Alan G Nyitray1, Fen Peng2, Rena S Day3, Roberto J Carvalho Da Silva4, Maria Luiza Baggio5, Jorge Salmerón6,7, Manuel Quiterio7, Martha Abrahamsen8, Eduardo Lazcano-Ponce7, Luisa L Villa9, Anna R Giuliano8. 1. a Clinical Cancer Center and Center for AIDS Intervention Research, Medical College of Wisconsin , Milwaukee , WI , USA. 2. b Department of Clinical Research, Medtronic, Inc , Northridge , CA , USA. 3. c Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Sciences Center School of Public Health at Houston , Houston , TX , USA. 4. d Department of STDs, Centro de Referência e Treinamento em DST/AIDS , São Paulo , Brazil. 5. e Centro de Investigação Translacional em Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil. 6. f Research Center on Policies, Population, and Health, Faculty of Medicine, National Autonomous University of Mexico , Mexico City , Mexico. 7. g Center for Population Health Research, National Institute of Public Health , Cuernavaca , Morelos , Mexico. 8. h Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute , Tampa , FL , USA. 9. i Faculdade de Medicina, Universidade de São Paulo Department of Radiology and Oncology, Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo , Brazil.
Abstract
Background: While receptive anal sex is an established risk factor for anal human papillomavirus (HPV) infection and squamous cell carcinoma of the anus (SCCA), people with anal HPV infection and SCCA commonly report no lifetime receptive anal sex suggesting other factors may also increase risk for anal HPV infection and persistence. Given potential associations between obesity and conditions that may cause perianal or anal canal lesions, we hypothesized that body mass index (BMI) was associated with HPV infection. Methods: Genotyping for 36 HPV types was conducted on anal canal specimens from men, ages 18-70, from Brazil, Mexico, and the USA. Eligibility included no history of genital warts or HIV. Evaluable specimens were collected from 328 men having sex with men (MSM) and 1348 men having sex with women (MSW) who reported no lifetime receptive anal sex. Prevalence of anal HPV infection and six-month persistence by BMI were estimated in addition to adjusted prevalence ratios for the association between BMI and HPV infection. Results: Among MSW, obese men had a higher prevalence of HPV-16 in the anal canal (3.1%), compared to normal weight men (1.3%) although 95% CI overlapped. Among MSM, prevalence of HPV decreased with increasing BMI. A similar pattern was observed for persistence. After adjustment for confounders, obese MSW had 2.4 times higher odds of HPV-16 compared to normal weight men. Conclusions: BMI may be positively associated with anal HPV (especially HPV-16) among MSW and negatively associated with anal HPV among MSM which supports continued universal HPV vaccination programs.
Background: While receptive anal sex is an established risk factor for anal human papillomavirus (HPV) infection and squamous cell carcinoma of the anus (SCCA), people with anal HPV infection and SCCA commonly report no lifetime receptive anal sex suggesting other factors may also increase risk for anal HPV infection and persistence. Given potential associations between obesity and conditions that may cause perianal or anal canal lesions, we hypothesized that body mass index (BMI) was associated with HPV infection. Methods: Genotyping for 36 HPV types was conducted on anal canal specimens from men, ages 18-70, from Brazil, Mexico, and the USA. Eligibility included no history of genital warts or HIV. Evaluable specimens were collected from 328 men having sex with men (MSM) and 1348 men having sex with women (MSW) who reported no lifetime receptive anal sex. Prevalence of anal HPV infection and six-month persistence by BMI were estimated in addition to adjusted prevalence ratios for the association between BMI and HPV infection. Results: Among MSW, obesemen had a higher prevalence of HPV-16 in the anal canal (3.1%), compared to normal weight men (1.3%) although 95% CI overlapped. Among MSM, prevalence of HPV decreased with increasing BMI. A similar pattern was observed for persistence. After adjustment for confounders, obese MSW had 2.4 times higher odds of HPV-16 compared to normal weight men. Conclusions: BMI may be positively associated with anal HPV (especially HPV-16) among MSW and negatively associated with anal HPV among MSM which supports continued universal HPV vaccination programs.
Authors: Alan G Nyitray; Jongphil Kim; Chiu-Hsieh Hsu; Mary Papenfuss; Luisa Villa; Eduardo Lazcano-Ponce; Anna R Giuliano Journal: Am J Epidemiol Date: 2009-09-09 Impact factor: 4.897
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