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 [1 ,2 ]
Sobngwi-Tambekou, Joelle [1 ]
Cutler, Ewalde [3 ]
Nieuwoudt, Marthi [3 ]
Lissouba, Pascale [1 ]
Puren, Adrian [3 ]
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
[4] Progressus, Johannesburg, South Africa
关键词
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.
引用
收藏
页码:14 / 19
页数:6
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