Male circumcision is associated with a lower prevalence of human papillomavirus-associated penile lesions among Kenyan men.
Male circumcision is associated with a lower prevalence of human papillomavirus-associated penile lesions among Kenyan men.
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DOI：
10.1002/ijc.26196
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发表时间：
2012-04-15
影响因子：
6.4
通讯作者：
Smith, Jennifer S.
中科院分区：
文献类型：
--
作者：
Backes, Danielle M.;Bleeker, Maaike C. G.;Meijer, Chris J. L. M.;Hudgens, Michael G.;Agot, Kawango;Bailey, Robert C.;Ndinya-Achola, J. O.;Hayombe, Juma;Hogewoning, Cornelis J. A.;Moses, Stephen;Snijders, Peter J. F.;Smith, Jennifer S.
人乳头瘤病毒（HPV）相关的男性阴茎病变可能会增加HPV传播给女性伴侣的风险。需要来自宫颈癌高负担地区的HPV相关阴茎病变的风险因素数据。2006年5月至2007年10月，在肯尼亚进行的男性包皮环切术随机对照试验的参与者中，在24个月访视时使用阴道镜对阴茎进行目视检查。所有照片均由两名观察员独立阅读以进行质量控制。采用GP 5 +/6+ PCR检测从阴茎头/冠状沟和阴茎干取样的阴茎脱落细胞的HPV DNA，并采用真实的时间PCR检测HPV 16、18和31病毒载量。在275名男子中，151人接受了割礼，124人未接受割礼。中位年龄为22岁。包皮环切术男性扁平阴茎病变的患病率（0.7%）低于未包皮环切术男性（26.0%）;调整后的比值比[OR]=0.02; 95%置信区间[CI]：0.003-0.1）。与HPV阴性的男性相比，HPV DNA阳性（OR=6.5; 95%CI：2.4-17.5）或HPV 16/18/31病毒载量高（OR=5.2; 95%CI：1.1-24.4）的男性发生扁平阴茎病变的几率更高。在阴茎扁平病变的男性中，HPV 56型（29.0%）和16型（25.8%）是最常见的类型。扁平阴茎病变在未行包皮环切术的男性中更常见，并且与HPV和病毒载量较高的患病率相关。这项研究表明，包皮环切术降低了HPV相关扁平病变的患病率，并可能最终减少男性到女性的HPV传播。
Human papillomavirus (HPV)-associated penile lesions in men may increase the risk of HPV transmission to their female partners. Risk factor data on HPV-associated penile lesions are needed from regions with a high burden of cervical cancer. Visual inspection of the penis was conducted using a colposcope at the 24-month visit among participants in a randomized controlled trial of male circumcision in Kenya, from May 2006 to October 2007. All photos were read independently by two observers for quality control. Penile exfoliated cells sampled from the glans/coronal sulcus and the shaft were tested for HPV DNA using GP5+/6+ PCR and for HPV16, 18 and 31 viral loads using a real time PCR assay. Of 275 men, 151 were circumcised and 124 uncircumcised. The median age was 22 years. Circumcised men had a lower prevalence of flat penile lesions (0.7%) versus uncircumcised (26.0%); adjusted odds ratio [OR]=0.02; 95% confidence interval [CI]: 0.003–0.1). Compared to men who were HPV-negative, men who were HPV DNA positive (OR=6.5; 95%CI: 2.4–17.5) or who had high HPV16/18/31 viral load (OR=5.2; 95%CI: 1.1–24.4) had higher odds of flat penile lesions. Among men with flat penile lesions, HPV56 (29.0%) and 16 (25.8%) were the most common types. Flat penile lesions are much more frequent in uncircumcised men, and associated with higher prevalence of HPV and higher viral loads. This study suggests that circumcision reduces the prevalence of HPV-associated flat lesions and may ultimately reduce male to female HPV transmission.
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