进行HPV检测为筛查这一难以触及的人群提供了独特机会，应在进一步研究中进行评估。
无。
