PO.PS01.11 · 人群科学
HIV感染者更新队列中非疫苗覆盖的高危口腔HPV负担：对公共卫生策略的意义
Burden of non-vaccine high-risk oral HPV in updated cohort of people with HIV: Implications for public health strategies
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摘要 Abstract
中文摘要
引言/背景：人乳头瘤病毒（HPV）是最常见的性传播感染，被认为是与癌症相关的第二大感染性病原体。HIV感染者（PWH）尽管接受抗逆转录病毒治疗，仍面临更高的口腔HPV感染风险，从而增加其患口咽癌（OPC）的风险。虽然HPV有200多种基因型，但其中约15种被归类为高危（hr）型，并对HPV相关癌症负责。目前，美国推荐九价HPV疫苗，可预防（6、11、16、18、31、33、45、52、58）HPV型别。HPV疫苗接种推荐用于女性以及13-26岁男性；27-45岁成人可根据与临床医生的讨论接种HPV疫苗。2023年，美国西班牙裔的HPV疫苗接种率为60%，但在波多黎各（PR）仍然有限，尤其是在PWH中。在此，我们描述了PWH中按HPV基因型划分的口腔HPV感染流行率，调查了HPV疫苗接种率，以及与HPV感染相关的非医学因素。
方法：我们评估了184名性活跃的PWH，中位年龄为48岁。采集口腔漱口样本，使用DNA ELISA试剂盒HPV SPF10和RHA试剂盒HPV SPF10-LiPA25进行HPV检测和基因分型。通过实施的问卷收集社会人口学特征和生活方式变量。统计分析在R统计软件中进行。
结果：口腔HPV感染的流行率为33%，其中62%为hr基因型，HPV-18最为丰富（30%）。此外，其他hr HPV的流行率为14%（HPV-35）、11%（HPV-33、HPV-16）、5%（HPV-39、HPV-51、HPV-53、HPV-56、HPV-59、HPV-74）和3%（HPV-44、HPV-43、HPV-70）。当前九价疫苗未覆盖的hr HPV基因型的流行率（57%）高于疫苗覆盖的hr基因型（41%）。hr HPV与社会行为因素之间无显著差异，如当前吸烟者（p=0.35）、一生中超过五十个性伴侣（p=0.40）和教育水平（p=0.53）。
结论：PWH表现出较高的口腔HPV感染流行率，高于此前在PR记录的水平。虽然当前HPV疫苗对某些hr HPV致癌基因型提供广泛保护，但有限的疫苗接种率可能导致口腔HPV感染的持续存在。此外，我们观察到其他几种目前现有疫苗未覆盖的hr HPV致癌基因型，凸显了对新型改良HPV疫苗的需求。
查看英文原文 English abstract
Introduction/Background: Human papillomavirus (HPV) is the most common sexually transmitted infection and is considered the second infectious agent related to cancer. People with HIV (PWH) are at a higher risk of acquiring oral HPV infection, despite antiretroviral therapy, increasing their risk for oropharyngeal cancer (OPC). While there are more than 200 HPV genotypes, about 15 of them are classified as high-risk (hr) and responsible for HPV-related cancers. Currently, a nine-valent HPV vaccine is recommended in the US, providing protection against (6,11,16,18,31,33,45,52,58) HPV types. HPV vaccination is recommended for females, and males aged 13-26 years; for adults ages 27-45 years might get the HPV vaccination based on discussion with their clinician. In 2023, HPV vaccination rates among US Hispanics were 60%, but in Puerto Rico (PR) remain limited, particularly among PWH. Here, we described the prevalence of oral HPV infection by HPV genotypes among PWH, investigated HPV vaccination rates, and nonmedical factors associated with HPV infection.
Methods: We evaluated 184 sexually active PWH with a median age of 48 years. Oral rinse samples were collected and analyzed for HPV and genotyped using the DNA ELISA kit HPV SPF10 and RHA kit HPV SPF10-LiPA25. An administered questionnaire collected sociodemographic characteristics and lifestyle variables. Statistical analyses were performed in R-statistical software.
Results: The prevalence of oral HPV infection was 33%, of which 62% were hr genotypes, with HPV-18 being the most abundant (30%). Also, the prevalence of other hr HPV was 14% (HPV-35), 11% (HPV-33, HPV-16), 5% (HPV-39, HPV-51, HPV-53, HPV-56, HPV-59, HPV-74), and 3% (HPV-44, HPV-43, HPV-70). The prevalence of hr HPV genotypes not covered by the current nine-valent vaccine were more prevalent (57%) than vaccine covered hr genotypes (41%). There are not significantly difference between hr HPV, and socio-behavioral factors as current smokers (p=0.35), more than fifty sexual partners in lifetime (p=0.40), and education level (p=0.53).
Conclusion: PWH exhibited an elevated prevalence of oral HPV infection, with rates higher than those previously documented in PR. Although current HPV vaccines offer broad protection to some hr HPV oncogenic genotypes, limited vaccination rates may contribute to the persistence of oral HPV infection. Additionally, we have observed several other hr HPV oncogenic genotypes which are not currently covered by the existing vaccines, highlight the need for novel improved HPV vaccines.
利益披露 Disclosure
J. Torres-Reyes, None..
G. Borges-Vélez, None..
J. L. Salgado Montilla, None..
M. M. Sánchez-Vázquez, None..
M. Martinez-Ferrer, None..
R. F. Gonzalez-Garcia, None..
J. Perez-Santiago, None.