The Infection Status And Molecular Epidemiological Study Of Human Papillomavirus At Different Anatomical Sites Of Men Who Have Sex With Men In 3 Cities Of China

Background:Human papillomavirus(HPV)infection is more common in men who have sex with men(MSM),especially in HIV-positive individuals.It is necessary to investigate the HPV infection status at different anatomical sites related to sexual behavior.There are few epidemiological studies of HPV infection in multiple anatomical sites of MSM population in China.Objective:To estimate the epidemiological characteristics and risk factors of HPV in different anatomical parts of MSM including oral cavity,coronal sulcus and perianal.Methods:A cross-sectional study was conducted among MSM in Beijing,Suzhou and Kunming from November 2018 to April 2019.Under the principle of informed consent,the questionnaire was filled and swabs from oral cavity,coronal sulcus,perianal and condyloma acuminate were collected and tested for HPV genotype(including high-risk HPVs of 16,18,31,33,35,39,45,51,52,53,56,58,59,66,68,73,82,82 and low-risk HPVs of 24,11,42,43,44,81).Data were entered using Epidata(Epidata 3.1)software,and Chi-square test,kappa value,and binary logistic regression model were used for analysis.Results:235 subjects were enrolled.The prevalence rates of HPV infection at sites of oral cavity,coronal sulcus and perianal among 235 MSM were 4.3%(9/210),42.6%(64/150),and 55.6%(75/135),respectively.Compared to HIV-negative subjects,HIV-positive subjects had significantly higher rates of HPV infection at sites of coronary sulcus(55.8%vs 37.7%)and perianal(92.1%vs 63.2%);the HR-HPV prevalence rate at perianal site was 68.3%vs 41.4%while the LR-HPV prevalence rate was 76.2%vs 43.4%,with a statistical significance(p<0.05).Regarding anal HPV infection,the differences of HPV mono-genotype infection,2 genotypes infection and 3 or more genotypes infection between HIV-positive and HIV-negative subjects were 23.8%vs 36.8%,23.8%vs 10.5%and 28%vs 15.8%respectively,with statistical significance(p<0.001).The prevalence rate of HPV(98.8%vs 55.6%),HR-HPV(58.8%vs 41.2%),LR-HPV(97.5%vs 26.7%),HPV-6(56.3%vs 11.9%)and HPV-11(44%vs 4.4%)in patients with perianal CA was higher than non-CA patients',and the difference was statistically significant(p<0.05).There was no concordance between HPV genotypes detected at coronal sulcus and perianal sites.A high concordance of HPV genotypes was detected in perianal and analtube in patients with perianal CA.The first time of homosexual behavior at the age of?19 years old is a risk factor for HPV infection in coronary sulcus and patients with perianal CA;HIV infection and the age of MSM are risk factors for patients with perianal CA.Conclusion:HPV prevalence rate in MSM population in China is relatively high,and HIV-positive individuals are more susceptible to HPV and tend to be infected by multiple HPV genotypes.The age of first homosexual behavior,the age of MSM and HIV infection status are associated with HPV infection.The prevalence rate of HPV vaccine targeted genotype is high at multiple sites in MSM population,and it is considered to promote HPV vaccine to them.