Viral Load in the Natural History of Human Papillomavirus Infection Among Men in Rural China: A Population-based Prospective Study
Viral Load in the Natural History of Human Papillomavirus Infection Among Men in Rural China: A Population-based Prospective Study
复制标题
中国农村男性人乳头瘤病毒感染自然史中的病毒载量：基于人群的前瞻性研究。
DOI：
10.1093/cid/ciy376
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发表时间：
2018-12-15
影响因子：
11.8
通讯作者：
Ke, Yang
中科院分区：
文献类型：
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作者：
Liu, Mengfei;Liu, Fangfang;Ke, Yang
背景高危人乳头瘤病毒（HR-HPV）载量可预测女性HR-HPV的持续性和随后的致癌性。然而，在男性中，生殖器HPV载量及其对HPV感染自然史的影响的数据有限。受试者包括1532名男性，年龄25-65岁，在2009-2013年期间接受了最多7次半年一次的生殖器HPV载量评估，这些男性通过通用引物介导的聚合酶链反应（PCR）和测序检测到18种选定的HPV类型（包括10种HR-HPV类型）中的≥ 1种阳性。用实时定量PCR定量HPV载量，并根据中位数进行二分。有多个性伴侣的男性更有可能在访视期间具有较高的HR-HPV载量总体水平（调整后的比值比，2.42; 95%置信区间[CI]，1.12-5.24; 2个伴侣vs 0-1个伴侣）。在首次HPV诊断时较高水平的HR-HPV载量使受试者保持类型特异性HPV阳性长达12个月的概率增加，并且与短暂感染（单次阳性）相比，持续/间歇性感染（反复检测到病毒，有或没有一段时间的间歇性阴性）的概率增加。较高的总体HR-HPV水平预测HR-HPV清除率降低（校正风险比，0.47; 95%CI，0.27 - 0.83）。一生中有多个性伴侣与男性生殖器HR-HPV载量增加有关。高HR-HPV载量预测中国农村男性中HR-HPV的持续性。
Background. High-risk human papillomavirus (HR-HPV) load is predictive of HR-HPV persistence and subsequent carcinogenesis in women. However, in men, data on genital HPV load and its effect on the natural history of HPV infection are limited.Methods. The subjects included 1532 men aged 25-65 years with up to 7 biannual visits for evaluation of genital HPV load in rural China during 2009-2013 who were positive for >= 1 of the 18 selected HPV types (including 10 HR-HPV types) detected by general primer-mediated polymerase chain reaction (PCR) and sequencing. Type-specific HPV load was quantified with real-time PCR and dichotomized based on median values.Results. Men with multiple lifetime sex partners were more likely to have higher overall levels of HR-HPV load across visits (adjusted odds ratio, 2.42; 95% confidence interval [CI], 1.12-5.24; 2 partners vs 0-1 partner). Higher levels of HR-HPV load at the time of the first HPV diagnosis conferred an increased probability of the subject remaining type-specific HPV-positive up to 12 months and an increased probability of persistent/intermittent infection (virus detected repeatedly with or without a period of intercurrent negativity) versus transient infections (single-time positive). Higher overall HR-HPV levels were predictive of reduced HR-HPV clearance rates (adjusted hazard ratio, 0.47; 95% CI, .27-.83).Conclusions. Having multiple lifetime sex partners is associated with increased male genital HR-HPV load. Higher HR-HPV load predicts persistence of HR-HPV in men from rural China.