TY - JOUR
T1 - Circumcision of HIV-infected men
T2 - Effects on high-risk human papillomavirus infections in a randomized trial in Rakai, Uganda
AU - Serwadda, David
AU - Wawer, Maria J.
AU - Makumbi, Frederick
AU - Kong, Xiangrong
AU - Kigozi, Godfrey
AU - Gravitt, Patti
AU - Watya, Stephen
AU - Nalugoda, Fred
AU - Ssempijja, Victor
AU - Tobian, Aaron A.R.
AU - Kiwanuka, Noah
AU - Moulton, Lawrence H.
AU - Sewankambo, Nelson K.
AU - Reynolds, Steven J.
AU - Quinn, Thomas C.
AU - Oliver, Amy E.
AU - Lga, Boaz
AU - Laeyendecker, Oliver
AU - Gray, Ronald H.
N1 - Funding Information:
Financial support: This study was funded by The Bill and Melinda Gates Foundation (grant 22006). Additional support for laboratory analyses and training were provided, respectively, by the Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, and the Fogarty International Center (grants 5D43TW001508 and D43TW00015). Support for HPV assays was provided by Dr Charles Rabkin under subcontract BRC 55502–23 from the National Cancer Institute.
PY - 2010/5/15
Y1 - 2010/5/15
N2 - In Rakai, Uganda, human immunodeficiency virus (HIV)-positive men were randomized to undergo either immediate circumcision (intervention arm) or delayed circumcision (control arm). Penile swab samples were assayed for high-risk human papillomavirus (HR-HPV) by Roche HPV Linear Array at enrollment and at 24 months (intervention arm, 103 subjects; control arm, 107 subjects). Rate ratios (RRs) of HR-HPV were estimated by Poisson regression. At 24 months, HR-HPV prevalence was found in 57 (55.3%) of 103 subjects in the intervention arm and in 77 (71.7%) of 107 subjects in the control arm (RR, 0.77; 95% confidence interval [CI], 0.62-0.97). Multiple HR-HPV infections were found in 19 (22.4%) of 85 subjects in the intervention arm and in 45 (42.5%) of 106 subjects in the control arm (RR, 0.53; 95% CI, 0.33-0.83). New HR-HPV genotypes were acquired by 34 (42.0%) of 81 subjects in the intervention arm and by 53 (57.0%) 85 subjects in the control arm (RR, 0.74; 95% CI, 0.54-1.01; P = .06). Multiple new HR-HPV genotypes were acquired by 8 (9.9%) of 81 subjects in the intervention arm and by 23 (24.7%) of 93 subjects in the control arm (RR, 0.40; 95% CI, 0.19-0.84; P = .01). Circumcision did not affect the acquisition of single HR-HPV infections (RR, 1.00; 95% CI 0.65-1.53) or clearance of HR-HPV infections (RR, 1.09; 95% CI 0.94-1.27). Circumcision of HIV-positive men reduced the prevalence and incidence of multiple HR-HPV infections. Trial Registration. ClinicalTrials.gov identifier: NCT00124878.
AB - In Rakai, Uganda, human immunodeficiency virus (HIV)-positive men were randomized to undergo either immediate circumcision (intervention arm) or delayed circumcision (control arm). Penile swab samples were assayed for high-risk human papillomavirus (HR-HPV) by Roche HPV Linear Array at enrollment and at 24 months (intervention arm, 103 subjects; control arm, 107 subjects). Rate ratios (RRs) of HR-HPV were estimated by Poisson regression. At 24 months, HR-HPV prevalence was found in 57 (55.3%) of 103 subjects in the intervention arm and in 77 (71.7%) of 107 subjects in the control arm (RR, 0.77; 95% confidence interval [CI], 0.62-0.97). Multiple HR-HPV infections were found in 19 (22.4%) of 85 subjects in the intervention arm and in 45 (42.5%) of 106 subjects in the control arm (RR, 0.53; 95% CI, 0.33-0.83). New HR-HPV genotypes were acquired by 34 (42.0%) of 81 subjects in the intervention arm and by 53 (57.0%) 85 subjects in the control arm (RR, 0.74; 95% CI, 0.54-1.01; P = .06). Multiple new HR-HPV genotypes were acquired by 8 (9.9%) of 81 subjects in the intervention arm and by 23 (24.7%) of 93 subjects in the control arm (RR, 0.40; 95% CI, 0.19-0.84; P = .01). Circumcision did not affect the acquisition of single HR-HPV infections (RR, 1.00; 95% CI 0.65-1.53) or clearance of HR-HPV infections (RR, 1.09; 95% CI 0.94-1.27). Circumcision of HIV-positive men reduced the prevalence and incidence of multiple HR-HPV infections. Trial Registration. ClinicalTrials.gov identifier: NCT00124878.
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U2 - 10.1086/652185
DO - 10.1086/652185
M3 - Article
C2 - 20370481
AN - SCOPUS:77951898090
SN - 0022-1899
VL - 201
SP - 1463
EP - 1469
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 10
ER -