An Epidemiological Survey On HPV/TB Infection Among HIVinfected Men Who Have Sex With Men In Xi’an, China

Objective:Human papillomavirus (HPV) and tuberculosis (TB) infection are common among HIV infected men who have sex with men (MSM). HPV infections can cause genital warts, anal cancer and other diseases, and TB is one of the main reasons caused death in AIDS patients. HIV infection leads to low immune function which causes the body more susceptible to HPV, TB and increases risk of progression from latent infection to disease. With increasing proportion of MSM transmission in HIV transmission, pooled HIV infection rate in MSM population increased rapidly. HPV, TB infection and related diseases have become important issues on affecting the population’s life quality. The epidemic situations of HPV, TB infection needto be clarified.Prevention and control strategies of research-related diseases should be strengthened among HIV-positive MSM in China.Methods:The primary objective of this study was to investigate the status and risk factors of HPV and TB infection among HIV-positive MSM population in Xi’an city. A cross-sectional study design was used. Between April and July 2014, socio-demographic characteristics, sexual behaviors, medical history and antiretroviral therapy (ART) status and other information were collected through one-to-one interviews by the trained interviewer using a standardized questionnaire. Blood and perianal epithelial cells samples were collected for peripheral blood CD4+T cell count detection, y-interferon release assays (IGRA) testing and HPV genotyping.X-ray screening was used for discovering TB-related radiographic changes.Results:A total of 195 eligible participants were included in the study, HPV genotyping results showed that 99.0%(191/193) of participants were positive for at least one HPV subtype.94.8%(183/193) of participants were infected with one or more high-risk (HR) subtypes,79.8%(154/193) ofparticipants were infected with one or more low-risk (LR) subtypes. HPV18 infection was highest in HR-HPV types (40.4%), followed by HPV16 (33.9%), HPV51 (31.7%). HPV11 infection rate was the highest in LR-HPV types (59.7%), followed by HPV6 (39.6%) and HPV81 (23.4%). Multivariate analysis showed that started ART was associated with decreased risk of HR-HPV infection, whereas higher CD4+T cell level was found to be associated with significantly increased rate of LR-HPV infection. IGRA testing positive rate was 8.8%(16/182), another two people were diagnosed as tuberculosis after investigating suspicious symptoms and chest X-ray screening.Conclusion:Our results showed that HPV and TB infection is common in HIV-positive MSM population. Besides active case finding and early treament, the prevention strategies should be further explored in high-risk groups as well.