Sex- and Type-specific Genital Human Papillomavirus Transmission Rates Between Heterosexual Partners: A Bayesian Reanalysis of the HITCH Cohort.
Sex- and Type-specific Genital Human Papillomavirus Transmission Rates Between Heterosexual Partners: A Bayesian Reanalysis of the HITCH Cohort.
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DOI：
10.1097/ede.0000000000001324
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发表时间：
2021-05-01
期刊：
影响因子：
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通讯作者：
HITCH Study Group
中科院分区：
文献类型：
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作者：
Malagón T;MacCosham A;Burchell AN;El-Zein M;Tellier PP;Coutlée F;Franco EL;HITCH Study Group
目前尚不清楚人类乳头瘤病毒(HPV)的性传播率是否在性别和HPV类型之间存在差异。我们从最终的顺风车队列研究中估计更新的传播率，并提出了一种考虑间隔删失数据和感染清除的估计方法。2005年至2011年，我们在加拿大蒙特雷亚尔招募了18-24岁的年轻女性及其18岁的男性性伴侣≥。我们对女性进行了24个月的跟踪调查，对男性进行了4个月的跟踪调查。我们用线性阵列对生殖器样本进行了HPV DNA检测和基因分型。我们通过贝叶斯方法使用多状态马尔可夫模型计算了伴侣之间的感染传播率。我们报告后中位数和2.5%−97.5%百分位间隔(95%PI)。我们观察到447名女性和402名男性发生了166起特定类型的HPV传播事件。从HPV阳性到阴性伴侣的估计中位数传播率为每100人月4.2(95%PI 3.1-5.3)。男性对女性的传播率为3.5(95%PI 2.5~4.7)，女性对男性的传播率为5.6(95%PI 3.8~7.0)/100人月，对应的比率为1.6(95%PI 1.0~2.5)。报告经常使用避孕套的伴侣的HPV传播率比从不使用避孕套的伴侣低0.22倍(95%PI 0.05-0.61)。与其他类型的HPV相比，HPV16/18的传播率并不是特别高。我们最新的分析支持了之前的研究，即女性对男性的HPV传播率高于男性对女性的传播率，避孕套在异性伴侣关系中具有保护作用。我们的结果还表明，由于间隔审查，粗发病率低估了HPV的传播率。
It is unclear whether sexual transmission rates of human papillomaviruses (HPV) differ between sexes and HPV types. We estimate updated transmission rates from the final HITCH cohort study, and propose an estimation method that accounts for interval-censored data and infection clearance. We enrolled young women 18–24 years old and their male sex partners ≥18 years old in Montréal, Canada between 2005–2011. We followed women over 24 months and men over 4 months. We tested genital samples with Linear Array for HPV DNA detection and genotyping. We calculated infection transmission rates between partners using a multistate Markov model via a Bayesian approach. We report the posterior median and 2.5%−97.5% percentile intervals (95%PI). We observed 166 type-specific incident HPV transmission events in 447 women and 402 men. The estimated median transmission rate from an HPV-positive to a negative partner was 4.2 (95%PI 3.1–5.3) per 100 person–months. The transmission rate from men to women was 3.5 (95%PI 2.5–4.7) and from women to men was 5.6 (95%PI 3.8–7.0) per 100 person–months, corresponding to a rate ratio of 1.6 (95%PI 1.0–2.5). Partners reporting always using condoms had a 0.22 (95%PI 0.05–0.61) times lower HPV transmission rate than those reporting never using condoms. HPV16/18 did not have particularly high transmission rates relative to other HPV types. Our updated analysis supports previous research suggesting higher women-to-men than men-to-women HPV transmission rates and a protective effect of condoms in heterosexual partnerships. Our results also suggest that crude incidence rates underestimate HPV transmission rates due to interval-censoring.