背景:先前的研究表明,男性包皮环切术对男性人乳头瘤病毒(HPV)感染具有保护作用,这种保护可以授予她们的女性性伴侣。
目的:综合男性和女性包皮环切术与HPV感染相关的现有证据。
方法:我们搜索了MEDLINE,Embase,Scopus,科克伦,LILACS,以及截至2022年6月22日发布的ProQuest论文和论文全球记录。
方法:我们考虑了评估男性包皮环切状态和HPV患病率的观察性和实验性研究,发病率,或清除男性或女性。
方法:男性及其女性性伴侣进行生殖器HPV感染检测。
方法:男性包皮环切术与无包皮环切术比较。
■纽卡斯尔-渥太华量表用于观察性研究,并将Cochrane偏倚风险工具用于随机试验.
结果:我们估计了患病率的效果汇总指标和95%CI,发病率,使用随机效应荟萃分析清除男性和女性的HPV感染。我们使用随机效应meta回归评估了男性阴茎部位包皮环切术对HPV患病率的影响。
结果:在32项研究中,男性包皮环切术与流行HPV感染的几率降低相关(优势比,0.45;95%CI,0.34-0.61),降低HPV感染的发病率(发病率比,0.69;95%CI,0.57-0.83),和清除HPV感染的风险增加(风险比,1.44;95%CI,1.28-1.61)在男性受试者的龟头。包皮环切术对龟头感染的保护作用比轴更强(赔率比,0.68;95%CI,0.48-0.98)。受割礼伴侣的女性受到保护,免受所有结果的影响。
结论:男性包皮环切术可以预防各种HPV感染结果,表明其预防潜力。了解包皮环切术对HPV感染患病率的特定部位影响对HPV传播的研究具有重要意义。
BACKGROUND: Previous studies have suggested a protective effect of male
circumcision on human papillomavirus (HPV) infections in males, and that this protection may be conferred to their female sexual partners.
OBJECTIVE: To synthesize the available evidence on the association between male
circumcision and HPV infections in males and females.
METHODS: We searched MEDLINE, Embase, Scopus, Cochrane, LILACS, and ProQuest Dissertations & Theses Global for records published up to 22 June 2022.
METHODS: We considered observational and experimental studies that assessed male
circumcision status and HPV prevalence, incidence, or clearance in males or females for inclusion.
METHODS: Males and their female sexual partners who were tested for genital HPV infection.
METHODS: Male
circumcision compared with no
circumcision.
UNASSIGNED: The Newcastle-Ottawa scale was used for observational studies, and the Cochrane risk-of-bias tool was used for randomized trials.
RESULTS: We estimated summary measures of effect and 95% CIs for the prevalence, incidence, and clearance of HPV infections in males and females using random-effects meta-analysis. We assessed the effect modification of circumcision on HPV prevalence by the penile site in males using random-effects meta-regression.
RESULTS: Across 32 studies, male circumcision was associated with decreased odds of prevalent HPV infections (odds ratio, 0.45; 95% CI, 0.34-0.61), a reduced incidence rate of HPV infections (incidence rate ratio, 0.69; 95% CI, 0.57-0.83), and an increased risk of clearing HPV infections (risk ratio, 1.44; 95% CI, 1.28-1.61) at the glans penis among male subjects.
Circumcision conferred greater protection against infection at the glans than the shaft (odds ratio, 0.68; 95% CI, 0.48-0.98). Females with circumcised partners were protected from all outcomes.
CONCLUSIONS: Male circumcision may protect against various HPV infection outcomes, suggesting its prophylactic potential. Understanding the site-specific effects of circumcision on HPV infection prevalence has important implications for studies of HPV transmission.