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

描述(由申请人提供)：最近的研究强调了艾滋病毒+个体共病的性传播感染的重要性，但很少有研究描述它们对慢性长期后遗症的影响，特别是在吸毒者中，在这些人中，初级预防工作可能会被推迟，筛查做法可能不存在。人乳头瘤病毒(HPV)是全世界最常见的性传播疾病之一，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，在艾滋病毒携带者中尤其令人担忧。在男性中，HPV感染不仅与口腔、阴茎和肛门癌有关，而且与普通人群相比，HIV+个体的这种风险更高。尽管吸烟等口腔癌众所周知的风险因素有所减少，但在美国(美国)和波多黎各(PR)观察到与HPV相关的口咽癌发病率增加，并已被确认为一种新的癌症病毒性流行。使用Colén-Lopez博士由NIDA资助的研究数据；这项研究将分析口腔生物样本并进行统计分析，以描述男性吸毒者口腔HPV感染的流行病学特征。这项研究的具体目的是：(1)描述口腔HPV感染的流行率和现有样本中HPV DNA的分布；(2)确定与口腔HPV感染几率增加相关的因素，包括年龄、艾滋病毒状况和吸毒方式(IDU/非IDU)；以及(3)描述口腔和肛门HPV感染流行之间的关系。这项申请旨在通过1)支持一名新的研究人员；2)作为扩大研究的基础，以研究药物滥用、艾滋病毒/艾滋病和相关共病的交集，从而实现艾滋病-科学轨道研究过渡奖(A-START)的目标。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参与流行病学和临床研究的讨论和发展。此外，这一机会将为未来的R01级研究提供必要的数据，这些研究将进一步评估HPV疫苗在减少口腔HPV感染以及随后在HIV+男性和艾滋病毒感染高危男性中降低HPV相关癌症风险方面的潜在影响。 公共卫生相关性：本申请涉及PA-07-34艾滋病--研究过渡科学轨道奖(A-START)的目标。它建议提供支持，以扩大现有的R03研究(R03DA027939)，在该研究中，我正在收集样本，以检测艾滋病毒+/艾滋病毒吸毒者中的人乳头瘤病毒(HPV)感染情况。尽管家长R03研究收集了生殖器、肛门和口腔样本，但其目标是只分析参与者的肛门生殖器区域的样本。分析口腔样本超出了R03级别的资助范围。这些标本目前保存在仓库中，是这项提案的重点。这项调查建议估计HIV+/HIV-男性吸毒者中口腔和同时(肛门和阴茎)HPV感染的流行率，描述HPV类型的分布，并评估波多黎各男性临床样本中与口腔HPV感染相关的因素。将对口腔样本进行分析，并进行统计分析，以评估高危男性口腔HPV感染的风险相关因素。这项拟议的研究将通过使用行为和分子流行病学方法来扩大科学知识，以了解和描述目前暴露于高风险药物和性风险做法的男性样本中HPV感染和基因分型的流行率。从这项研究中获得的科学证据将作为扩大研究药物滥用、艾滋病毒/艾滋病和相关共病的交集的研究的基础，并将成为我今后开展的针对这一问题的R01级调查的基础。

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.