An Examination of HPV16 Natural Immunity in Men Who Have Sex with Men (MSM) in the HPV in Men (HIM) Study.
An Examination of HPV16 Natural Immunity in Men Who Have Sex with Men (MSM) in the HPV in Men (HIM) Study.
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DOI：
10.1158/1055-9965.epi-17-0853
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发表时间：
2018-04
期刊：
影响因子：
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通讯作者：
Giuliano AR
中科院分区：
文献类型：
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作者：
Beachler DC;Pinto LA;Kemp TJ;Nyitray AG;Hildesheim A;Viscidi R;Schussler J;Kreimer AR;Giuliano AR
有证据表明，感染 HPV16 后产生的天然抗体可以保护一些女性，但不能保护男性免受后续 HPV16 的再次感染。目前尚不清楚 HPV16 感染后产生的抗体是否对男男性行为者 (MSM) 具有保护作用。使用酶联免疫吸附测定对来自男性人乳头瘤病毒 (HIM) 研究的 475 名 MSM 进行了 HPV16 L1 血清抗体检测，并使用 PCR 共有引物系统 (PGMY 09/11) 对肛门和生殖器 HPV16 DNA 进行了检测。调整后的 Cox 回归用于评估基线 HPV16 血清阳性是否影响随后的生殖器或肛门 HPV16 DNA。 MSM 中后续生殖器 HPV16（aHR=1.05，95%CI=0.66-1.68）和肛门 HPV16 感染（aHR=2.34，95%CI=0.92-5.98）的风险与 HPV16 血清阴性 MSM 相似或不显着较高。在 HPV16 抗体水平最高三分位以及仅限于随访期间有新性伴侣的患者中，HPV16 血清阴性和 HPV16 血清阳性 MSM 的生殖器 HPV16 风险也相似（p 值>0.20）。在 118 名 HPV16 血清阳性的 MSM 中，90% 的人在 4 年后仍保持 HPV16 血清阳性。当一起测试时，具有最高抗体滴度（顶部三分位）的 MSM 与女性具有相似的水平（平均值 = 130.3 vs. 134.5 EU/mL，p 值 = 0.84）。尽管 HPV16 血清阳性持续存在多年，抗体滴度与女性相当，但这项研究表明，没有证据表明 HPV16 天然抗体可以预防 MSM 中随后的生殖器或肛门 HPV16 感染。这可能有助于部分解释中老年 MSM 中生殖器和肛门 HPV16 感染以及相关肛门癌的高发病率。
Evidence suggests that natural antibodies developed after HPV16 infection may protect some women but not men against subsequent HPV16 re-acquisition. Less is known whether antibodies developed following HPV16 infection are protective among men-who-have-sex-with-men (MSM). 475 MSM from the Human Papillomavirus in Men (HIM) study were tested for serum antibodies to HPV16 L1 using enzyme-linked immunosorbent assays, and for anal and genital HPV16 DNA using PCR consensus primer system (PGMY 09/11). Adjusted Cox regression was used to evaluate whether baseline HPV16 seropositivity impacts subsequent genital or anal HPV16 DNA. The risk of subsequent genital HPV16 (aHR=1.05, 95%CI= 0.66-1.68) and anal HPV16 infections among MSM (aHR=2.34, 95%CI=0.92-5.98) was similar or non-significantly higher in HPV16 seropositive than HPV16 seronegative MSM. The risk of genital HPV16 was also similar between HPV16 seronegative and HPV16 seropositive MSM in the highest tertile of HPV16 antibody levels and when restricting to those with new sex partners during follow-up (p-values>0.20). Among the 118 MSM who were HPV16 seropositive, 90% remained HPV16 seropositive up to 4 years later. When tested together, MSM with the highest antibody titers (top tertile) had similar levels to females (mean=130.3 vs. 134.5 EU/mL, p-value=0.84). Despite years of HPV16 seropositivity persistence and antibody titers comparable to females, this study suggested no evidence of HPV16 natural antibodies protecting against subsequent genital or anal HPV16 infection in MSM. This could help partially explain the high incidence of genital and anal HPV16 infection and related anal cancer seen in middle aged and older MSM.