男男性行为人群乙型肝炎病毒对人乳头瘤病毒持续感染的影响

MSM(men who have sex with men) is one of high-risk groups of sexually transmitted diseases. With its scale expands unceasingly, the further study about MSM is developing quickly in public health. HPV(Human Papilloma viruses) and Hepatitis B virus (HBV) infection is more common in the MSM. Most cases of HPV infection were cleared in four to twenty months, but persistent HPV infection may cause epithelial malignant lesions or other related adverse outcomes. As HBV infection could reduce cell-mediated immunity. People with low immunity could get HPV infection easily. It is worthy of in-depth study that if the HPV persistent infection rate will increase or not with the co-infection of HBV. Mechanism also should be discussed in this study. The purpose of this study is to discuss the effect of MSM HBV on the HPV persistent infection. This survey will using snowball sampling method to recruit 600 more in the MSM which HIV positive will be excluded for ruling out the influence of HIV. This study base on National Twelfth Fifth Science and Technology Major Project of the Ministry of Science and Technology of China(2012ZX10001-007). MSM will be recruit by 2 NGO(Non-Governmental Organization) in Urumqi, Xinjiang province. Each of them will take a self-administered questionnaire to gather the information of their demographics and the characteristics of their sexual behavior after signing informed consent. Blood sampling and genital cells exfoliated are collected, MSM who is diagnosed HPV need to make intraepithelial neoplasia syndrome classification by the anus cytology and/or high resolution anoscope. Immunology ,molecular biology detection method, etiology and bioinformatics method are used to get the information of the prevalence of HPV, HPV types in MSM, the infection rate of overt and occult HBV and HBV molecular evolution characteristic by analysis of the S gene variation and getting the rate of virus evolutionary prevalence. In two-years follow-up study, to know the natural outcome of HPV infection. To know morbidity of HPV, prognosis of HPV with overt or occult HBV infectious. To know the effects of HBV gene mutation on HPV persistent infection. From the cellular immune level, flow cytometry is used to measure CD4 +, CD8 + and CD4 + CD25 + Treg, ELISA(enzyme-linked immunosorbent assay) is used to measure IL - 2 , IL - 4, IL - 10 and IFN -γcytokines among the different group of HPV prognosis with or without HBV infection. This study combined with molecular epidemiology, etiology and bioinformatics methods, from the level of cellular immunity to explore the influencing mechanism of HPV persistent infection co-infection with HBV. To provide scientific basis for prevention, control, treatment and behavioral intervention of HPV in men who have sex with men.

人乳头瘤病毒（HPV）和乙型肝炎病毒（HBV）持续感染严重威胁我国人群健康，在男男性行为人群（MSM）尤为常见。本研究旨在阐明HBV是否增加HPV持续感染，并探讨其可能的影响机制。在前期MSM研究队列的基础上，拟进一步招募600名HIV阴性MSM；通过自填式问卷了解MSM人口学信息及性行为特征，收集血样及肛门脱落细胞，采用免疫学、分子生物学技术结合生物信息学方法，获得HPV感染率及其分型、显性和隐匿性HBV感染率及HBV分子进化特征；经过两年随访后，比较HBV感染是否影响HPV的转归以及HBV基因变异对HPV持续感染的影响；分析并比较各组HPV不同转归者间CD4+、CD8+和CD4+CD25+Treg细胞亚群及IL-2、IL-4、IL-10和IFN-γ等免疫指标，从细胞免疫水平探讨HBV对HPV持续感染的影响机制。本研究为MSM人群HPV、HBV感染的治疗和干预策略的制定提供科学依据。

人乳头瘤病毒（HPV）和乙型肝炎病毒（HBV）持续感染严重威胁我国人群健康，在男男性行为人群中（MSM）尤为常见。本研究旨在阐明HBV是否增加HPV持续感染，并探讨其可能的影响机制。本研究通过乌市非政府组织采用滚雪球法招募MSM，建立MSMHPV动态队列。研究对象每6个月随访一次，基线完成问卷调查、血样采集及肛周脱落细胞采集，随访完成问卷调查及肛周脱落细胞采集。通过前瞻性数据分析，获得MSMHPV患病率、乙肝显性及隐匿性患病率、乙肝感染对HPV感染的影响、HPV新发感染率、持续阴性率、持续感染率及免疫水平对HPV感染影响。结果：MSM任意一型HPV患病率为47.13%，乙肝显性患病率为7.36%，隐匿性乙肝患病率为0.91%，HBV感染与HPV感染及持续感染无相关性；MSM任意一型HPV新发感染率为39.8/1000人月，各型别新发感染中以HPV16、6型新发感染率较高；持续阴性率为19.63/1000人月；MSM任意一型HPV持续感染率为29.72%；对HPV感染者及未感染者分析发现，两组外周血T淋巴细胞水平及血浆细胞因子IL-2、IL-4、IL-10、TNF及INF-γ水平差异无统计学意义。本研究可获以下结论：HBV感染不增加HPV持续感染，可能与两种病毒感染的途径不同有关；MSM肛周HPV感染风险高于一般人群，HPV16、6型感染较为常见，为了解MSMHPV感染自然史提供一定帮助；暂未发现外周血T淋巴细胞及血浆细胞因子水平影响HPV感染，可能与HPV感染引起局部免疫应答有关。