High-risk human papillomavirus (HR-HPV) anal infection is a major problem among men who have sex with men (MSM) living in sub-Saharan Africa. The prevalence of anal HR-HPV infection and associated risk factors were estimated in a cross-sectional study in MSM living in Bamako, Mali. MSM consulting at sexual health center of the National NGO Soutoura, Bamako, were prospectively included. Sociodemographic and clinical-biological data were collected. HPV detection and genotyping were performed from anal swabs using multiplex real-time PCR. Risk factors associated with anal HPV infection were assessed by logistic regression analysis. Fifty MSM (mean age, 24.2 years; range, 18–35) of which 32.0% were infected with HIV-1, were prospectively included. The overall prevalence of anal HPV infection of any genotypes was 70.0% (35/50) with 80.0% (28/35) of swabs positive for HR-HPV. HR-HPV-58 was the most detected genotype [13/35 (37.1%)], followed by HR-HPV-16 and low-risk (LR)-HPV-6 [12/35 (34.2%)], LR-HPV-40 [10/35 (28.6%)], LR-HPV-11 [9/35 (25.7%)], HR-HPV-51 [8/35 (22.8%)], HR-HPV types 18 and 39 [7/35 (20.0%)] and LR-HPV-43 [6/35 (17.1%)]. HR-HPV-52 and LR-HPV-44 were detected in lower proportions [5/35 (14.3%) and 4/35 (11.4%), respectively]. LR-HPV-42, LR-HPV-54, HR-HPV-31 and HR-HPV-35 were detected in very low proportions [3/35 (8.5%)]. Multiple HR-HPV infections were diagnosed in one-third of anal samples [16/50 (32.0%)], including around half of HR-HPV-positive anal swabs [16/35 (45.7%)]. More than half [27/50 (54.0%)] swabs were infected by at least one of HPV genotypes targeted by Gardasil-9® vaccine, including a majority of vaccine HR-HPV [22/50 (44.0%)]. In multivariate analysis, participation to sex in group was associated with anal infection by multiple HPV (aOR: 4.5, 95% CI: 1.1–18.1%; P = 0.032), and HIV-1 infection was associated with anal shedding of multiple HR-HPV (aOR: 5.5, 95% CI: 1.3–24.5%; P = 0.024). These observations indicate that the MSM community living in Bamako is at high-risk for HR-HPV anal infections, with a unique epidemiological HPV genotypes profile and high prevalence of anal HPV covered by the Gardasil-9® vaccine. Scaling up prevention strategies against HPV infection and related cancers adapted to this highly vulnerable MSM community should be urgently prioritized with innovative interventions.

中文翻译：

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生活在马里巴马科的男男性接触者肛门致癌性人乳头瘤病毒感染率高

高危人乳头瘤病毒 (HR-HPV) 肛门感染是生活在撒哈拉以南非洲的男男性行为者 (MSM) 中的一个主要问题。在居住在马里巴马科的 MSM 的横断面研究中估计了肛门 HR-HPV 感染的流行率和相关的危险因素。预期包括在巴马科国家非政府组织 Soutoura 的性健康中心进行的 MSM 咨询。收集了社会人口学和临床生物学数据。使用多重实时 PCR 从肛门拭子中进行 HPV 检测和基因分型。通过逻辑回归分析评估与肛门HPV感染相关的危险因素。前瞻性纳入了 50 名 MSM（平均年龄，24.2 岁；范围，18-35 岁），其中 32.0% 感染了 HIV-1。任何基因型肛门 HPV 感染的总患病率为 70.0% (35/50)，其中 80。0% (28/35) 的拭子 HR-HPV 呈阳性。HR-HPV-58 是检测到最多的基因型 [13/35 (37.1%)]，其次是 HR-HPV-16 和低风险 (LR)-HPV-6 [12/35 (34.2%)]，LR- HPV-40 [10/35 (28.6%)]、LR-HPV-11 [9/35 (25.7%)]、HR-HPV-51 [8/35 (22.8%)]、HR-HPV 18 和 39 型[7/35 (20.0%)] 和 LR-HPV-43 [6/35 (17.1%)]。HR-HPV-52 和 LR-HPV-44 的检测比例较低 [分别为 5/35 (14.3%) 和 4/35 (11.4%)]。LR-HPV-42、LR-HPV-54、HR-HPV-31 和 HR-HPV-35 的检测比例非常低 [3/35 (8.5%)]。在三分之一的肛门样本中诊断出多种 HR-HPV 感染 [16/50 (32.0%)]，其中包括大约一半的 HR-HPV 阳性肛门拭子 [16/35 (45.7%)]。超过一半 [27/50 (54.0%)] 的拭子被 Gardasil-9® 疫苗靶向的 HPV 基因型中的至少一种感染，包括大多数疫苗 HR-HPV [22/50 (44.0%)]。在多变量分析中，组内参与性行为与肛门感染多种 HPV 相关（aOR：4.5，95% CI：1.1-18.1%；P = 0.032），HIV-1 感染与肛门脱落多种 HR- HPV（aOR：5.5，95% CI：1.3–24.5%；P = 0.024）。这些观察结果表明，生活在巴马科的 MSM 社区处于 HR-HPV 肛门感染的高风险中，具有独特的流行病学 HPV 基因型谱和 Gardasil-9® 疫苗覆盖的肛门 HPV 的高流行率。应紧急优先考虑创新干预措施，以扩大针对 HPV 感染和相关癌症的预防策略，以适应这个高度脆弱的 MSM 社区。HIV-1 感染与肛门排出多种 HR-HPV 相关（aOR：5.5，95% CI：1.3-24.5%；P = 0.024）。这些观察结果表明，生活在巴马科的 MSM 社区处于 HR-HPV 肛门感染的高风险中，具有独特的流行病学 HPV 基因型谱和 Gardasil-9® 疫苗覆盖的肛门 HPV 的高流行率。应紧急优先考虑创新干预措施，以扩大针对 HPV 感染和相关癌症的预防策略，以适应这个高度脆弱的 MSM 社区。HIV-1 感染与肛门排出多种 HR-HPV 相关（aOR：5.5，95% CI：1.3-24.5%；P = 0.024）。这些观察结果表明，生活在巴马科的 MSM 社区处于 HR-HPV 肛门感染的高风险中，具有独特的流行病学 HPV 基因型谱和 Gardasil-9® 疫苗覆盖的肛门 HPV 的高流行率。应紧急优先考虑创新干预措施，以扩大针对 HPV 感染和相关癌症的预防策略，以适应这个高度脆弱的 MSM 社区。