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HIV+个体合并性传播感染的重要性，但很少有研究描述其对慢性长期后遗症的影响，特别是对吸毒者的影响，在这些人群中，初级预防工作可能被推迟，筛查实践可能不存在。人乳头瘤病毒（HPV）是世界上最常诊断的性传播感染之一，在艾滋病毒感染者中引起特别关注，因为该病毒具有致癌潜力以及HPV感染和肿瘤与艾滋病毒合并感染的协同作用。在男性中，HPV感染不仅与口腔癌、阴茎癌和肛门癌相关，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危险因素（如烟草消费）有所减少，但在美国（US）和波多黎各（PR）观察到hpv相关口咽癌的发病率有所增加，并已被确定为一种新出现的病毒流行癌症。使用Col¿n-Lopez博士的NIDA资助研究的数据；本研究将对口腔生物标本进行分析，并进行统计分析，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)描述在临床收集的16-65岁PR中HIV+/HIV-男性的现有样本中口腔HPV感染的患病率和HPV DNA基因型分布；(2)确定与口腔HPV感染几率增加相关的因素，包括年龄、HIV感染状况和药物使用方式（IDU/非IDU）；(3)描述流行的口腔和肛门生殖器HPV感染之间的关系。该申请通过以下方式实现了艾滋病科学跟踪研究过渡奖（a - start）的目标：1)支持一名新的研究人员；2)为进一步研究药物滥用与艾滋病毒/艾滋病及其相关合并症之间的关系奠定基础。此外，拟议的研究将确定疫苗可预防疾病的流行病学特征，并将促使研究科学家讨论和发展流行病学和临床研究。此外，这一机会将为未来的r01水平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HIV阳性男性和HIV感染高风险男性的口腔HPV感染和随后的HPV相关癌症风险降低方面的潜在影响。

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.