HIV感染者HPV感染及相关疾病管理策略

Management of HPV infection and related diseases in HIV infectors

相比人类免疫缺陷病毒(HIV)阴性人群,HIV感染者不同部位人乳头瘤病毒(HPV)感染率及持续感染率明显升高,同时HPV相关肿瘤发生率及进展速度也明显升高。抗反转录治疗(ART)大大延长了HIV+者的寿命,但却使HPV感染及相关肿瘤的发生率不降反升,因此我们急需制定HIV+人群HPV及相关肿瘤的预防策略。目前HPV疫苗已证实对HIV+者同样有效,但仍需进一步确立适合HIV+者的HPV疫苗接种方案。HIV+者中不乏男男性行为者(MSM),这部分人群HPV相关肛门癌发生风险较高,单纯对女性实施HPV群体免疫对MSM不具备保护作用。由于疫苗覆盖率仍然有限,对未能接种疫苗的人群进行正确筛查及治疗也同等重要。本研究系统总结了HIV+者HPV感染及相关肿瘤的发病情况以及HPV感染的预防管理。

Compared with the HIV-negative population,the infection rate and persistent infection rate ofhuman papilloma virus(HPV)in different sites of HIV infected persons were significantly higher,and the incidenceand progression rate of HPV-associated tumors were also significantly higher.Anti-retroviral therapy(ART)greatlyprolongs the life span of HIV^(+) patients,but increases the incidence of HPV infection and related tumors.Therefore,it is urgent to develop prevention strategies for HPV and related tumors in HIV^(+) patients.The HPV vaccine hasbeen shown to be equally effective in people with HIV^(+),but more needs to be done to develop HPV vaccination protocols for people with HIV^(+).Among HIV^(+) patients,there are many men who have sex with men(MSM),who areat a higher risk of HPV-related anal cancer.HPV herd immunization in women alone has no protective effect on MSM.As vaccine coverage remains limited,it is equally important to properly screen and treat those who are notvaccinated.This paper systematically summarizes the incidence of HPV infection and related tumors in HIV^(+) patients,as well as the prevention and management of HPV infection.