Higher HPV16 and HPV18 Penile Viral Loads Are Associated With Decreased Human Papillomavirus Clearance in Uncircumcised Kenyan Men.
Higher HPV16 and HPV18 Penile Viral Loads Are Associated With Decreased Human Papillomavirus Clearance in Uncircumcised Kenyan Men.
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DOI：
10.1097/olq.0000000000000500
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发表时间：
2016-09
影响因子：
3.1
通讯作者：
Smith JS
中科院分区：
文献类型：
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作者：
Senkomago V;Backes DM;Hudgens MG;Poole C;Meshnick SR;Agot K;Moses S;Snijders PJ;Meijer CJ;Hesselink AT;Schlecht NF;Bailey RC;Smith JS
较高的阴茎人乳头瘤病毒（HPV）病毒载量是否与较低的HPV清除率有关尚不清楚。我们研究了未割包皮的肯尼亚男性阴茎HPV16和HPV18病毒载量与随后HPV清除之间的关系。参与者是艾滋病毒血清阴性，性活跃，18-24岁的男性，随机分配到肯尼亚基苏木男性包皮环切试验的对照组。男性每6个月从两个解剖部位（龟头/冠状沟和阴茎干）提供脱落的阴茎细胞，持续2年。采用GP5+/6+聚合酶链反应（PCR）对44种HPV-DNA进行鉴定。采用LightCyler实时PCR检测HPV病毒载量；对于不可量化的值，病毒载量分为高（250拷贝/刮）和低（≤250拷贝/刮）。使用Kaplan-Meier方法和Cox回归模型来检验HPV病毒载量与HPV清除率之间的关系。共分析了1097名男性，其中291名HPV16和131名HPV18累计感染24个月。首次检测HPV后6个月，高病毒载量HPV16感染的龟头和轴（aHR=0.44(0.16-0.90)） HPV清除率低于低病毒载量HPV16感染的龟头[aHR=0.05(0.01-0.17)]和HPV18感染的龟头[aHR=0.05(0.01-0.17)]。在未割包皮的年轻男性中，HPV病毒载量高与低与HPV16和HPV18在龟头和阴茎轴感染的HPV清除率降低有关。与低病毒载量HPV感染的男性相比，男性清除高病毒载量HPV16和HPV18感染的减少可能会增加HPV向其女性伴侣的传播，并促进阴茎病变的发展。对313名未割包皮的肯尼亚男性进行的为期两年的研究发现，阴茎HPV病毒载量的高低与HPV16清除率（龟头和阴茎轴）和HPV18清除率（龟头）的降低有关。
Whether higher penile human papillomavirus(HPV) viral load is associated with a lower rate of HPV clearance remains unknown. We examined the association between penile HPV16 and HPV18 viral load and subsequent HPV clearance in uncircumcised Kenyan men. Participants were HIV-seronegative, sexually active, 18–24 year old men randomized to the control arm of a male circumcision trial in Kisumu, Kenya. Men provided exfoliated penile cells from two anatomical sites (glans/coronal sulcus and shaft) every 6 months for 2 years. GP5+/6+ polymerase chain reaction(PCR) was used to identify 44 HPV-DNA types. HPV viral load testing was conducted using a LightCyler real-time PCR assay; viral load was classified as high(> 250 copies/scrape) or low(≤250 copies/scrape), for non-quantifiable values. The Kaplan-Meier method and Cox regression modelling were used to examine the association between HPV viral load and HPV clearance. A total of 1097 men, with 291 HPV16 and 131 HPV18 cumulative infections over 24 months were analyzed. HPV clearance at 6 months after first HPV detection was lower for high versus low viral load HPV16 infections in the glans [adjusted hazard ratio (aHR) = 0.65(95% confidence interval, 0.46-0.92)] and shaft (aHR=0.44(0.16-0.90), and HPV18 infections in the glans [aHR=0.05(0.01-0.17)]. High versus low HPV viral load was associated with reduced HPV clearance for HPV16 infections in the glans and shaft, and for HPV18 infections in the glans, among young uncircumcised men. Reduced clearance of high viral load HPV16 and HPV18 infections in men may increase HPV transmission to their female partners as well as enhance the development of penile lesions in comparison to men with low viral load HPV infections. Two-year study of 313 uncircumcised Kenyan men found that high versus low penile HPV viral load was associated with reduced HPV16 clearance (glans and shaft), and reduced HPV18 clearance (glans).