Effect of Male Circumcision on the Prevalence of High-Risk Human Papillomavirus in Young Men: Results of a Randomized Controlled Trial Conducted in Orange Farm, South Africa
被引:201
作者:
Auvert, Bertran
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机构:
INSERM, U687, F-94804 Villejuif, France
Univ Versailles, AP HP, Versailles, FranceINSERM, U687, F-94804 Villejuif, France
Auvert, Bertran
[1
,2
]
Sobngwi-Tambekou, Joelle
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h-index: 0
机构:
INSERM, U687, F-94804 Villejuif, FranceINSERM, U687, F-94804 Villejuif, France
Sobngwi-Tambekou, Joelle
[1
]
Cutler, Ewalde
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h-index: 0
机构:
Natl Inst Communicable Dis, Johannesburg, South AfricaINSERM, U687, F-94804 Villejuif, France
Cutler, Ewalde
[3
]
Nieuwoudt, Marthi
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h-index: 0
机构:
Natl Inst Communicable Dis, Johannesburg, South AfricaINSERM, U687, F-94804 Villejuif, France
Nieuwoudt, Marthi
[3
]
Lissouba, Pascale
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机构:
INSERM, U687, F-94804 Villejuif, FranceINSERM, U687, F-94804 Villejuif, France
Lissouba, Pascale
[1
]
Puren, Adrian
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机构:
Natl Inst Communicable Dis, Johannesburg, South AfricaINSERM, U687, F-94804 Villejuif, France
Puren, Adrian
[3
]
Taljaard, Dirk
论文数: 0引用数: 0
h-index: 0
机构:
Progressus, Johannesburg, South AfricaINSERM, U687, F-94804 Villejuif, France
Taljaard, Dirk
[4
]
机构:
[1] INSERM, U687, F-94804 Villejuif, France
[2] Univ Versailles, AP HP, Versailles, France
[3] Natl Inst Communicable Dis, Johannesburg, South Africa
CERVICAL-CANCER;
NORMAL CYTOLOGY;
HIV PREVENTION;
INFECTION;
HPV;
NEOPLASIA;
WOMEN;
D O I:
10.1086/595566
中图分类号:
R392 [医学免疫学];
Q939.91 [免疫学];
学科分类号:
100102 ;
摘要:
Background. A causal association links high-risk human papillomavirus (HR-HPV) and cervical cancer, which is a major public health problem. The objective of the present study was to investigate the association between male circumcision ( MC) and the prevalence of HR-HPV among young men. Methods. We used data from a MC trial conducted in Orange Farm, South Africa, among men aged 18-24 years. Urethral swab samples were collected during a period of 262 consecutive days from participants in the intervention (circumcised) and control (uncircumcised) groups who were reporting for a scheduled follow-up visit. Swab samples were analyzed using polymerase chain reaction. HR-HPV prevalence rate ratios (PRRs) were assessed using univariate and multivariate log Poisson regression. Results. In an intention-to-treat analysis, the prevalences of HR-HPV among the intervention and control groups were 14.8% (94/637) and 22.3% (140/627), respectively, with a PRR of 0.66 (0.51-0.86) (P =.002). Controlling for propensity score and confounders (ethnic group, age, education, sexual behavior [including condom use], marital status, and human immunodeficiency virus status) had no effect on the results. Conclusions. This is the first randomized controlled trial to show a reduction in the prevalence of urethral HR-HPV infection after MC. This finding explains why women with circumcised partners are at a lower risk of cervical cancer than other women.