泰国急性HIV队列中与男性发生性关系的顺性别男性和跨性别女性肛门癌相关人乳头瘤病毒感染的自然史
The natural history of anal cancer-associated human papillomavirus infection among cisgender men and transgender women who have sex with men in an acute HIV cohort in Thailand.
作者信息
Thitipatarakorn Supanat, Suriwong Sujittra, Nonenoy Siriporn, Klinsukontakul Aphakan, Makphol Jirat, Tongmuang Sumitr, Hongchookiat Piranun, Chinlaertworasiri Napasawan, Mingkwanrungruang Pravit, Sacdalan Carlo, Poltavee Kultida, Chomchey Nitiya, Pankam Tippawan, Kerr Stephen J, Ramautarsing Reshmie, Colby Donn, Teeratakulpisarn Nipat, Phanuphak Nittaya
机构信息
Institute of HIV Research and Innovation, Chamchuri Square Building 11th Floor, Unit 1109-1116, 319 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand.
SEARCH Research Foundation, Bangkok, Thailand.
出版信息
BMC Infect Dis. 2025 Aug 5;25(1):984. doi: 10.1186/s12879-025-11323-5.
INTRODUCTION
Anal cancer-associated human papillomavirus (caHPV) infection is the leading cause of anal cancer. This study describes human papillomavirus (HPV) progression among participants with acute HIV acquisition.
METHOD
Cisgender men and transgender women initiating antiretroviral therapy during acute HIV acquisition (Fiebig 1–5) underwent anal HPV testing at a sexual health clinic in Bangkok from May 2017 to June 2020. Demographic, sexual history, and laboratory data were collected at HIV diagnosis. Two-state Markov models were created to estimate probabilities and durations of HPV 16, 18/45, other caHPV, and any caHPV. Multivariate analyses were performed by adjusting for age and baseline CD4 count.
RESULTS
A total of 94 participants (median age 26 years) were enrolled. Among 92 participants with valid baseline HPV results, 15.2% had HPV 16, 15.2% had HPV 18/45, 39.1% had other caHPV, and 67.4% had any caHPV at baseline. Over 225.9 person-years (PY), incidence rates were 18.0, 13.9, 44.1, and 82.5 per 100 PY, respectively. Clearance rates were 78.9, 102.9, 93.8, and 56.4 per 100 PY, respectively. Within 2 years of HIV, probabilities of caHPV acquisition were 0.42 for HPV 16, 0.37 for HPV 18/45, 0.82 for other caHPV, and 0.96 for any caHPV. Probabilities of caHPV clearance were 0.91, 0.97, 0.97, and 0.89, respectively. Having ≥ 6 lifetime sexual partners was associated with higher HPV 16 incidence compared to fewer partners (aHR 4.80, 95% CI 1.08–21.37), after adjusting for age and baseline CD4 count.
CONCLUSION
Cancer-associated HPV acquisition remains high after acute HIV acquisition and initiation of antiretroviral therapy. Ongoing sexual health consultation, HPV vaccination, and anal cancer screening are necessary for people living with HIV.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s12879-025-11323-5.
引言
肛门癌相关的人乳头瘤病毒（caHPV）感染是肛门癌的主要病因。本研究描述了急性感染艾滋病毒参与者中人乳头瘤病毒（HPV）的进展情况。
方法
2017年5月至2020年6月期间，在曼谷一家性健康诊所，对急性感染艾滋病毒（Fiebig 1-5期）开始接受抗逆转录病毒治疗的顺性别男性和跨性别女性进行肛门HPV检测。在艾滋病毒诊断时收集人口统计学、性病史和实验室数据。创建双状态马尔可夫模型以估计HPV 16、18/45、其他caHPV和任何caHPV的概率和持续时间。通过调整年龄和基线CD4细胞计数进行多变量分析。
结果
共纳入94名参与者（中位年龄26岁）。在92名有有效基线HPV检测结果的参与者中，基线时15.2%感染HPV 16，15.2%感染HPV 18/45，39.1%感染其他caHPV，67.4%感染任何caHPV。在225.9人年期间，发病率分别为每100人年18.0、13.9、44.1和82.5。清除率分别为每100人年78.9、102.9、93.8和56.4。在感染艾滋病毒的2年内，HPV 16感染caHPV的概率为0.42，HPV 18/45为0.37，其他caHPV为0.82，任何caHPV为0.96。caHPV清除的概率分别为0.91、0.97、0.97和0.89。在调整年龄和基线CD4细胞计数后，与性伴侣较少的人相比，终身性伴侣≥6个与较高的HPV 16发病率相关（调整后风险比4.80，95%置信区间1.08-21.37）。
结论
急性感染艾滋病毒并开始抗逆转录病毒治疗后，癌症相关的HPV感染率仍然很高。对于艾滋病毒感染者，持续的性健康咨询、HPV疫苗接种和肛门癌筛查是必要的。
补充信息
在线版本包含可在10.1186/s12879-025-11323-5获取的补充材料。
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