Incidence, Duration, Persistence, and Factors Associated With High-risk Anal Human Papillomavirus Persistence Among HIV-negative Men Who Have Sex With Men: A Multinational Study
Incidence, Duration, Persistence, and Factors Associated With High-risk Anal Human Papillomavirus Persistence Among HIV-negative Men Who Have Sex With Men: A Multinational Study
复制标题
DOI：
10.1093/cid/ciw140
复制
发表时间：
2016-06-01
影响因子：
11.8
通讯作者：
Giuliano, Anna R.
中科院分区：
文献类型：
--
作者：
Nyitray, Alan G.;Carvalho da Silva, Roberto J.;Giuliano, Anna R.
背景鉴于肛门疾病的高发病率，我们调查了一组18-64岁的男性同性性行为者（MSM）中高危肛门人乳头瘤病毒（HPV）的自然史。对来自巴西、墨西哥和美国的人类免疫缺陷病毒阴性男性的肛门标本进行基因分型。在2年内，406名MSM每6个月提供一次可评价的标本，接受≥ 2次访视。这些男性被分为只与男性发生性关系的男性（MSOM，n = 70）和与女性和男性发生性关系的男性（MSWM，n = 336）。持续性定义为>= 12个月的类型特异性持续时间，并且可以从流行或偶发感染开始开始。采用Poisson回归分析计算患病率和95%可信区间。中位随访时间为2.1年。保留率为82%。MSOM和MSWM中9价疫苗类型的年累积发病率分别为19%和8%（对数秩P =.02）。肛门HPV的持续时间在MSOM和MSWM中没有差异，在合并两组男性后，HPV-16的中位数为6.9个月。在流行性高风险感染的男性中（n = 106），共有36.8%的人感染至少24个月。对于HPV-16流行的患者（n = 27），29.6%持续至少24个月。高危型HPV的持续存在与男性肛交伴侣的数量相关，与女性肛交伴侣的数量呈负相关。流行高危型HPV感染的MSM应被认为是非暂时性感染的风险增加。
Background. Given high rates of anal disease, we investigated the natural history of high-risk anal human papillomavirus (HPV) among a multinational group of men who have sex with men (MSM) aged 18-64 years.Methods. Anal specimens from human immunodeficiency virus-negative men from Brazil, Mexico, and the United States were genotyped. Over 2 years, 406 MSM provided evaluable specimens every 6 months for >= 2 visits. These men were stratified into men who have sex only with men (MSOM, n = 70) and men who have sex with women and men (MSWM, n = 336). Persistence was defined as >= 12 months' type-specific duration and could begin with either a prevalent or incident infection. Prevalence ratios and 95% confidence intervals were calculated by Poisson regression.Results. Median follow-up time was 2.1 years. Retention was 82%. Annual cumulative incidence of 9-valent vaccine types was 19% and 8% among MSOM and MSWM, respectively (log-rank P =.02). Duration of anal HPV did not differ for MSOM and MSWM and was a median of 6.9 months for HPV-16 after combining men from the 2 groups. Among men with prevalent high-risk infection (n = 106), a total of 36.8%, retained the infection for at least 24 months. For those with prevalent HPV-16 (n = 27), 29.6% were persistent for at least 24 months. Persistence of high-risk HPV was associated with number of male anal sex partners and inversely associated with number of female sex partners.Conclusions. MSM with prevalent high-risk HPV infection should be considered at increased risk for nontransient infection.