Oral HPV Infection Among HIV+/HIV- Male Drug Users in Puerto Rico

波多黎各 HIV/HIV 男性吸毒者的口腔 HPV 感染

• 批准号: 8138223
• 负责人: Vivian Colon
• 金额: $ 15万
• 依托单位: UNIVERSITY OF PUERTO RICO MED SCIENCES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8138223
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Affect; Age; Anogenital Human Papilloma Virus Infection; Anus; Area; Award; Behavioral; Biological; Chronic; Clinic; Clinical Research; Collaborations; Commit; Comorbidity; Crack Cocaine; DNA; DNA laboratory; Data; Data Analyses; Detection; Development; Diagnosis; Disease; Drug abuse; Drug usage; Drug user; Epidemic; Epidemiologic Studies; Epidemiology; Exposure to; Foundations; Funding; Funding Mechanisms; Future; General Population; Genital system; Genotype; HIV; HIV Infections; HIV Seropositivity; Heroin; Heterosexuals; High Prevalence; Hispanics; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papilloma virus infection; Immunologic Surveillance; Incidence; Individual; Infection; Infectious Disease Epidemiology; Injection of therapeutic agent; Investigation; Island; Knowledge; Laboratories; Life; Life Expectancy; Malignant Neoplasms; Malignant neoplasm of anus; Malignant neoplasm of penis; Marijuana; Methodology; Molecular Epidemiology; National Institute of Drug Abuse; Neoplasms; Oncogenic Viruses; Oral; Oral cavity; Parents; Participant; Peer Review; Persons; Pharmaceutical Preparations; Population; Preparation; Prevalence; Primary Prevention; Publications; Puerto Rican; Puerto Rico; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Sampling; Science; Scientist; Screening procedure; Sex Behavior; Sexually Transmitted Diseases; Social Network; Specimen; Testing; Time; Tobacco use; Underserved Population; United States; Unsafe Sex; Ursidae Family; Vaccines; Viral; Virus; Vulnerable Populations; aged; antiretroviral therapy; base; cancer risk; cancer type; carcinogenesis; career; high risk; high risk men; high risk sexual behavior; male; malignant mouth neoplasm; malignant oropharynx neoplasm; men; mortality; penis; sex; surveillance data; transmission process

DESCRIPTION (provided by applicant): Recent studies have highlighted the significance of co-morbid STIs among HIV+ individuals but few have described their impact in chronic long-term sequelae, particularly among drug users, where primary prevention efforts might be delayed and screening practices might be nonexistent. Human papillomavirus (HPV), one of the most commonly diagnosed STIs world-wide, is of particular concern among persons living with HIV, due to the virus's oncogenic potential and the synergy of HPV infection and neoplasias with HIV coinfections. In men, not only is HPV infection associated with oral, penile and anal cancer, this risk is higher in HIV+ individuals as compared to the general population. Despite reductions in well known risk factors for oral cancers such as tobacco consumption, an augmented incidence of HPV-associated oropharyngeal cancers has been observed in the United States (US) and Puerto Rico (PR) and has been identified as an emerging viral epidemic of cancer. Using data from Dr. Col¿n-Lopez's NIDA funded study; this study will analyze oral biological specimens and conduct statistical analysis to describe the epidemiological profile of oral HPV infection among male drug users. Specific aims of this study are to: (1) describe the prevalence of oral HPV infection and HPV DNA genotype distribution in an existing sample collected among a clinic-based sample of HIV+/HIV- men 16-65 years in PR; (2) identify factors associated with increased odds of oral HPV infection, including age, HIV status and mode of drug use (IDU/non-IDU) administration; and (3) describe the relationship between prevalent oral and anogenital HPV infection. This application addresses the objectives of the AIDS-Science Track Award for Research Transition (A-START) by 1) supporting a new researcher; 2) serve as a foundation for expanding research to study the intersection of drug abuse, HIV/AIDS and related comorbidities. In addition, the proposed study will characterize the epidemiology of vaccine-preventable diseases and will move research scientists into discussion and development of epidemiological and clinical studies. Also, this opportunity will provide data necessary for future R01-level studies which will further evaluate the potential impact of the HPV vaccine in a reduction of oral HPV infection and subsequent HPV-related cancer risk reduction among men who are HIV+ and also men at high- risk for HIV infection. PUBLIC HEALTH RELEVANCE: This application addresses the objectives of PA-07-34 AIDS--Science Track Award for Research Transition (A-START). It proposes to provide support to extend an existing R03 study (R03DA027939) in which I am collecting specimens for detection of human papillomavirus (HPV) infection among HIV+/HIV- drug users. Although the parent R03 study collected genital, anal, and oral specimens, its objective was to analyze only those derived from the anogenital areas of participants. Analyzing the oral samples was beyond the scope of R03-level funding. These specimens currently are held in storage and are the focus of this proposal. This investigation proposes to estimate the prevalence of oral and concurrent (anus and penis) HPV infection in HIV+/HIV- male drug users, describe the distribution of HPV types, and assess factors associated with oral HPV infection in a clinic-based sample of Puerto Rican men. Oral specimens will be analyzed and statistical analysis will be performed to evaluate risk correlates of oral HPV infection among high-risk men. The proposed study will expand scientific knowledge by employing behavioral and molecular epidemiology methodologies to understand and describe the prevalence of HPV infection and genotyping in a sample of men currently exposed to both high-risk drug and sexual-risk practices. Scientific evidence obtained from this study will serve as a foundation for expanding research to study the intersection of drug abuse, HIV/AIDS and related comorbidities, and my development of a future R01-level investigation addressing this problem.

描述（由申请人提供）：最近的研究强调了艾滋病毒阳性个体中共病性传播感染的重要性，但很少有人描述其对慢性长期后遗症的影响，特别是在吸毒者中，初级预防工作可能会延迟，筛查实践可能不存在。人乳头瘤病毒（HPV）是全世界最常诊断的性传播感染之一，由于该病毒的致癌潜力以及HPV感染和肿瘤与艾滋病毒合并感染的协同作用，在艾滋病毒感染者中特别令人关注。在男性中，HPV感染不仅与口腔癌、阴茎癌和肛门癌有关，而且与一般人群相比，HIV+个体的这种风险更高。尽管众所周知的口腔癌风险因素（如烟草消费）减少，但在美国（US）和波多黎各（PR）观察到HPV相关口咽癌的发病率增加，并已被确定为一种新兴的病毒性癌症流行病。使用Col博士的数据n-Lopez的NIDA资助的研究;这项研究将分析口腔生物标本并进行统计分析，以描述男性吸毒者口腔HPV感染的流行病学概况。本研究的具体目的是：（1）描述口腔HPV感染的患病率和HPV DNA基因型分布在现有样本中收集的HIV+/HIV-男性16-65岁PR的临床样本中;（2）确定与口腔HPV感染几率增加相关的因素，包括年龄，HIV状态和药物使用方式（IDU/非IDU）管理;（3）描述流行的口腔和肛门生殖器HPV感染之间的关系。该应用程序通过以下方式解决了艾滋病科学跟踪研究过渡奖（A-START）的目标：1）支持新的研究人员; 2）作为扩大研究的基础，以研究药物滥用，艾滋病毒/艾滋病和相关合并症的交叉。此外，拟议的研究将描述疫苗可预防疾病的流行病学特征，并将推动研究科学家讨论和开展流行病学和临床研究。此外，这一机会将为未来的R 01水平研究提供必要的数据，这些研究将进一步评价HPV疫苗在减少HIV+男性和HIV感染高风险男性中口腔HPV感染和随后HPV相关癌症风险降低方面的潜在影响。 公共卫生相关性：此应用程序解决了PA-07-34艾滋病-科学跟踪研究过渡奖（A-START）的目标。它提议为扩展现有的R 03研究（R 03 DA 027939）提供支持，在该研究中，我正在采集标本，用于检测HIV+/HIV-吸毒者中的人乳头瘤病毒（HPV）感染。尽管母研究R 03收集了生殖器、肛门和口腔标本，但其目的仅是分析来自参与者肛门生殖器区域的标本。口腔样本的分析超出了R 03级资金的范围。这些标本目前存放在仓库中，是本提案的重点。本研究拟估计HIV+/HIV-男性吸毒者口腔和并发（肛门和阴茎）HPV感染的患病率，描述HPV类型的分布，并评估与波多黎各男性门诊样本中口腔HPV感染相关的因素。将对口腔标本进行分析，并进行统计分析，以评估高危男性口腔HPV感染的风险相关性。这项拟议的研究将通过采用行为和分子流行病学方法来了解和描述目前暴露于高风险药物和性风险行为的男性样本中HPV感染和基因分型的患病率，从而扩展科学知识。从这项研究中获得的科学证据将作为扩大研究的基础，以研究药物滥用，艾滋病毒/艾滋病和相关合并症的交叉点，以及我对解决这一问题的未来R 01级调查的发展。