Influence of age and CD4+ T cell counts on the prevalence of genital human papillomavirus infection among HIV‐seropositive men who have sex with men in Taiwan

This study aimed to examine the baseline prevalence of genital human papillomavirus (HPV) infection among human immunodeficiency virus (HIV)‐seropositive men who have sex with men in Taiwan and to determine the association of age and CD4+ T cell counts with HPV infection. In 2010, 305 men who have sex with men infected with HIV and 100 HIV‐seronegative men who have sex with men were recruited. Genital swabs were collected and 37 HPV genotypes were detected using linear array HPV genotyping. HPV infection was present in 45.3% of the patients infected with HIV and in 18% of the HIV‐negative subjects (P < 0.001). HPV types 52, 51, and 16 were the most commonly identified oncogenic types. Oncogenic HPV types were identified in 31.2% of the patients infected with HIV and in 13% of the seronegative subjects (P < 0.001). Adjusted odd ratios (ORs) for the detection of any HPV type were 2.9 (95% confidence interval [CI], 1.4–5.9) for men who have sex with men aged 30–34 and 2.1 (95% CI, 1.1–4.3) for those aged >35 compared with that for those aged <25. ORs were 2.8 (95% CI, 1.0–7.4) for a CD4+ T cell count of 200–350 cells/µl and 8.5 (95% CI, 2.9–24.5) for a CD4+ T cell count of <200 cells/µl compared with that for seronegative subjects. In conclusion, this novel HPV study, carried out in Northern Taiwan on men who have sex with men, revealed that age and immune state were associated significantly and independently with HPV infection. J. Med. Virol. 84:1876–1883, 2012. © 2012 Wiley Periodicals, Inc.     

Seroprevalence of Kaposi's sarcoma‐associated herpesvirus among men who have sex with men in Japan

Kaposi's sarcoma‐associated herpesvirus (KSHV), the etiologic agent of Kaposi's sarcoma, causes malignancies frequently in patients with acquired immunodeficiency syndrome. In the United States and Europe, KSHV infection is common among men who have sex with men. However, the seroprevalence of KSHV among men who have sex with men in Japan is unknown. In the present study, the seroprevalence of KSHV was investigated among 230 men who have sex with men and 400 age‐ and area of residence‐matched men (controls) using a mixed‐antigen (KSHV‐encoded K8.1, open reading frame 59, 65, and 73 proteins) enzyme‐linked immunosorbent assay and an immunofluorescence assay. Among the Japanese men who have sex with men, serological assays revealed that 27 (11.7%) were seropositive for KSHV; 20 (5%) of the men in the control group were also KSHV seropositive. The seroprevalence of KSHV among men who have sex with men was significantly higher than in the control group (odds ratio = 2.52, 95% confidence intervals = 1.38–4.62, P = 0.0019, Chi‐square test). Infection with the human immunodeficiency virus, Treponema pallidum, or hepatitis B and C virus did not correlate with KSHV infection. Furthermore, the association of KSHV seropositivity with specific sexual activities was not statistically significant. In conclusion, a higher KSHV seroprevalence was found among Japanese men who have sex with men than among the controls, suggesting that the circulation of KSHV infection is more efficient among men who have sex with men in Japan than among men who do not engage in such sexual activities. J. Med. Virol. 85: 1046–1052, 2013. © 2013 Wiley Periodicals, Inc.     

Human papillomavirus (HPV) prevalence and type distribution,and HPV‐associated cytological abnormalities in anal specimens from men infected with HIV who have sex with men

Human papillomavirus (HPV) detection and typing using the PapilloCheck® test and cytological examination were carried out in anal samples collected from 67 men seropositive for human immunodeficiency virus (HIV) who have sex with men. Fifty (74.6%) patients had anal HPV infection, 46 (68.7%) had high‐risk (HR) HPV infection, and 38 (56.7%) had multiple infection involving 2–9 (median, 3) HPV types. The HPV types identified most frequently were HPV 44/55 (19.4%), HPV 53 (19.4%), HPV 16 (16.4%), HPV 39 (16.4%), and HPV 42 (14.9%). Thirty‐two of the 66 interpretable smears (48.5%) revealed cytological abnormalities: 9 (13.4%) atypical cells of undetermined significance, 20 (30.3%) low‐grade intraepithelial lesions, and 3 (4.5%) high‐grade intraepithelial lesions. Cytological abnormalities were associated significantly with HPV detection (P < 0.001), multiple HPV infection (P < 0.001), and increased number of HPV types (P < 0.001). The HPV types associated most frequently with cytological abnormalities were HPV 39 (28.1%), HPV 42 (28.1%), HPV 53 (28.1%), HPV 16 (25.0%), HPV 44/55 (25.0%), and HPV 59 (21.9%). HPV DNA detection as well as cytological abnormalities were associated neither with HIV RNA detection in plasma nor with CD4+ T‐cell count. Differences in age or in time since HIV acquisition were not observed in patients with or without cytological abnormalities. The present study confirms the high prevalence of anal HR‐HPV infection and cytological abnormalities in men infected with HIV who have sex with men. HPV testing and/or cytological analysis may be helpful in selecting the patients to be referred to proctological examination. J. Med. Virol. 82:592–596, 2010. © 2010 Wiley‐Liss, Inc.     

HIV阳性男男同性性行为者的执行功能及自评抑郁

目的:探讨HIV阳性男男同性性行为者(MSM)执行功能、自评抑郁的特征及两者的关系。方法:选取HIV感染MSM的患者209例及年龄、受教育程度匹配的HIV阴性MSM 84例。用威斯康星卡片分类测验64张卡片版(WCST-64)评估执行功能,流调中心抑郁量表(CES-D)评估抑郁状态。结果:HIV阳性MSM的WCST-64错误应答数、随机错误数高于HIV阴性MSM,完成分类数低于HIV阴性MSM(均P<0.05)。HIV阳性MSM中,抑郁组WCST-64错误应答数高于无抑郁组,概念化水平百分数低于无抑郁组(均P<0.05)。多元回归分析显示,HIV阳性MSM的年龄、CES-D得分与WCST-64错误应答数正向关联(β=0.33、0.15)、最低CD4+T细胞数与WCST-64错误应答数负向关联(β=-0.15)。结论:HIV阳性男男同性性行为者的执行功能低于HIV阴性者,且与抑郁状态负相关。     

Oral human papillomavirus type-specific infection in HIV-infected men: a prospective cohort study among men who have sex with men and heterosexual men

The natural history of type-specific oral infection of human papillomavirus (HPV) was assessed in a cohort of HIV-infected men (538 men who have sex with men (MSM); 195 heterosexuals). Risk factors associated with oral HPV infections were examined. The overall prevalence of HPV was 16%: HPV-16 was the most prevalent type (3.7% MSM; 7.8% heterosexuals). The prevalence of HPV-16 in heterosexuals was associated with CD4 nadir counts <200 cells/μL (OR_adjusted = 3.0, 95% CI, 1.4–6.3). The overall incidence of HPV was similar between groups (11%), but the incidence of HPV-16 was higher in heterosexuals (OR_adjusted = 3.2, 95% CI, 1.1–9.5). Not only MSM but also HIV-infected heterosexual men are at risk of HPV infection. Regular and careful oral inspection is needed.     

HIV检测对MSM人群艾滋病感染风险的影响

目的分析艾滋病检测对MSM人群知识、行为与感染HIV风险的影响,为调整MSM人群艾滋病防治策略提供依据。方法以过去一年接受过艾滋病检测的MSM人群为干预组,未接受过艾滋病检测的为对照组,比较两组的人口学特征、知识、行为以及梅毒与HIV感染率。结果干预组和对照组分别有423人和528人,平均年龄分别为（26.8±8.0）岁和（26.3±6.2）岁。干预组艾滋病防治知识知晓率高于对照组（χ2=28.9,P〈0.001）,最近6个月与男性发生无保护性性行为的比例低于对照组（χ2=14.7,P〈0.001）,HIV感染率明显低于对照组（χ2=15.0,P〈0.001）。结论艾滋病检测可以有效提高MSM人群安全套使用率,降低感染艾滋病的风险,应在MSM人群中倡导主动咨询检测,扩大咨询检测覆盖面。     

A survey of HIV infection and related high-risk factors among men who have sex with men in Suzhou,Jiangsu,China

A cross-sectional study using the snowball sampling method was conducted in May 2008 to investigate human immunodeficiency virus (HIV) infection status and related high risk factors among men who have sex with men (MSM) in Suzhou city of Jiangsu province. The researchers carried out a face-to-face questionnaire interview among MSM, and collected their blood samples to test for HIV and other sexually transmitted diseases (STDs). Among the 280 respondents, 91.1% had homosexual acts in the past 6 months and 87.5% had multiple homosexual partners; 46.4% had heterosexual sex in the past 6 months and 33.1% had multiple heterosexual partners. The rate of continued condom use was 44.3% in homosexual sex in the past 6 months, while the rate in heterosexual sex was 33.9%. Laboratory test results showed that the prevalences of HIV and syphilis were 7.1% (20/280) and 15.0% (42/280), respectively, but no HCV-positive person was found. In the multivariate logistic regression model, subjects with a monthly income of more than RMB $ 1,000 (OR=4.83,95% CI=1.44-16.22), subjects who often went to bars for sexual partners (OR=2.25, 95%CI=1.21-4.20), and subjects who had more than one sexual partner in the past 6 months (OR=0.49, 95%CI=0.25-0.97) and had sex with fixed sexual partners in the past 6 months (OR=0.42, 95%CI=0.25-0.75) were significantly associated with the rate of continued condom use in homosexual sex in the past 6 months. Unprotected sex and multiple sexual partners were more common among MSM in Suzhou city; furthermore, the prevalences of HIV infection and syphilis were relatively high. HIV preventive measures should be designed to address these risk factors and control the spread of HIV among MSM.     

Prevalence and risk factors of HIV and syphilis,and knowledge and risk behaviors related to HIV/AIDS among men who have sex with men in Chongqing,China

High HIV prevalence and incidence burdens have been reported in men who have sex with men (MSM) in Chongqing, China. We aimed to estimate the prevalence of HIV and other sexually transmitted infections (STIs), to appraise the knowledge and risk behaviors related to HIV/AIDS among MSM, and to analyze the possible causes of deviation between behavior and knowledge to make better strategies. We recruited 617 MSM from February to July in 2008 by using a respondent-driven sampling (RDS) method in Chongqing, China. Through the collection of questionnaire-based data and biological testing results from all objects, we launched a cross-sectional survey. STATA/SE was used for data analysis by frequency, ANOVA, rank sum test and logistic regression models. MSM with syphilis (OR=4.16, 95%CI: 2.35-7.33, P<0.0001) were more likely to be HIV infected. Being a company employee (OR=3.64, 95%CI: 1.22-10.08, P<0.0001) and having bought male for sex (OR=3.52, 95%CI: 1.10-11.32, P < 0.034) were associated with a higher probability of syphilis. MSM with younger age, higher education and greater monthly income had a higher mean knowledge score. MSM who had HIV testing had a higher mean knowledge score than those who never had. Students, venues for finding sex partners by Internet and homosexuals in MSM had a higher mean knowledge score compared to other occupations, venues for finding sex partners and sexual orientation. There is an urgent need for delivery of barrier and biomedical interventions with coordinated behavioral and structural strategies to improve the effect of HIV interventions among MSM.     

CXCR4-using HIV variants in a cohort of Black men who have sex with men: HIV Prevention Trials Network 061

Objective: To evaluate factors associated with HIV tropism among Black men who have sex with men (MSM) in the United States enrolled in a clinical study (HIV Prevention Trials Network 061).

Methods: HIV tropism was analyzed using a phenotypic assay (Trofile assay, Monogram Biosciences). Samples were analyzed from 43 men who were HIV infected at enrollment and reported either exclusive insertive intercourse or exclusive receptive intercourse; samples were also analyzed from 20 men who were HIV uninfected at enrollment and seroconverted during the study. Clonal analysis of individual viral variants was performed for seroconverters who had dual/mixed (DM) viruses.

Results: DM viruses were detected in samples from 11 (26%) of the 43 HIV-infected men analyzed at the enrollment visit; HIV tropism did not differ between those reporting exclusive insertive vs receptive intercourse. DM viruses were also detected in five (25%) of the 20 seroconverters. DM viruses were associated with lower CD4 cell counts. Seroconverters with DM viruses had dual-tropic viruses only or mixed populations of CCR5- and dual-tropic viruses.

Conclusions: DM viruses were frequently detected among Black MSM in this study, including seroconverters. Further studies are needed to understand factors driving transmission and selection of CXCR4- and dual-tropic viruses among Black MSM.     

2006-2009年重庆市男男性行为人群性行为特征及HIV和梅毒感染率分析

目的了解男男性行为（MSM）人群性行为特征及HIV和梅毒感染率与趋势变化,为开展该人群艾滋病综合防治提供建议。方法收集2006-2009年MSM人群调查资料,比较分析该人群性行为特征和HIV、梅毒感染率,以及估计HIV发病率的趋势变化。结果 2006-2009年分别调查了1000、1044、743和604名MSM,最近1次与男性发生性行为时安全套使用率由2006年的56.2%上升至2009年的66.1%,最近6个月与男性发生性行为时每次都使用安全套的比例低于40%。2006-2009年梅毒感染率分别为9.3%、8.5%、8.5%和11.9%,梅毒感染率2009年较2008年有上升的趋势,差异有统计学意义（P=0.04）;HIV感染率分别是10.4%、12.5%、16.6%和19.0%,2008年与2007年相比HIV感染率差异有统计学意义（P=0.01）;〈23岁年龄组MSM估计HIV发病率分别为2.4%、2.8%、4.8%和5.2%,2008年较2007年估计发病率差异有统计学意义（P=0.03）。结论重庆市MSM人群HIV感染率和估计发病率均呈逐年上升的趋势,安全套使用率低,MSM人群的艾滋病防治工作应引起高度重视。     

Human papillomavirus prevalence among men who have sex with men in China: a systematic review and meta-analysis

European Journal of Clinical Microbiology & Infectious Diseases - Human papillomavirus (HPV) infection among men who have sex with men (MSM) in China is underreported. We performed a systematic...     

Epidemiology of HIV-1 subtypes in an urban area of northern Italy

The distribution of the different subtypes of HIV varies from one region of the world to another. Subtype B is predominant in Europe and the USA, but there has been a gradual increase in non-B subtypes as a result of migration from regions where they are endemic, and this may have important implications for the control of HIV-1. The aim of this study was to assess the prevalence of HIV-1 subtypes in an urban area of northern Italy in the period 1997–2008. Forty-nine (12.2%; 95% CI, 9.00–15.40) of 401 patients investigated carried a non-B subtype, the prevalence of which was 7.7% (95% CI, 4.96–10.44) among native Italians and 55.3% (95% CI, 39.49–71.11) among non-Italians, 1.6% (95% CI, 0.00–3.81) among ex-intravenous drug addicts, 7.6% (95% CI, 1.21–13.99) among homosexual/bisexual men and 20.5% (95% CI, 14.83–26.17) among heterosexuals, 6.8% (95% CI, 3.37–10.23) among Italians infected as a result of sexual contacts in Italy, and 55.0% (95% CI, 33.20–76.80) among Italians infected abroad or by foreign partners. Overall prevalence increased from 2.9% (95% CI, 0.00–6.11) before 1993 to 23.0% (95% CI, 16.31–29.69) in the period 2001–2008. The results demonstrate that there has been an increase in non-B subtypes (especially sexually transmitted infections), particularly among patients infected abroad or by foreign partners.     

Prevalence of human papillomavirus infections among heterosexual men and women with multiple sexual partners.

A prospective study of 65 men and 111 women with multiple heterosexual partners was designed to assess the prevalence and potential risk factors of genital human papillomavirus (HPV) infections. In addition, the HPV reservoir in genital, rectal, and oral mucosa was examined. The specimens for the detection of HPV DNA were taken from different sites such as the urethra and coronal sulcus (men), cervix and labia minora (women), anus, rectum, tongue, and buccal mucosa (both men and women). Women underwent speculum examination and colposcopic evaluation of the anogenital region, and a smear for routine cytological classification was also taken. In men, the anogenital region was examined clinically and colposcopically. The polymerase chain reaction (PCR) was used for the detection of HPV types 6/11, 16, 18, and 33. A high prevalence of HPV infection at one or more sites was detected, in 32% of the male and in 23% of the female participants. Seventeen percent of the male distal urethral specimens were positive for HPV DNA. From the female cervical specimens 14% were found positive. Ten proctal specimens (five men and five women) were positive for HPV DNA without any discernible lesion. The persons from whom these samples were taken denied anal insertive intercourse. No oral manifestation of HPV infection was detected. In both men and women a difference between HPV DNA-positive and -negative persons was not found in relation to known risk factors associated HPV infection.(ABSTRACT TRUNCATED AT 250 WORDS)     

东莞市男男性行为者艾滋病知识行为调查

目的了解男男性行为者（MSM）艾滋病防治知识掌握情况及高危行为方式,为在该人群中开展艾滋病预防干预工作提供依据。方法在男男性行为者聚集场所进行问卷调查。结果调查对象年龄中位数为29岁,以未婚、高中文化程度、省外流动人口及在东莞居住2年以上者为主;艾滋病知识知晓率为91.75%;74.75%的调查者在过去的6个月中有过同性性行为（其中3.34%的人有过同性商业性行为）,其中51.84%的人每次都使用安全套;39%的人在过去的6个月与女性有过性行为,其中37.82%的人每次都使用安全套;27.25%的人在过去的6个月与男性、女性都有过性行为;7.25%的人在最近一年曾患过性病;10.5%的人HIV抗体筛查结果阳性。结论应采用民间组织宣传干预与VCT检测相结合的模式,加强MSM人群的艾滋病宣传教育工作,推广使用安全套,防止HIV在MSM人群中的传播及经其女性性伴向一般人群传播。     

Sofosbuvir in the treatment of early HCV infection in HIV-infected men

Background: There is an international epidemic of hepatitis C virus (HCV) infection among HIV-infected men who have sex with men. We previously showed that adding telaprevir to pegylated interferon (IFN) and ribavirin (RBV) both shortened treatment and increased the cure rate of early HCV in these men. Whether shortening treatment of early HCV using IFN-free regimens would be similarly successful has not yet been demonstrated.

Methods: We performed a pilot study of treatment with sofosbuvir (SOF) + RBV for 12 weeks in early genotype 1 HCV infection in HIV-infected men. The primary endpoint was SVR 12.

Results: Twelve men were treated with 12 weeks SOF + RBV and 11 (92%) achieved SVR 12. Most (63%) were actively using recreational drugs, mostly methamphetamine. The one man who failed had laboratory results more characteristic of chronic than of early HCV infection. The overall safety profile was similar to that known for SOF + RBV.

Conclusions: The success of this short-duration IFN-free treatment in early HCV infection is proof in principle that enhanced treatment responsiveness is an inherent characteristic of early HCV infection and not a function of IFN treatment itself. Future studies should now be done with more potent regimens to try to further shorten therapy. In the mean time, in clinical practice early HCV infection should be treated immediately after detection to take advantage of short-duration treatments, as well as to decrease further HCV transmission among HIV-infected MSM.