HIV阳性的男男性行为者肛门人乳头瘤病毒感染现状分析
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摘要
目的了解人免疫缺陷病毒(HIV)阳性的男男性行为者(MSM)肛门人乳头瘤病毒(HPV)感染情况。方法选择门诊患有尖锐湿疣或疑似尖锐湿疣的HIV阳性的MSM病例作为研究对象,共140例。采用基因芯片技术对肛门部位进行HPV检测。结果 140例HIV阳性的MSM中,HPV感染率为77.86%(109/140),高危型HPV感染率为57.86%(81/140),低危型HPV感染率为61.43%(86/140)。低危型以HPV6和HPV11型检出率最高。高危型检出率前5位依次为:HPV16、58、51、52、18型。109例HIV阳性MSM感染了HPV的患者中,以多重感染为主,占71.56%(78/109),最多有十重感染。在HIV阳性的MSM中,≤20岁和>50岁年龄组HPV阳性率均为100%,21～30岁年龄组HPV阳性率为76.25%,31～40岁年龄组HPV阳性率为74.36%,41～50岁年龄组HPV阳性率为81.82%。CD4+T<500/μL和CD4+T≥500/μL组在HPV阳性率、低危型HPV感染率、多重基因型感染率差异均无统计学意义(χ2=1.46、3.40、1.53,P均>0.05),而两组在高危型HPV的感染率差异有统计学意义(χ2=4.50,P<0.05)。结论在HIV阳性的MSM中,HPV感染率和高危型HPV感染率均高,以多重感染为主,在各年龄组的阳性率都保持在较高水平,并未随年龄增长而降低,需要高度重视这一高危人群的HPV感染情况,从多方面做好HPV相关性恶性肿瘤的预防。
Objective To analyze the prevalence and genotype distribution of anal human papillomavirus(HPV)among human immunodeficiency virus(HIV)positive men who have sex with men. Methods HIV-positive men who have sex with men with condyloma aeuminatum or persons with suspected condyloma aeuminatum were enrolled into this study. An anal cytological sample was taken for HPV testing. Results 140 HIV-positive men who have sex with men were recruited. The prevalence of HPV infection,high risk HPV types and low risk HPV types among them were 77.86%(109/140),57.86%(81/140)and 61.43%(86/140),respectively. The top two genotypes of low risk HPV were types 6 and 11,and the top five genotypes of high risk HPV were types 16,58,51,52 and 18. Co-infections with multiple HPV subtypes were common(71.56%)among HIV positive men who have sex with men. The number of concurrent HPV genotypes was as high as 10. The HPV prevalence in those aged ≤20 and>50 among HIV positive men who have sex with men were both 100%. The HPV prevalence in those aged 21-30,31-40,41-50 among HIV positive men who have sex with men were 76.25%,74.36% and81.82%,respectively. The prevalence of HPV infection,low risk HPV types,multiple HPV subtypes were not significantly higher in CD4+T<500/μL than in CD4+T≥500/μL groups(χ2=1.46,3.40,1.53,P>0.05). However,the prevalence of high risk HPV types were significantly higher in CD4+T <500/μL than CD4+T≥500/μL groups(χ2=4.50,P<0.05). Conclusion HPV infection and high-risk HPV infection were very common among HIV positive men who have sex with men,mainly multiple HPV infections. The prevalence did not decrease with increasing age. High attention of HPV prevalence must be paid on this high-risk population. Prevention of HPV related cancer should be done as soon as possible through several aspects.
Objective To analyze the prevalence and genotype distribution of anal human papillomavirus(HPV)among human immunodeficiency virus(HIV)positive men who have sex with men. Methods HIV-positive men who have sex with men with condyloma aeuminatum or persons with suspected condyloma aeuminatum were enrolled into this study. An anal cytological sample was taken for HPV testing. Results 140 HIV-positive men who have sex with men were recruited. The prevalence of HPV infection,high risk HPV types and low risk HPV types among them were 77.86%(109/140),57.86%(81/140)and 61.43%(86/140),respectively. The top two genotypes of low risk HPV were types 6 and 11,and the top five genotypes of high risk HPV were types 16,58,51,52 and 18. Co-infections with multiple HPV subtypes were common(71.56%)among HIV positive men who have sex with men. The number of concurrent HPV genotypes was as high as 10. The HPV prevalence in those aged ≤20 and>50 among HIV positive men who have sex with men were both 100%. The HPV prevalence in those aged 21-30,31-40,41-50 among HIV positive men who have sex with men were 76.25%,74.36% and81.82%,respectively. The prevalence of HPV infection,low risk HPV types,multiple HPV subtypes were not significantly higher in CD4+T<500/μL than in CD4+T≥500/μL groups(χ2=1.46,3.40,1.53,P>0.05). However,the prevalence of high risk HPV types were significantly higher in CD4+T <500/μL than CD4+T≥500/μL groups(χ2=4.50,P<0.05). Conclusion HPV infection and high-risk HPV infection were very common among HIV positive men who have sex with men,mainly multiple HPV infections. The prevalence did not decrease with increasing age. High attention of HPV prevalence must be paid on this high-risk population. Prevention of HPV related cancer should be done as soon as possible through several aspects.
引文
[1]Zou H,Fairley CK,Hocking JS,et al.The prevalence of anal human papillomavirus among young HIV negative men who have sex with men[J].BMC Infect Dis,2012,12:341.
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[7]Colon-Lopez V,Shiels MS,Machin M,et al.Analcancer risk among people with HIV infection in the United States[J].J Clin Oncol,2018,36(1):68-75.
[8]Gao L,Zhou F,LiX,et al.Anal HPV infection in HIV-positive men who have sex with men from China[J].PLoS One,2010,5(12):e15256.
[9]Zhang DY,Yin YP,Feng TJ,et al.HPV infections among MSMin Shenzhen,China[J].PLoS One,2014,9(5):e96364.
[10]Li Z,Zhang H,Li X,et al.Anal human papillomavirus genotyping among HIV-positive men who have sex with men in Xi′an,China[J].PLoS One,2015,10(4):e0125120.
[11]Supindham T,Chariyalertsak S,Utaipat U,et al.High prevalence and genotype diversity of anal HPV infection among MSM in Northern Thailand[J].PLoS One,2015,10(5):e0124499.
[12]Li X,Li M,Yang Y,et al.Anal HPV/HIV co-infection among Men Who Have Sex with Men:a crosssectional survey from three cities in China[J].Sci Rep,2016,6:21368.
[13]Tobian AA,Kigozi G,Gravitt PE,et al.Human papillomavirus incidence and clearance among HIV-positive and HIV-negative men in sub-Saharan Africa[J].AIDS,2012,26(12):1555-1565.
[14]Yu CT,Chao SC,Lee HC,et al.High prevalence of anal human papillomavirus infection and associated risky behaviors in men infected with human immunodeficiency virus in Taiwan[J].AIDSBehav,2013,17(3):1211-1218.
[15]Drobacheff C,Dupont P,Mougin C,et al.Anal human papillomavirus DNA screening by Hybrid Capture II in human immunodeficiency virus-positive patients with or without anal788intercourse[J].Eur J Dermatol,2003,13(4):367-371.
[16]Ca?adas MP,Darwich L,Sirera G,et al.Human papillomavirus16 integration and risk factors associated in anal samples of HIV-1 infected men[J].Sex Transm Dis,2010,37(5):311-315.
[17]Jong E,van Gorp EC,Mulder JW,et al.Effect of HIV viral load,CD4 cell count and antiretroviral therapy on human papillomavirus prevalence in urine samples of HIV-infected men[J].Int J STD AIDS,2009,20(4):262-264.
[18]Silverberg MJ,Lau B,Justice AC,et al.Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America[J].Clin Infect Dis,2012,54(7):1026-1034.2019-01-28
[2]Arroyo LS,Basaras M,Arrese E,et al.Distribution of genital human papillomavirus genotypes in benign clinical manifestations among men from Northern Spain[J].BMC Public Health,2016,16:81.
[3]Zhang L,Chow EP,Jing J,et al.HIV prevalence in China:integration of surveillance data and a systematic review[J].Lancet Infect Dis,2013,13(11):955-963.
[4]Machalek DA,Poynten M,Jin F,et al.Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men:a systematic review and meta-analysis[J].Lancet Oncol,2012,13(5):487-500.
[5]De Vuyst H,Clifford GM,Nascimento MC,et al.Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva,vagina and anus:a metaanalysis[J].Int J Cancer,2009,124(7):1626-1636.
[6]D′Souza G,Wiley DJ,Li X,et al.Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study[J].J Acquir Immune Defic Syndr,2008,48(4):491-499.
[7]Colon-Lopez V,Shiels MS,Machin M,et al.Analcancer risk among people with HIV infection in the United States[J].J Clin Oncol,2018,36(1):68-75.
[8]Gao L,Zhou F,LiX,et al.Anal HPV infection in HIV-positive men who have sex with men from China[J].PLoS One,2010,5(12):e15256.
[9]Zhang DY,Yin YP,Feng TJ,et al.HPV infections among MSMin Shenzhen,China[J].PLoS One,2014,9(5):e96364.
[10]Li Z,Zhang H,Li X,et al.Anal human papillomavirus genotyping among HIV-positive men who have sex with men in Xi′an,China[J].PLoS One,2015,10(4):e0125120.
[11]Supindham T,Chariyalertsak S,Utaipat U,et al.High prevalence and genotype diversity of anal HPV infection among MSM in Northern Thailand[J].PLoS One,2015,10(5):e0124499.
[12]Li X,Li M,Yang Y,et al.Anal HPV/HIV co-infection among Men Who Have Sex with Men:a crosssectional survey from three cities in China[J].Sci Rep,2016,6:21368.
[13]Tobian AA,Kigozi G,Gravitt PE,et al.Human papillomavirus incidence and clearance among HIV-positive and HIV-negative men in sub-Saharan Africa[J].AIDS,2012,26(12):1555-1565.
[14]Yu CT,Chao SC,Lee HC,et al.High prevalence of anal human papillomavirus infection and associated risky behaviors in men infected with human immunodeficiency virus in Taiwan[J].AIDSBehav,2013,17(3):1211-1218.
[15]Drobacheff C,Dupont P,Mougin C,et al.Anal human papillomavirus DNA screening by Hybrid Capture II in human immunodeficiency virus-positive patients with or without anal788intercourse[J].Eur J Dermatol,2003,13(4):367-371.
[16]Ca?adas MP,Darwich L,Sirera G,et al.Human papillomavirus16 integration and risk factors associated in anal samples of HIV-1 infected men[J].Sex Transm Dis,2010,37(5):311-315.
[17]Jong E,van Gorp EC,Mulder JW,et al.Effect of HIV viral load,CD4 cell count and antiretroviral therapy on human papillomavirus prevalence in urine samples of HIV-infected men[J].Int J STD AIDS,2009,20(4):262-264.
[18]Silverberg MJ,Lau B,Justice AC,et al.Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America[J].Clin Infect Dis,2012,54(7):1026-1034.2019-01-28