Objective: To analyze the correlation between circumcision and incidence and clearance of male genital HPV infection. Methods: From May to July 2014, 18-55 year old men who had sexual behavior history were recruited from the general population in Liuzhou, Guangxi to set up a cohort. Totally, 113 circumcised and 560 uncircumcised men were enrolled and interviewed using a questionnaire (including information on demographic characteristics and sexual behaviors), then they were followed-up with 6-month interval for 2 times. On each visit, specimens of male external genitalia were collected and genotyped for HPV DNA. The differences of incidence and clearance of genital HPV infections between circumcised and uncircumcised men were analyzed by Log-rank test. Cox regression was used to analyze the relationship between circumcision and incidence and clearance of HPV infection. Results: The median age (P(25), P(75)) of circumcised and uncircumcised men were 28 (24, 35) and 32 (24, 31), respectively. The incidences of any HPV infections were 9.1 (95%CI: 2.4-15.7) and 8.4 (95% CI: 5.6-11.2) per 1 000 person-months (χ(2)=0.10, P=0.758), respectively. The clearance of circumcised men [136.3 (95%CI: 70.0-202.7) per 1 000 person-months] was higher than that in uncircumcised men [89.6 (95%CI: 65.9-113.3) per 1 000 person-months] (χ(2)=8.19, P=0.004). In multivariate COX regression analysis, compared with uncircumcised men, circumcised men had higher possibility to clear any HPV infections (HR: 2.41, 95%CI: 1.30-4.46). Compared with men having one sexual partner, people having more than 4 sexual partners had lower possibility to clear any HPV infections (HR: 0.49, 95%CI: 0.25-0.96). Compared with 18-25 years old men, men aged 26-35 years old had higher possibility to clear high-risk HPV infections (HR: 2.14, 95%CI: 1.08-4.23). Conclusion: Circumcised and uncircumcised men had similar incidence of genital HPV infection, whereas, men conducted circumcision and having fewer sexual partners could increase the clearance of genital HPV infections.
目的： 分析包皮环切与男性外生殖器部位HPV感染及清除的相关性。 方法： 于2014年5—7月，在广西柳州市自然人群中招募18~55岁有性生活史的男性建立随访队列，其中包皮过长环切者113名，包皮过长未环切者560名，完成基线调查（收集人口学及性行为信息等）后，每隔6个月对其随访调查1次，共随访2次，每次调查均采集其外生殖器部位脱落细胞标本并进行HPV DNA分型检测。分析两组HPV新发感染率和清除率的差异，采用Cox风险比例回归模型分析包皮环切与HPV新发感染和清除的相关性。 结果： 包皮环切组和未环切组男性年龄的P(50)（P(25)，P(75)）分别为28(24，35)和32(24，31)岁，两组HPV的新发感染率分别为9.1(95%CI: 2.4~15.7)/1 000人月和8.4(95%CI: 5.6~11.2)/1 000人月(χ(2)=0.10，P=0.758)；包皮环切组清除率[136.3(95%CI:70.0~202.7)/1 000人月]高于未环切组[89.6(95%CI:65.9~113.3)/1 000人月] (χ(2)=8.19，P=0.004)。多因素Cox比例风险回归模型分析显示，与包皮未环切组男性相比，包皮环切组清除HPV感染的HR(95%CI)值为2.41(1.30~4.46)，与仅有1个性伴侣的男性相比，性伴侣数≥4个者清除HPV感染的HR(95%CI)值为0.49(0.25~0.96)；与18~25岁男性相比，26~35岁男性清除高危型HPV的HR(95%CI)值为2.14(1.08~4.23)。 结论： 包皮环切组男性和未环切组男性HPV新发感染率相近，但进行过包皮环切和性伴侣数量较少的男性清除HPV感染的可能性更高。.
Keywords: Circumcision, male; Clearance; Cohort studies; Human papillomavirus; Incidence.