Risk Factors for Acquisition and Clearance of Oral Human Papillomavirus Infection Among HIV-Infected and HIV-Uninfected Adults
Risk Factors for Acquisition and Clearance of Oral Human Papillomavirus Infection Among HIV-Infected and HIV-Uninfected Adults
复制标题
DOI：
10.1093/aje/kwu247
复制
发表时间：
2015-01-01
影响因子：
5
通讯作者：
D'Souza, Gypsyamber
中科院分区：
文献类型：
--
作者：
Beachler, Daniel C.;Sugar, Elizabeth A.;D'Souza, Gypsyamber
在美国，人乳头瘤病毒（HPV）是导致口咽癌的主要原因，但口腔HPV感染的危险因素和自然史在很大程度上是未知的。2010-2011年，在美国开展了一项纵向队列研究，研究对象包括来自多中心艾滋病队列研究和妇女机构间艾滋病毒研究的761名人类免疫缺陷病毒（HIV）感染者和469名高危HIV未感染者。使用Roche LINEAR ARRAY HPV基因分型测试（Roche Molecular Systems, Pleasanton, California）评估每半年收集一次的口腔冲洗液中37种HPV基因型，并使用调整后的weilin - weissfeld模型探讨与口腔HPV发病率和清除率相关的因素。截至2013年，任何类型的口腔HPV感染的2年累积发病率在hiv感染者中为34%，在hiv未感染者中为19%。然而，这些感染中的许多都被清除了。7%的偶发感染和35%的流行感染持续了至少2年。在校正其他危险因素后，HIV感染（校正后的危险比为2.3,95%可信区间为1.7,3.2）、当前CD4细胞计数减少、口交和“边缘”伴侣数量增加增加了口腔HPV感染的发生风险，而男性、年龄较大和当前吸烟增加了口腔HPV持续存在的风险（各P < 0.05）。这有助于解释在以前的横断面研究中观察到的这些因素与流行的口腔HPV感染之间的一致关联。
Human papillomavirus (HPV) causes the majority of oropharyngeal cancers in the United States, yet the risk factors for and natural history of oral HPV infection are largely unknown. In 2010-2011, a US-based longitudinal cohort study of 761 human immunodeficiency virus (HIV)-infected and 469 at-risk HIV-uninfected participants from the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study was initiated. Semiannually collected oral rinses were evaluated for 37 HPV genotypes using the Roche LINEAR ARRAY HPV Genotyping Test (Roche Molecular Systems, Pleasanton, California), and factors associated with oral HPV incidence and clearance were explored using adjusted Wei-Lin-Weissfeld modeling. Through 2013, the 2-year cumulative incidence of any type of oral HPV infection was 34% in HIV-infected persons and 19% in HIV-uninfected persons. However, many of these infections cleared. Seven percent of incident infections and 35% of prevalent infections persisted for at least 2 years. After adjustment for other risk factors, HIV infection (adjusted hazard ratio = 2.3, 95% confidence interval: 1.7, 3.2), reduced current CD4 cell count, and increased numbers of oral sex and "rimming" partners increased the risk of incident oral HPV infection, whereas male sex, older age, and current smoking increased the risk of oral HPV persistence (each P < 0.05). This helps explain the consistent associations observed between these factors and prevalent oral HPV infection in previous cross-sectional studies.