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Oral Human Papillomavirus Infection: Differences in Prevalence Between Sexes and Concordance With Genital Human Papillomavirus Infection, NHANES 2011 to 2014
Annals of Internal Medicine ( IF 19.6 ) Pub Date : 2017-10-17 , DOI: 10.7326/m17-1363
Kalyani Sonawane 1 , Ryan Suk 1 , Elizabeth Y Chiao 1 , Jagpreet Chhatwal 1 , Peihua Qiu 1 , Timothy Wilkin 1 , Alan G Nyitray 1 , Andrew G Sikora 1 , Ashish A Deshmukh 1
Affiliation  

Background:

The burden of human papillomavirus (HPV)–positive oropharyngeal squamous cell carcinoma (OPSCC) is disproportionately high among men, yet empirical evidence regarding the difference in prevalence of oral HPV infection between men and women is limited. Concordance of oral and genital HPV infection among men is unknown.

Objective:

To determine the prevalence of oral HPV infection, as well as the concordance of oral and genital HPV infection, among U.S. men and women.

Design:

Nationally representative survey.

Setting:

Civilian noninstitutionalized population.

Participants:

Adults aged 18 to 69 years from NHANES (National Health and Nutritional Examination Survey, 2011 to 2014).

Measurements:

Oral rinse, penile swab, and vaginal swab specimens were evaluated by polymerase chain reaction followed by type-specific hybridization.

Results:

The overall prevalence of oral HPV infection was 11.5% (95% CI, 9.8% to 13.1%) in men and 3.2% (CI, 2.7% to 3.8%) in women (equating to 11 million men and 3.2 million women nationwide). High-risk oral HPV infection was more prevalent among men (7.3% [CI, 6.0% to 8.6%]) than women (1.4% [CI, 1.0% to 1.8%]). Oral HPV 16 was 6 times more common in men (1.8% [CI, 1.3% to 2.2%]) than women (0.3% [CI, 0.1% to 0.5%]) (1.7 million men vs. 0.27 million women). Among men and women who reported having same-sex partners, the prevalence of high-risk HPV infection was 12.7% (CI, 7.0% to 18.4%) and 3.6% (CI, 1.4% to 5.9%), respectively. Among men who reported having 2 or more same-sex oral sex partners, the prevalence of high-risk HPV infection was 22.2% (CI, 9.6% to 34.8%). Oral HPV prevalence among men with concurrent genital HPV infection was fourfold greater (19.3%) than among those without it (4.4%). Men had 5.4% (CI, 5.1% to 5.8%) greater predicted probability of high-risk oral HPV infection than women. The predicted probability of high-risk oral HPV infection was greatest among black participants, those who smoked more than 20 cigarettes daily, current marijuana users, and those who reported 16 or more lifetime vaginal or oral sex partners.

Limitation:

Sexual behaviors were self-reported.

Conclusion:

Oral HPV infection is common among U.S. men. This study's findings provide several policy implications to guide future OPSCC prevention efforts to combat this disease.

Primary Funding Source:

National Cancer Institute.



中文翻译:


口腔人乳头瘤病毒感染:性别之间的患病率差异以及生殖器人乳头瘤病毒感染的一致性,NHANES 2011 至 2014 年


 背景:


男性中人乳头瘤病毒 (HPV) 阳性口咽鳞状细胞癌 (OPSCC) 的负担过高,但有关男性和女性口腔 HPV 感染患病率差异的经验证据有限。男性口腔和生殖器 HPV 感染的一致性尚不清楚。

 客观的:


旨在确定美国男性和女性口腔 HPV 感染的患病率以及口腔和生殖器 HPV 感染的一致性。

 设计:


全国代表性调查。

 环境:


非制度化平民人口。

 参加者:


来自 NHANES 的 18 至 69 岁成年人(国家健康和营养检查调查,2011 年至 2014 年)。

 尺寸:


通过聚合酶链反应和类型特异性杂交对口腔冲洗液、阴茎拭子和阴道拭子样本进行评估。

 结果:


男性口腔 HPV 感染总体患病率为 11.5%(95% CI,9.8% 至 13.1%),女性为 3.2%(CI,2.7% 至 3.8%)(相当于全国有 1100 万男性和 320 万女性)。高危口腔 HPV 感染在男性 (7.3% [CI, 6.0% to 8.6%]) 中比女性 (1.4% [CI, 1.0% to 1.8%]) 更常见。男性口腔 HPV 16 的发病率(1.8% [CI,1.3% 至 2.2%])是女性(0.3% [CI,0.1% 至 0.5%])的 6 倍(170 万男性 vs. 27 万女性)。在自称有同性伴侣的男性和女性中,高危 HPV 感染率分别为 12.7%(CI,7.0% 至 18.4%)和 3.6%(CI,1.4% 至 5.9%)。在自称有 2 个或以上同性口交伴侣的男性中,高危 HPV 感染率为 22.2%(CI,9.6% 至 34.8%)。同时感染生殖器 HPV 的男性口腔 HPV 患病率 (19.3%) 是未感染男性 (4.4%) 的四倍。男性高危口腔 HPV 感染的预测概率比女性高 5.4%(CI,5.1% 至 5.8%)。高危口腔 HPV 感染的预测概率在黑人参与者、每天吸 20 支以上香烟的参与者、当前吸食大麻的参与者以及报告有 16 个或以上终生阴道或口交伴侣的参与者中最高。

 局限性:


性行为是自我报告的。

 结论:


口腔 HPV 感染在美国男性中很常见。这项研究的结果提供了一些政策启示,以指导未来对抗这种疾病的 OPSCC 预防工作。

 主要资金来源:


国家癌症研究所。

更新日期:2017-10-17
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