Circumcision of HIV-infected men: Effects on high-risk human papillomavirus infections in a randomized trial in Rakai, Uganda

David Serwadda, Maria J. Wawer, Frederick Makumbi, Xiangrong Kong, Godfrey Kigozi, Patti Gravitt, Stephen Watya, Fred Nalugoda, Victor Ssempijja, Aaron A.R. Tobian, Noah Kiwanuka, Lawrence H. Moulton, Nelson K. Sewankambo, Steven J. Reynolds, Thomas C. Quinn, Amy E. Oliver, Boaz Lga, Oliver Laeyendecker, Ronald H. Gray

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1463-1469
Number of pages7
JournalJournal of Infectious Diseases
Volume201
Issue number10
DOIs
StatePublished - May 15 2010
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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