Hernández-López Omar, González-Contreras Brenda Clara, Cano-Díaz Ana Luz, Mata-Marín José Antonio, Pompa-Mera Ericka Nelly, Noyola-Gómez Javier Vicente, Triana-González Salma, Padilla-Noguera Paola Edith, Chaparro-Sánchez Alberto, García-Gutiérrez Sócrates Alberto, Barriga-Angulo Gustavo, Gaytan-Martinez Jesús Enrique
Infectious Diseases Department, Hospital de Infectología "La Raza", National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico.
Medicine School, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico.
Viruses. 2025 Aug 21;17(8):1147. doi: 10.3390/v17081147.
Human papillomavirus (HPV) significantly contributes to anogenital cancers, with elevated risks among people living with HIV (PWH), particularly men who have sex with men (MSM). This study assessed anal HPV prevalence and associated risk factors in PWH in Mexico, focusing on the role of antiretroviral therapy (ART). A cross-sectional study at an HIV clinic in Mexico City (October 2023-December 2024) enrolled 214 MSM with HIV. The participants completed a validated risk factor questionnaire and provided anal samples for real-time PCR testing of 28 HPV genotypes. Logistic regression analyzed associations between HPV infection, ART regimens, and clinical/behavioral factors. HPV prevalence was 89.3%, with HPV-16 (20.1%) being the most common high-risk genotype. Integrase inhibitor (INSTI) use was inversely associated with HPV-16 infection (OR: 0.42; 95% CI: 0.21-0.83; = 0.011), while protease inhibitor use increased HPV-16 (OR: 2.16; 95% CI: 1.09-4.29; = 0.025) and HPV-6 risks. Higher CD4+ counts (≥500 cells/mm) and undetectable HIV viral load (<40 copies/mL) were protective against multiple HPV genotypes. Lower education and smoking increased HPV risk. This first Mexican study in the ART and HPV vaccination era highlights high anal HPV prevalence in PWH and suggests that INSTI-based regimens may reduce HPV-16 risk, informing ART selection for HPV prevention.
人乳头瘤病毒（HPV）是导致肛门生殖器癌的重要因素，在人类免疫缺陷病毒（HIV）感染者（PWH）中风险更高，尤其是男男性行为者（MSM）。本研究评估了墨西哥PWH人群的肛门HPV感染率及相关风险因素，重点关注抗逆转录病毒疗法（ART）的作用。在墨西哥城一家HIV诊所开展的一项横断面研究（2023年10月至2024年12月）纳入了214名感染HIV的MSM。参与者完成了一份经过验证的风险因素问卷，并提供肛门样本用于对28种HPV基因型进行实时PCR检测。采用逻辑回归分析HPV感染、ART治疗方案与临床/行为因素之间的关联。HPV感染率为89.3%，其中HPV-16（20.1%）是最常见的高危基因型。使用整合酶抑制剂（INSTI）与HPV-16感染呈负相关（OR：0.42；95%CI：0.21-0.83；P = 0.011），而使用蛋白酶抑制剂会增加HPV-16（OR：2.16；95%CI：1.09-4.29；P = 0.025）和HPV-6感染风险。较高的CD4+细胞计数（≥500个细胞/mm³）和无法检测到的HIV病毒载量（<40拷贝/mL）对多种HPV基因型具有保护作用。较低的教育水平和吸烟会增加HPV感染风险。这项在ART和HPV疫苗接种时代开展的墨西哥首项研究凸显了PWH人群中肛门HPV的高感染率，并表明基于INSTI的治疗方案可能会降低HPV-16感染风险，为预防HPV的ART选择提供了依据。
