联合抗逆转录病毒治疗对人类免疫缺陷病毒感染的男男性行为者肛门人乳头瘤病毒感染率的影响

Junli Fan, Min Zhao, X. Gui, Hong-Yan Qiu, Li Wang
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引用次数: 0

摘要

目的探讨抗逆转录病毒联合治疗(cART)对人类免疫缺陷病毒(HIV)感染的男男性行为者(MSM)肛门人乳头瘤病毒(HPV)感染的影响。方法选取2012年6月至2013年12月在武汉市皮肤病医院就诊的未接受cART治疗的hiv感染男男性接触者,在开始cART治疗前进行纵向研究,其中hiv阳性81例,hiv阴性50例。比较hiv阳性和hiv阴性男男性接触者HPV感染情况。并比较hiv阳性MSM肛部HPV感染率和尖锐湿疣发病率。采用通用引物PCR和反向点杂交进行HPV基因分型。统计学分析采用t检验或χ2检验。结果hiv阳性男男性感染者HPV感染率、高危型HPV感染率、多亚型HPV感染率均显著高于hiv阴性男男性感染者(分别为91.4%比62.0%、75.3%比30.0%、56.8%比20.0%,χ2分别为16.75、26.05、19.10,P均<0.05)。77例hiv阳性MSM患者术后36个月肛门HPV感染率、高危HPV感染率和多亚型HPV感染率均较基线显著降低(分别为90.9%比74.0%、75.3%比44.2%、57.1%比41.5%,χ2分别=7.590、15.551、3.741,P均<0.05)。HPV16和HPV43感染率分别由治疗前的27.3%降至治疗第36个月时的15.6%和13.0% (χ2分别=16.92和14.86,P均<0.05)。尖锐湿疣的发病率也从基线时的16.9%下降到36个月时的5.2% (χ2=4.069, P<0.05)。结论hiv阳性男男性接触者肛门HPV感染率高于hiv阴性男男性接触者。cART可降低肛门HPV感染率和尖锐湿疣发病率,尤其是高危HPV感染。关键词:抗逆转录病毒联合治疗;人类乳头状瘤病毒;人类免疫缺陷病毒;尖锐湿疣;感染
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Effect of combined antiretroviral therapy on the prevalence of anal human papillomavirus infection in human immunodeficiency virus-infected men who have sex with men
Objective To investigate the effect of combined antiretroviral therapy (cART) on anal human papillomavirus (HPV) infection in human immunodeficiency virus (HIV)-infected men who sex with men (MSM). Methods HIV-infected MSM naive of cART who visited Wuhan Dermatological Hospital from June 2012 to December 2013 were enrolled in a longitudinal study before starting cART, including 81 HIV-positive and 50 HIV-negative cases. HPV infection situations between HIV-positive and HIV-negative MSM were compared. And anal HPV infection rate and condyloma acuminate incidence of HIV-positive MSM before and after cART were also compared. HPV genotyping was performed by universal primer PCR and reverse dot hybridization. The statistical analysis was done by t test or χ2 test. Results The prevalence rates of HPV infection, high-risk HPV infection and multiple HPV subtypes infection in HIV-positive MSM were all significantly higher than those in HIV-negative MSM (91.4% vs 62.0%, 75.3% vs 30.0%, 56.8% vs 20.0%, respectively, χ2=16.75, 26.05, and 19.10, respectively, all P<0.05). The prevalence rates of anal HPV infection, high-risk HPV infection and multiple HPV subtypes infection in 77 HIV-positive MSM at month 36 of cART were all significantly decreased than baseline (90.9% vs 74.0%, 75.3% vs 44.2% and 57.1% vs 41.5%, respectively, χ2=7.590, 15.551, and 3.741, respectively, all P<0.05). HPV16 and HPV43 infection rates were reduced from 27.3% at baseline to 15.6% and 13.0%, respectively at month 36 of cART (χ2=16.92 and 14.86, respectively, both P<0.05). Condyloma acuminate incidence also reduced from 16.9% at baseline to 5.2% at month 36 (χ2=4.069, P<0.05). Conclusions The prevalence of anal HPV infection in HIV-positive MSM is higher than HIV-negative MSM. cART could reduce the prevalence of anal HPV infection rate and condyloma acuminate incidence , especially high-risk HPV infection. Key words: Combined antiretroviral therapy; Human papillomavirus; Human immunodeficiency virus; Condyloma acuminatum; Infections
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