HIV暴露前预防(PrEP)与人乳头瘤病毒(HPV)的自然史之间的关联尚未得到充分证明。我们的目的是评估PrEP对患病率的影响,发病率,与男性发生性关系(MSM)的男性中肛门HPV的清除。性活动,新疆18岁及以上HIV阴性MSM,自2016年9月1日起,中国纳入了一项正在进行的HPV观察性队列研究。在基线和每6个月,我们用肛门拭子检测HPV,并收集社会人口统计学特征和性行为问卷.同意接受PrEP的人从2019年11月1日至2021年6月30日参加了一项开放标签PrEP干预研究。这项研究分析了2019年11月1日至2021年6月30日之间HPV队列中参与者的数据。我们比较了患病率,发病率,接受PrEP(PrEP使用者)和未接受PrEP(非PrEP使用者)的男性之间的肛门HPV清除,并比较了男性在开始PrEP之前和之后。我们计算了患病率比率(PRs),发病率比率(IRR),以及两种比较的清除率比(CRR)。在2019年11月1日至2021年6月30日期间HPV队列中的870名参与者中,有859名具有足够的β-珠蛋白用于HPV基因型检测,并被纳入我们的研究。其中,429个是PrEP用户,而430是非PrEP用户。中位年龄为32岁(四分位间距[IQR]:26-38)。在PrEP用户中,在PrEP开始之前对217进行肛门HPV检测。PrEP使用者的HPV45、51和54的患病率较低(PR:0.27[95%CI:0.09-0.80],0.42[0.21-0.85],和0.41[0.17-0.99],分别)和与非PrEP使用者相比,HPV16的清除率较低(CRR:0.31[0.10-0.91])。PrEP使用者表现出较低的HPV51患病率(PR:0.31[0.12-0.84]),HPV6、11、16、39和61的发病率较低(IRR:0.34[0.13-0.90],0.26[0.08-0.87],0.44[0.21-0.91],0.21[0.05-0.93],和0.19[0.04-0.82],分别),以及PrEP开始后HPV52的清除率更高(CRR:2.17[1.08-4.35])。使用PrEP可以降低新疆MSM人群HPV感染的风险,中国。我们的发现进一步扩展了PrEP对性传播感染的影响的知识。
The association between HIV pre-exposure prophylaxis (PrEP) and the natural history of human papillomavirus (HPV) has not been well documented. Our objective was to evaluate the impact of PrEP on the prevalence, incidence, and clearance of anal HPV among men who have sex with men (MSM). Sexually active, HIV-negative MSM aged 18 years and older in Xinjiang,
China since September 1, 2016, were enrolled in an ongoing observational cohort study of HPV. At baseline and every 6 months, an anal swab was taken to test for HPV and a questionnaire on sociodemographic characteristics and sexual behaviors was collected. Those who consented to receive PrEP were enrolled in an open-label PrEP intervention study from November 1, 2019, to June 30, 2021. This study analyzed data from participants present in the HPV cohort between November 1, 2019, and June 30, 2021. We compared the prevalence, incidence, and clearance of anal HPV between men who received PrEP (PrEP users) and those who did not (non-PrEP users), and compared men before and after initiating PrEP. We calculated prevalence ratios (PRs), incidence rate ratios (IRRs), and clearance rate ratios (CRRs) for both comparisons. Of the 870 participants present in the HPV cohort during the period between November 1, 2019, and June 30, 2021, 859 had adequate β-globin for HPV genotype testing and were included in our study. Among them, 429 were PrEP users, while 430 were non-PrEP users. Median age was 32 years (interquartile range [IQR]: 26-38). Among PrEP users, 217 were tested for anal HPV before PrEP initiation. PrEP users had lower prevalence of HPV 45, 51, and 54 (PRs: 0.27 [95% CI: 0.09-0.80], 0.42 [0.21-0.85], and 0.41 [0.17-0.99], respectively) and lower clearance of HPV 16 (CRR: 0.31 [0.10-0.91]) compared with non-PrEP users. PrEP users exhibited lower prevalence of HPV 51 (PR: 0.31 [0.12-0.84]), lower incidence of HPV 6, 11, 16, 39 and 61 (IRRs: 0.34 [0.13-0.90], 0.26 [0.08-0.87], 0.44 [0.21-0.91], 0.21 [0.05-0.93], and 0.19 [0.04-0.82], respectively), as well as higher clearance of HPV 52 (CRR: 2.17 [1.08-4.35]) after PrEP initiation. PrEP use may lower the risk of HPV infection among MSM in Xinjiang,
China. Our findings further extend the knowledge of the impact of PrEP on sexually transmitted infections.