抗反转录病毒治疗对人类免疫缺陷病毒阳性男男性接触者肛门人乳头状瘤病毒感染的影响  

Effect of combined antiretroviral therapy on the prevalence of anal human papillomavirus infection in human immunodeficiency virus-infected men who have sex with men

作　　者：范俊丽[1] 赵敏 桂希恩[2] 邱红艳 王琍 张永喜[2] Fan Junli;Zhao Min;Gui Xien;Qiu Hongyan;Wang Li;Zhang Yongxi(Department of Clinical Laboratory,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院检验科,430071 [2]武汉大学中南医院感染科,430071 [3]武汉市皮肤病防治研究所

出　　处：《中华传染病杂志》2018年第12期736-740,共5页Chinese Journal of Infectious Diseases

基　　金：湖北省自然基金面上项目(2015CFB665).

摘　　要：目的探讨联合抗反转录病毒治疗(combined antiretroviral therapy,cART)与HIV阳性MSM者肛门人乳头状瘤病毒(human papillomavirus,HPV)感染的关系。方法选择2012年6月至2013年12月武汉市皮肤病防治所就诊的MSM者为研究对象,HIV阳性81例,阴性50例。比较HIV阳性和阴性MSM者的HPV感染状况,以及cART前后HIV阳性MSM者肛门HPV感染率和尖锐湿疣的发病率。HPV分型采用通用引物PCR和反向点杂交技术建立的检测方法。统计学分析采用t检验和χ2检验。结果HIV阳性MSM者任何型、高危型和多重HPV感染率高于HIV阴性的MSM者,分别为91.4%比62.0%、75.3%比30.0%和56.8%比20.0%(χ2值分别为16.75、26.05和19.10,均P<0.05)。cART持续36个月与cART前比较,77例HIV阳性MSM者肛门任何型、高危型和多重HPV感染率显著降低,分别为90.9%比74.0%、75.3比44.2%和57.1%比41.5%(χ2值分别为7.590、15.551和3.741,均P<0.05)。HPV16型和43型感染率由cART前的27.3%降至15.6%和13.0%(χ2值分别为16.92和14.86,均P<0.05),尖锐湿疣的发病率由16.9%降至5.2%(χ2=4.069,P<0.05)。结论HIV阳性MSM者肛门HPV感染率高于HIV阴性MSM者,cART可降低肛门HPV感染率和尖锐湿疣的发病率,尤其是降低高危型HPV感染率。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 na?ve 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.

关 键 词：抗反转录病毒治疗 人乳头状瘤病毒 人类免疫缺陷病毒 尖锐湿疣 感染 

分 类 号：R512.91[医药卫生—内科学]