人乳头瘤病毒感染对精液质量影响的Meta分析

Effects of Human Papillomavirus Infection on Semen Quality:a Meta-analysis

背景 人乳头瘤病毒(HPV)被认为是常见的性传播病毒之一,可能与男性不明原因不育有关。目前有研究表明HPV感染对男性精子质量的部分影响,但缺乏统一认知。目的 分析精液HPV感染对精液质量可能存在的影响。方法 计算机检索PubMed、EMBase和Cochrane Library数据库中有关HPV感染和精子质量关系的文献,检索时间为2000年1月至2021年10月。由研究人员完成文献筛选和数据提取,并对文献进行质量评价,采用RevMan 5.3软件进行Meta分析。结果 共纳入7篇文献,包括2 236例研究对象,其中331例HPV DNA阳性者和1 905例HPV DNA阴性者。纳入的文献均为观察性研究,存在中至重度偏倚风险。Meta分析结果显示,HPV DNA阳性者和HPV DNA阴性者精液浓度、精液体积、精液总数比较,差异均无统计学意义〔MD=-4.08,95%CI(-10.29,2.13),P=0.20;MD=-0.13,95%CI(-0.25,0),P=0.05;MD=-12.44,95%CI(-37.30,12.43),P=0.33〕;HPV DNA阳性者精液活力、精子形态率低于HPV DNA阴性者〔MD=-8.29,95%CI(-10.03,-6.55),P<0.000 01;MD=-3.75,95%CI(-5.58,-1.92),P<0.000 1〕。结论 HPV感染精液后降低了精子的运动能力和精子正常形态率。

Background Human papillomavirus(HPV) has been considered as one of the most common sexually transmitted viruses that may be linked to unexplained infertility in men.Current studies have indicated that HPV infection is partly associated with sperm quality in men,but have not shown consistent results.Objective To assess the possible influence of HPV infection on semen quality in men.Methods Studies examining the association between HPV infection and semen quality in men published from January 2000 to October 2021 were searched in databases of PubMed,EMBase and Cochrane Library.Literature enrollment,data extraction,and methodological quality assessment were performed.RevMan 5.3 was used for meta-analysis.Results Seven studies were identified,including 2 236 cases in total,and 331 of them were positive for HPV DNA,and the other 1 905 were negative.All these studies adopted an observational design,and were rated as having a moderate to severe risk of bias.Analysis revealed that compared to the controls,the HPV-infected semen samples showed lower sperm motility and lower rate of normal morphology〔MD=-8.29,95%CI(-10.03,-6.55),P<0.000 01;MD=-3.75,95%CI(-5.58,-1.92),P<0.000 1〕,but demonstrated insignificantly differences in sperm concentration,sperm volume and sperm count〔MD=-4.08,95%CI(-10.29,2.13),P=0.20;MD=-0.13,95%CI(-0.25,0),P=0.05;MD=-12.44,95%CI(-37.30,12.43),P=0.33〕.Conclusion HPV infection may be associated with decreased sperm motility and normal morphology rate.