Effect of HIV infection on the natural history of anal human papillomavirus infection
Effect of HIV infection on the natural history of anal human papillomavirus infection
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DOI：
10.1097/00002030-199810000-00010
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发表时间：
1998-07-09
期刊：
影响因子：
3.8
通讯作者：
Kiviat, NB
中科院分区：
文献类型：
--
作者：
Critchlow, CW;Hawes, SE;Kiviat, NB
目的：为了确定危险因素的检测流行和意外肛门人乳头瘤病毒（HPV）感染，和HPV的持久性之间的艾滋病毒血清阳性和血清阴性homosexual man.Design：纵向研究287艾滋病毒血清阴性和322艾滋病毒血清阳性男子参加了社区为基础的clinic.Methods：受试者进行了采访和检查;结果：91.6%的HIV感染者和65.9%的非HIV感染者在入组时肛门HPV DNA阳性。HPV检测与终生性伴侣数量和最近接受肛交（HIV血清阴性男性），CD 4+淋巴细胞计数下降（HIV血清阳性男性）和肛门疣（所有男性）相关。在进入研究时HPV阴性的男性中，随后检测到HPV与HIV、无保护的接受性肛交以及自上次访视以来的任何性接触相关。在进入研究时HPV阳性的男性中，随后检测到其他HPV类型在HIV血清阳性男性中更常见。在随访期间HPV阴性在HIV或高HPV水平的男性中不太常见。在那些与艾滋病毒，HPV的持久性与存在的肛门HIV DNA，但不与CD 4+淋巴细胞count.Conclusions：肛门HPV感染的风险似乎增加与性暴露，上皮创伤，HIV感染和免疫缺陷。偶发感染可能是由于最近的性接触或潜伏感染的重新激活。需要进一步的研究来阐明肛管中的HIV DNA增加HPV持续性风险的机制。(C)1998 Lippincott-Raven出版社。
Objective: To identify risk factors for the detection of prevalent and incident anal human papillomavirus (HPV) infection, and HPV persistence among HIV-seropositive and seronegative homosexual men.Design: Longitudinal study of 287 HIV-seronegative and 322 HIV-seropositive men attending a community-based clinic.Methods: Subjects underwent an interview and examination; specimens were collected for HIV serology and assessment of anal HPV and HIV DNA.Results: Anal HPV DNA was detected at study entry in 91.6% of HIV-infected men, and 65.9% of men not infected with HIV. HPV detection was associated with lifetime number of sexual partners and recent receptive anal intercourse (HIV-seronegative men), decreased CD4+ lymphocyte count (HIV-seropositive men), and anal warts (all men). Among men negative for HPV at study entry, subsequent detection of HPV was associated with HIV, unprotected receptive anal intercourse, and any sexual contact since the last visit. Among men positive for HPV at study entry, subsequent detection of additional HPV types was more common among HIV-seropositive men. Becoming HPV negative during follow-up was less common among men with HIV or high HPV levels at study entry. Among those with HIV, HPV persistence was associated with presence of anal HIV DNA, but not with CD4+ lymphocyte count.Conclusions: Risk of anal HPV infection appears to increase with sexual exposure, epithelial trauma, HIV infection and immune deficiency. Incident infection may result from recent sexual exposure or reactivation of latent infection. Further studies are needed to elucidate the mechanism by which HIV DNA in the anal canal increases the risk of HPV persistence. (C) 1998 Lippincott-Raven Publishers.