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Association between Free Testosterone Levels and Anal Human Papillomavirus Types 16/18 Infections in a Cohort of Men Who Have Sex with Men
BACKGROUND: Human papillomavirus (HPV) types 16 and 18 cause invasive cervical cancer and most invasive anal cancers (IACs). Overall, IAC rates are highest among men who have sex with men (MSM), especially MSM with HIV infection. Testosterone is prescribed for men showing hypogonadism and HIV-relate...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368778/ https://www.ncbi.nlm.nih.gov/pubmed/25794147 http://dx.doi.org/10.1371/journal.pone.0119447 |
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author | Hsu, Hilary K. Brown, Todd T. Li, Xiuhong Young, Stephen Cranston, Ross D. D’Souza, Gypsyamber Jacobson, Lisa P. Martínez-Maza, Otoniel Seaberg, Eric C. Margolick, Joseph B. Jenkins, Frank J. Moran, Matthew G. Chua, Kristofer Bolan, Robert K. Detels, Roger Wiley, Dorothy J. |
author_facet | Hsu, Hilary K. Brown, Todd T. Li, Xiuhong Young, Stephen Cranston, Ross D. D’Souza, Gypsyamber Jacobson, Lisa P. Martínez-Maza, Otoniel Seaberg, Eric C. Margolick, Joseph B. Jenkins, Frank J. Moran, Matthew G. Chua, Kristofer Bolan, Robert K. Detels, Roger Wiley, Dorothy J. |
author_sort | Hsu, Hilary K. |
collection | PubMed |
description | BACKGROUND: Human papillomavirus (HPV) types 16 and 18 cause invasive cervical cancer and most invasive anal cancers (IACs). Overall, IAC rates are highest among men who have sex with men (MSM), especially MSM with HIV infection. Testosterone is prescribed for men showing hypogonadism and HIV-related wasting. While there are direct and indirect physiological effects of testosterone in males, its role in anal HPV16/18 infections in men is unknown. METHODS: Free testosterone (FT) was measured in serum from 340 Multicenter AIDS Cohort Study (MACS) participants who were tested for anal HPV16/18-DNA approximately 36 months later. The effect of log10-transformed current FT level on anal HPV16/18 prevalence was modeled using Poisson regression with robust error variance. Multivariate models controlled for other HPV types, cumulative years of exogenous testosterone use, race, age, lifetime number of receptive anal intercourse partnerships, body mass index, tobacco smoking, HIV-infection and CD4+ T-cell counts among HIV-infected, and blood draw timing. RESULTS: Participants were, on average, 60 (+5.4) years of age, White (86%), and HIV-uninfected (56%); Twenty-four percent tested positive for anal HPV16 and/or 18-DNA (HPV16 prevalence=17.1%, HPV18=9.1%). In adjusted analysis, each half-log10 increase of FT was associated with a 1.9-fold (95% Confidence Interval: 1.11, 3.24) higher HPV16/18 prevalence. Additionally, other Group 1 high-risk HPVs were associated with a 1.56-fold (1.03, 2.37) higher HPV16/18 prevalence. Traditional risk factors for HPV16/18 infection (age, tobacco smoking; lifetime number of sexual partners, including the number of receptive anal intercourse partnerships within 24 months preceding HPV testing) were poorly correlated with one another and not statistically significantly associated with higher prevalence of HPV16/18 infection in unadjusted and adjusted analyses. CONCLUSIONS: Higher free testosterone was associated with increased HPV16/18 prevalence measured approximately three years later, independent of sexual behavior and other potential confounders. The mechanisms underlying this association remain unclear and warrant further study. |
format | Online Article Text |
id | pubmed-4368778 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-43687782015-03-27 Association between Free Testosterone Levels and Anal Human Papillomavirus Types 16/18 Infections in a Cohort of Men Who Have Sex with Men Hsu, Hilary K. Brown, Todd T. Li, Xiuhong Young, Stephen Cranston, Ross D. D’Souza, Gypsyamber Jacobson, Lisa P. Martínez-Maza, Otoniel Seaberg, Eric C. Margolick, Joseph B. Jenkins, Frank J. Moran, Matthew G. Chua, Kristofer Bolan, Robert K. Detels, Roger Wiley, Dorothy J. PLoS One Research Article BACKGROUND: Human papillomavirus (HPV) types 16 and 18 cause invasive cervical cancer and most invasive anal cancers (IACs). Overall, IAC rates are highest among men who have sex with men (MSM), especially MSM with HIV infection. Testosterone is prescribed for men showing hypogonadism and HIV-related wasting. While there are direct and indirect physiological effects of testosterone in males, its role in anal HPV16/18 infections in men is unknown. METHODS: Free testosterone (FT) was measured in serum from 340 Multicenter AIDS Cohort Study (MACS) participants who were tested for anal HPV16/18-DNA approximately 36 months later. The effect of log10-transformed current FT level on anal HPV16/18 prevalence was modeled using Poisson regression with robust error variance. Multivariate models controlled for other HPV types, cumulative years of exogenous testosterone use, race, age, lifetime number of receptive anal intercourse partnerships, body mass index, tobacco smoking, HIV-infection and CD4+ T-cell counts among HIV-infected, and blood draw timing. RESULTS: Participants were, on average, 60 (+5.4) years of age, White (86%), and HIV-uninfected (56%); Twenty-four percent tested positive for anal HPV16 and/or 18-DNA (HPV16 prevalence=17.1%, HPV18=9.1%). In adjusted analysis, each half-log10 increase of FT was associated with a 1.9-fold (95% Confidence Interval: 1.11, 3.24) higher HPV16/18 prevalence. Additionally, other Group 1 high-risk HPVs were associated with a 1.56-fold (1.03, 2.37) higher HPV16/18 prevalence. Traditional risk factors for HPV16/18 infection (age, tobacco smoking; lifetime number of sexual partners, including the number of receptive anal intercourse partnerships within 24 months preceding HPV testing) were poorly correlated with one another and not statistically significantly associated with higher prevalence of HPV16/18 infection in unadjusted and adjusted analyses. CONCLUSIONS: Higher free testosterone was associated with increased HPV16/18 prevalence measured approximately three years later, independent of sexual behavior and other potential confounders. The mechanisms underlying this association remain unclear and warrant further study. Public Library of Science 2015-03-20 /pmc/articles/PMC4368778/ /pubmed/25794147 http://dx.doi.org/10.1371/journal.pone.0119447 Text en © 2015 Hsu et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Hsu, Hilary K. Brown, Todd T. Li, Xiuhong Young, Stephen Cranston, Ross D. D’Souza, Gypsyamber Jacobson, Lisa P. Martínez-Maza, Otoniel Seaberg, Eric C. Margolick, Joseph B. Jenkins, Frank J. Moran, Matthew G. Chua, Kristofer Bolan, Robert K. Detels, Roger Wiley, Dorothy J. Association between Free Testosterone Levels and Anal Human Papillomavirus Types 16/18 Infections in a Cohort of Men Who Have Sex with Men |
title | Association between Free Testosterone Levels and Anal Human Papillomavirus Types 16/18 Infections in a Cohort of Men Who Have Sex with Men |
title_full | Association between Free Testosterone Levels and Anal Human Papillomavirus Types 16/18 Infections in a Cohort of Men Who Have Sex with Men |
title_fullStr | Association between Free Testosterone Levels and Anal Human Papillomavirus Types 16/18 Infections in a Cohort of Men Who Have Sex with Men |
title_full_unstemmed | Association between Free Testosterone Levels and Anal Human Papillomavirus Types 16/18 Infections in a Cohort of Men Who Have Sex with Men |
title_short | Association between Free Testosterone Levels and Anal Human Papillomavirus Types 16/18 Infections in a Cohort of Men Who Have Sex with Men |
title_sort | association between free testosterone levels and anal human papillomavirus types 16/18 infections in a cohort of men who have sex with men |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368778/ https://www.ncbi.nlm.nih.gov/pubmed/25794147 http://dx.doi.org/10.1371/journal.pone.0119447 |
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