Circumcision of HIV-infected men and transmission of human papillomavirus to female partners: analyses of data from a randomised trial in Rakai, Uganda.
Background: Male circumcision reduces the transmission of high-risk human papillomavirus (HPV) in HIV-uninfected men and their female partners. We assessed whether circumcision of HIV-infected men would reduce the transmission of high-risk HPV to their female partners.Methods: Female partners of HIV...
| Publicado en: | Lancet Infectious Diseases Vol. 11; no. 8; pp. 604 - 613 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Elsevier B.V.
Aug2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104665770&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104665770 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14733099 KIL jtl: Lancet Infectious Diseases issn: 14733099 maglogo: N pubinfo: dt: Aug2011 vid: 11 iid: 8 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 104665770 NLM21489882 2011229308 10.1016/S1473-3099(11)70073-1 NLM21489882 PMC3146628 104665770 ppf: 604 ppct: 9 formats: tig: atl: Circumcision of HIV-infected men and transmission of human papillomavirus to female partners: analyses of data from a randomised trial in Rakai, Uganda. aug: au: Tobian AA Kong X Wawer MJ Kigozi G Gravitt PE Serwadda D Eaton KP Nalugoda F Quinn TC Gray RH Tobian, Aaron A R Kong, Xiangrong Wawer, Maria J Kigozi, Godfrey Gravitt, Patti E Serwadda, David Eaton, Kevin P Nalugoda, Fred Quinn, Thomas C Gray, Ronald H affil: Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA sug: subj: Circumcision HIV Infections Transmission Human Immunodeficiency Virus Physiology Papillomavirus Infections Transmission Papillomaviruses Physiology Adolescence Adult Female HIV Infections HIV Infections Epidemiology Human Male Middle Age Papillomavirus Infections Papillomavirus Infections Epidemiology Papillomavirus Infections Prevention and Control Prevalence Prospective Studies Randomized Controlled Trials Regression Sexual Partners Uganda Young Adult Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Background: Male circumcision reduces the transmission of high-risk human papillomavirus (HPV) in HIV-uninfected men and their female partners. We assessed whether circumcision of HIV-infected men would reduce the transmission of high-risk HPV to their female partners.Methods: Female partners of HIV-infected men (aged 15-49 years) in Rakai, Uganda, with CD4 counts of greater than 350 cells per mL who were randomly assigned to undergo circumcision immediately (intervention group) and after 24 months (control group) were assessed for infection with high-risk HPV. Randomisation was done in blocks of 20, stratified by community, with computer-generated random numbers. Laboratory technicians and female fieldworkers were masked to the circumcision status of male participants. The main outcome assessed in this study was the effects of circumcision of HIV-infected men on transmission of HPV to their female partners. Analysis was by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT00124878.Findings: 474 men were assigned to the intervention group, 448 to the control group. 211 women were in consensual relationships with 193 men in the intervention group, and 171 women were in consensual unions with 155 men in the control group. High-risk HPV at the 2-year follow-up was prevalent in 88 female partners (55%) of 159 men in the intervention group and 68 (52%) of 131 female partners of men in the control group (prevalence risk ratio 1·07, 95% CI 0·86-1·32, p=0·64). Incidence of high-risk HPV over 2 years was 32·0 per 100 person-years in the female partners of men in the intervention group and 30·6 per 100 person-years in the female partners of men in the control group (incidence rate ratio 1·05, 0·77-1·43, p=0·78). No difference was noted in the clearance of genotype-specific high-risk HPV between the intervention group (196 [46%] of 424) and control group (167 [48%] of 347; rate ratio 0·96, 0·83-1·12; p=0·61).Interpretation: Because circumcision of HIV-infected men did not affect transmission of high-risk HPV to their female partners, promotion of consistent safe sexual practices for HIV-infected men remains important.Funding: Bill & Melinda Gates Foundation and National Institutes of Health. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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