HPV Infections among MSM in Shenzhen, China
Citation: Zhang D-Y, Yin Y-P, Feng T-J, Hong F-C, Jiang N, et al. (
HPV Infections among MSM in Shenzhen, China
Dong-Yan Zhang 0
Yue-Ping Yin 0
Tie-Jian Feng 0
Fu-Chang Hong 0
Ning Jiang 0
Bao-Xi Wang 0
Xiang-Sheng Chen 0
Michael Scheurer, Baylor College of Medicine, United States of America
0 1 Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Dermatology , Nanjing , China , 2 National Center for STD Control , China CDC, Nanjing , China , 3 Shenzhen Center for Chronic Disease Control and Prevention , Shenzhen , China
Background: An increasing incidence of anal cancer among men, especially men who have sex with men (MSM) suggests a need to better understand anal human papillomavirus (HPV) infection among this group. Methods: A cross-sectional study was conducted among MSM in Shenzhen, China. Blood was collected for HIV serological testing and syphilis serological screening, and anal swabs were collected for HPV genotyping. Difference of HPV prevalence between HIV seropositive and HIV seronegative MSM was assessed by chi-square test. Factors associated with anal canal HPV infection were assessed by univariate and multivariate logistic regression.
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Results: A total of 408 MSM were recruited. HIV and HPV prevalence were 6.9% and 36.4%, respectively. HPV was detected
in the anal canal in 71.4% of the HIV-positive MSM and in 33.8% of the HIV-negative MSM (P,0.001). Oncogenic types were
seen more often in anal specimens of HIV-positive MSM than in specimens of HIV-negative MSM (P = 0.001). The HPV
genotypes detected most frequently were HPV06 (8.2%), HPV16 (7.2%), HPV11 (6.4%), HPV18 (4.7%), HPV58 (4.7%), and
HPV52 (4.2%).
Conclusions: In this study, HIV positive MSM had a higher burden of HPV infection, especially oncogenic HPV infection. HPV
types 52 and 58 were as popular as those types designed for the currently available vaccine (HPV6, 11, 16, 18).
Funding: The study was supported by a grant from the Mega Project of China National Science Research for the 11th Five-Year Plan (2008ZX10001005).
Additional funding was received from National science and technology major special project- jiangsu provincial demonstration project on infectious diseases
control and prevention (Grant No:2009ZX10004904). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of
the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Infection with Human papillomavirus (HPV) is the most
common sexually transmitted infection worldwide [1]. More than
40 types of HPV could infect the anogenital region. HPV types
that infect the ano-genital location could be divided into oncogenic
types and non-oncogenic types [2].
Approximately 85% of anal cancers worldwide are attributed to
the oncogenic HPV [3]. Although anal cancers are rare in the
general population (1.5 cases/100,000 population)[4], they are
more common among men who has sex with men (MSM) and
those infected with human immunodeficiency virus (HIV).
HIVpositive MSM have an approximately 1.5 times higher prevalence
of anal HPV infection and a 5 times higher risk to develop anal
cancer than HIV-negative MSM [57]. The high prevalence of
oncogenic HPV infection and its association with anal cancer
among MSM call for molecular epidemiological studies on anal
HPV infection among MSM [8].
In China, most studies on prevalence of anal HPV infection
among MSM were in northern part of China, while the data on
molecular epidemiological studies of anal HPV infection in
southern China is limited [912]. The current cross-sectional
study was aimed to investigate the HPV prevalence and genotype
distribution in a Chinese southern City, Shenzhen.
Ethic statement
The study protocol was reviewed and approved by the Medical
Ethics Committee of the Chinese Academy of Medical Sciences
Institute of Dermatology in Nanjing. Written informed consent
was obtained from each study participant before the interview and
testing. Publication of the study data is in accordance with the
community standards and approved by the ethics committee.
Study population and samples
The study was carried out between July and September of 2009
in a sexually transmitted diseases (STD) clinic specially providing
health care for MSM in Shenzhen, China. Those eligible to
participate were males, at least 18 years old, ever had sex with
another man, willing to provide anal swabs and blood for the tests,
physically able and willing to provide written informed consent.
After an informed consent was obtained, socio-demographic and
sexual behavior data were collected through a face-to-face
interview by the trained clinical staff in a separate room using a
standardized questionnaire. The questions included age, ethnicity,
education, marriage status, place of domicile, dwelling status,
selfreported sexual orientation, ever had skin lesions in genitalia
(including abnormal secretions, bleeding, breakage, a (...truncated)