Incidence and clearance of oral human papillomavirus infection in men: the HIM cohort study.
Incidence and clearance of oral human papillomavirus infection in men: the HIM cohort study.
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DOI：
10.1016/s0140-6736(13)60809-0
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发表时间：
2013-09-07
期刊：
影响因子：
168.9
通讯作者：
Giuliano, Anna R.
中科院分区：
文献类型：
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作者：
Kreimer, Aimee R.;Campbell, Christine M. Pierce;Lin, Hui-Yi;Fulp, William;Papenfuss, Mary R.;Abrahamsen, Martha;Hildesheim, Allan;Villa, Luisa L.;Salmeron, Jorge J.;Lazcano-Ponce, Eduardo;Giuliano, Anna R.
口腔人乳头瘤病毒（HPV）感染可导致一部分口咽癌。这些癌症不成比例地影响男性，发病率正在增加，并且没有经过验证的预防方法。我们的目的是建立男性口腔HPV感染的自然史。为了估计HPV感染的发生率和清除率，将居住在巴西、墨西哥和美国的HIV阴性且报告无肛门生殖器癌病史的男性招募到男性HPV感染（HIM）队列研究中。该分析包括提供两个或更多个具有有效HPV结果的口腔冲洗和漱口样本并且完成至少2周随访的队列亚组。每6个月获得一次口腔漱口液样本和问卷调查数据，持续4年。通过线性阵列方法分析样本中致癌和非致癌HPV感染的存在。1626名年龄在18-73岁之间的男性被纳入分析，中位随访时间为12.7个月（IQR 12.1 - 14.7）。在前12个月的随访中，4.4%（95%CI 3.5 - 5.6; n=115例偶发感染）的男性获得了偶发口腔HPV感染，1.7%（1.2 - 2.5; n=53例偶发感染）的口腔致癌HPV感染，0.6%（0.3 - 1.1; n=18例偶发感染）的口腔HPV 16感染。口腔致癌HPV的获得与吸烟、未婚或同居显著相关，但在不同国家、年龄组和报告的性行为之间相似。任何HPV的中位感染持续时间为6.9个月（95% CI 6.2 - 9.3; n=45例清除感染），致癌HPV为6.3个月（6.0 - 9.9; n=18例清除感染），HPV 16为7.3个月（6.0-无法估计; n=5例清除感染）。18例口腔HPV 16感染中有8例持续了两次或两次以上的研究访视。在健康男性中，新获得的口腔致癌HPV感染是罕见的，大多数在1年内被清除。需要对HPV的自然史进行更多的研究，以告知感染相关预防工作的发展。
Oral human papillomavirus (HPV) infection causes a subset of oropharyngeal cancers. These cancers disproportionately affect men, are increasing in incidence, and have no proven prevention methods. We aimed to establish the natural history of oral HPV infection in men. To estimate incidence and clearance of HPV infections, men residing in Brazil, Mexico, and the USA who were HIV negative and reported no history of anogenital cancer were recruited into the HPV Infection in Men (HIM) cohort study. A subset of the cohort who provided two or more oral rinse-and-gargle samples with valid HPV results and who completed a minimum of 2 weeks of follow-up were included in this analysis. Oral rinse-and-gargle samples and questionnaire data were obtained every 6 months for up to 4 years. Samples were analysed for the presence of oncogenic and non-oncogenic HPV infections by the linear array method. 1626 men aged 18–73 years and with a median follow-up of 12·7 months (IQR 12·1–14·7) were included in the analysis. During the first 12 months of follow-up, 4·4% (95% CI 3·5–5·6; n=115 incident infections) of men acquired an incident oral HPV infection, 1·7% (1·2–2·5; n=53 incident infections) an oral oncogenic HPV infection, and 0·6% (0·3–1·1; n=18 incident infections) an oral HPV 16 infection. Acquisition of oral oncogenic HPV was significantly associated with smoking and not being married or cohabiting, but was similar across countries, age groups, and reported sexual behaviours. Median duration of infection was 6·9 months (95 % CI 6·2–9·3; n=45 cleared infections) for any HPV, 6·3 months (6·0–9·9; n=18 cleared infections) for oncogenic HPV, and 7·3 months (6·0–not estimable; n=5 cleared infections) for HPV 16. Eight of the 18 incident oral HPV 16 infections persisted for two or more study visits. Newly acquired oral oncogenic HPV infections in healthy men were rare and most were cleared within 1 year. Additional studies into the natural history of HPV are needed to inform development of infection-related prevention efforts.