Abstract:
Human papillomaviruses (HPVs) commonly infect the anogenital mucosa; most infections are transient, but a fraction of those caused by high-risk (HR) types persist and may lead to anogenital cancer. The epidemiology of HPV genotypes in anal infections in groups at different risk for anal cancer has not been well described in Italy. This retrospective study reports the results of HPV DNA testing and complete genotyping performed on anal swabs from 691 female and male patients attending proctology clinics in Rome during 2012-2021; one-third had repeated testing. Cumulative HPV positivity in 1212 anal swabs was approximately 60%, was not age related, and showed an increasing trend over the study period. HPV rates differed significantly by sex and HIV status: HIV-negative women had the lowest (43.6%) and HIV-positive men the highest (83.5%) HPV prevalence. HIV-positive men had more oncogenic HPV genotypes detected, more multiple infections, and the highest frequency of persistent infections. Two-thirds of all infections were vaccine-preventable. This study found that anal HPV infection rates are still elevated and even increasing in groups at low and high risk of developing anal cancer. Prevention programs need to be improved to reduce rates of anal infection in young women and men.
摘要:
人乳头瘤病毒(HPV)通常感染肛门生殖器粘膜;大多数感染是短暂的,但是由高风险(HR)类型引起的一小部分仍然存在,并可能导致肛门生殖器癌。在意大利,在肛门癌的不同风险人群中,肛门感染中HPV基因型的流行病学尚未得到很好的描述。这项回顾性研究报告了2012-2021年期间在罗马诊所就诊的691名女性和男性患者的肛门拭子的HPVDNA检测和完整基因分型结果;三分之一的人进行了重复测试。1212个肛门拭子中的累积HPV阳性约为60%,与年龄无关,并在研究期间显示出增加的趋势。不同性别和HIV感染状况的HPV感染率差异显著:HIV阴性女性的HPV感染率最低(43.6%),HIV阳性男性的HPV感染率最高(83.5%)。HIV阳性男性检测到更多的致癌HPV基因型,更多的多重感染,持续感染的频率最高。所有感染的三分之二是疫苗可预防的。这项研究发现,在低风险和高风险发生肛门癌的人群中,肛门HPV感染率仍在升高,甚至在增加。需要改进预防方案,以降低年轻男女的肛门感染率。