台湾男男性行为人群肛门生殖器人乳头瘤病毒感染率、持续性和清除率：一项社区队列研究。

Incidence, persistence, and clearance of anogenital human papillomavirus among men who have sex with men in Taiwan: a community cohort study.

机构信息

School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.

Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Front Immunol. 2023 Jun 20;14:1190007. doi: 10.3389/fimmu.2023.1190007. eCollection 2023.

DOI:10.3389/fimmu.2023.1190007

PMID:37409111

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10318129/

Abstract

BACKGROUND

Men who have sex with men (MSM) have an increased risk of human papillomavirus (HPV) infection. This study aimed to assess the incidence, persistence, and clearance of anogenital HPV infections among MSM and the correlates in a 3-year community cohort study.

METHODS

From 2015 to 2019, MSM were recruited and followed up at 6, 12, 24, and 36 months in Taiwan. Questionnaires and anogenital swabs were collected at baseline and each follow-up visit. Thirty-seven HPV genotypes were tested and genotyped using the linear array HPV genotyping test. The incidence, persistence, and clearance rates of anogenital HPV infection and 95% confidence intervals (CIs) were estimated through Poisson regression. Correlates of the incidence and clearance rates were examined using a generalized estimating equations (GEE) model.

RESULTS

A total of 201 MSM were retained in the cohort study with a median age of 27 years (interquartile range [IQR]: 24-32) at baseline. The incidence, persistence, and clearance rates of any anal HPV infection among MSM were 43.6 (95% CI: 33.7-55.6), 23.4 (17.7-30.2), and 58.3 (45.1-74.1) per 1,000 person months (pms), respectively. The incidence, persistence, and clearance rates of any penile HPV infection among MSM were 26.8 (20.1-34.9), 13.4 (8.0-20.9), and 51.5 (37.8-68.5) pms, respectively. MSM who did not consistently use a condom in receptive sex (adjusted odds ratio [AOR]: 2.06, 95% CIs: 1.14-3.72) were more likely to acquire any anal HPV infection. Age at recruitment (1.05, 1.01-1.09) was positively associated with any penile HPV incidence. MSM with over one sex partner in receptive anal sex (0.53, 0.30-0.94) were less likely to clear any anal HPV infection. MSM who were unemployed/students (0.55, 0.30-0.98) were less likely to clear any penile HPV infection.

CONCLUSION

High incidence and low clearance of anogenital HPV infection among MSM in the study serve as a reminder that this population needs to be targeted for HPV vaccination. It is essential for MSM to scale up HPV screening and adhere to safe sex.

摘要

背景

男男性行为者（MSM）感染人乳头瘤病毒（HPV）的风险增加。本研究旨在评估 3 年社区队列研究中 MSM 肛门生殖器 HPV 感染的发生率、持续性和清除率，以及相关因素。

方法

2015 年至 2019 年，在台湾招募 MSM，并在 6、12、24 和 36 个月时进行随访。在基线和每次随访时收集问卷和肛门生殖器拭子。使用线性阵列 HPV 基因分型检测法检测和基因分型 37 种 HPV 基因型。通过泊松回归估计肛门生殖器 HPV 感染的发生率、持续性和清除率，并通过广义估计方程（GEE）模型检查发生率和清除率的相关因素。

结果

共 201 名 MSM 保留在队列研究中，基线时的中位年龄为 27 岁（四分位距 [IQR]：24-32）。MSM 肛门 HPV 感染的发生率、持续性和清除率分别为 43.6（95%CI：33.7-55.6）、23.4（17.7-30.2）和 58.3（45.1-74.1）/1000 人月（pms）。MSM 阴茎 HPV 感染的发生率、持续性和清除率分别为 26.8（20.1-34.9）、13.4（8.0-20.9）和 51.5（37.8-68.5）/pms。在接受性性行为中未持续使用安全套的 MSM（调整后的优势比 [AOR]：2.06，95%CI：1.14-3.72）更有可能感染肛门 HPV。招募时的年龄（1.05，1.01-1.09）与阴茎 HPV 感染的发生率呈正相关。在接受性肛交中有超过一个性伴侣的 MSM（0.53，0.30-0.94）更不可能清除任何肛门 HPV 感染。失业/学生的 MSM（0.55，0.30-0.98）更不可能清除任何阴茎 HPV 感染。