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Circumcision of HIV-infected men and transmission of human papillomavirus to female partners: analyses of data from a randomised trial in Rakai, Uganda

Summary 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... Full description

Journal Title: The Lancet infectious diseases 2011, Vol.11 (8), p.604-612
Main Author: Tobian, Aaron AR, Dr
Other Authors: Kong, Xiangrong , Wawer, Maria J, Prof , Kigozi, Godfrey, MBChB , Gravitt, Patti E , Serwadda, David, Prof , Eaton, Kevin P , Nalugoda, Fred , Quinn, Thomas C, Prof , Gray, Ronald H, Prof
Format: Electronic Article Electronic Article
Language: English
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Quelle: Alma/SFX Local Collection
Publisher: London: Elsevier Ltd
ID: ISSN: 1473-3099
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title: Circumcision of HIV-infected men and transmission of human papillomavirus to female partners: analyses of data from a randomised trial in Rakai, Uganda
format: Article
creator:
  • Tobian, Aaron AR, Dr
  • Kong, Xiangrong
  • Wawer, Maria J, Prof
  • Kigozi, Godfrey, MBChB
  • Gravitt, Patti E
  • Serwadda, David, Prof
  • Eaton, Kevin P
  • Nalugoda, Fred
  • Quinn, Thomas C, Prof
  • Gray, Ronald H, Prof
subjects:
  • Adolescent
  • Adult
  • Biological and medical sciences
  • CD4 antigen
  • Circumcision
  • Circumcision, Male
  • Data processing
  • Disease transmission
  • Female
  • Follow-Up Studies
  • HIV - physiology
  • HIV infection
  • HIV Infections - epidemiology
  • HIV Infections - transmission
  • HIV Infections - virology
  • Human immunodeficiency virus
  • Human papillomavirus
  • Human viral diseases
  • Humans
  • Immunodeficiencies
  • Immunodeficiencies. Immunoglobulinopathies
  • Immunopathology
  • Infection
  • Infectious Disease
  • Infectious diseases
  • Male
  • Medical sciences
  • Middle Aged
  • Motivation
  • Papillomaviridae - physiology
  • Papillomavirus infections
  • Papillomavirus Infections - epidemiology
  • Papillomavirus Infections - prevention & control
  • Papillomavirus Infections - transmission
  • Papillomavirus Infections - virology
  • Papillomaviruses
  • Prevalence
  • Public health
  • Regression Analysis
  • Risk factors
  • Risk groups
  • Sexual Partners
  • Uganda - epidemiology
  • Viral diseases
  • Viral diseases of the lymphoid tissue and the blood. Aids
  • Young Adult
ispartof: The Lancet infectious diseases, 2011, Vol.11 (8), p.604-612
description: Summary 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.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1473-3099
fulltext: fulltext
issn:
  • 1473-3099
  • 1474-4457
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titleCircumcision of HIV-infected men and transmission of human papillomavirus to female partners: analyses of data from a randomised trial in Rakai, Uganda
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creatorTobian, Aaron AR, Dr ; Kong, Xiangrong ; Wawer, Maria J, Prof ; Kigozi, Godfrey, MBChB ; Gravitt, Patti E ; Serwadda, David, Prof ; Eaton, Kevin P ; Nalugoda, Fred ; Quinn, Thomas C, Prof ; Gray, Ronald H, Prof
creatorcontribTobian, Aaron AR, Dr ; Kong, Xiangrong ; Wawer, Maria J, Prof ; Kigozi, Godfrey, MBChB ; Gravitt, Patti E ; Serwadda, David, Prof ; Eaton, Kevin P ; Nalugoda, Fred ; Quinn, Thomas C, Prof ; Gray, Ronald H, Prof
descriptionSummary 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.
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languageeng
publisherLondon: Elsevier Ltd
subjectAdolescent ; Adult ; Biological and medical sciences ; CD4 antigen ; Circumcision ; Circumcision, Male ; Data processing ; Disease transmission ; Female ; Follow-Up Studies ; HIV - physiology ; HIV infection ; HIV Infections - epidemiology ; HIV Infections - transmission ; HIV Infections - virology ; Human immunodeficiency virus ; Human papillomavirus ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infection ; Infectious Disease ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Motivation ; Papillomaviridae - physiology ; Papillomavirus infections ; Papillomavirus Infections - epidemiology ; Papillomavirus Infections - prevention & control ; Papillomavirus Infections - transmission ; Papillomavirus Infections - virology ; Papillomaviruses ; Prevalence ; Public health ; Regression Analysis ; Risk factors ; Risk groups ; Sexual Partners ; Uganda - epidemiology ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Young Adult
ispartofThe Lancet infectious diseases, 2011, Vol.11 (8), p.604-612
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0Circumcision of HIV-infected men and transmission of human papillomavirus to female partners: analyses of data from a randomised trial in Rakai, Uganda
1The Lancet infectious diseases
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descriptionSummary 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.
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9Follow-Up Studies
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12HIV Infections - epidemiology
13HIV Infections - transmission
14HIV Infections - virology
15Human immunodeficiency virus
16Human papillomavirus
17Human viral diseases
18Humans
19Immunodeficiencies
20Immunodeficiencies. Immunoglobulinopathies
21Immunopathology
22Infection
23Infectious Disease
24Infectious diseases
25Male
26Medical sciences
27Middle Aged
28Motivation
29Papillomaviridae - physiology
30Papillomavirus infections
31Papillomavirus Infections - epidemiology
32Papillomavirus Infections - prevention & control
33Papillomavirus Infections - transmission
34Papillomavirus Infections - virology
35Papillomaviruses
36Prevalence
37Public health
38Regression Analysis
39Risk factors
40Risk groups
41Sexual Partners
42Uganda - epidemiology
43Viral diseases
44Viral diseases of the lymphoid tissue and the blood. Aids
45Young Adult
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titleCircumcision of HIV-infected men and transmission of human papillomavirus to female partners: analyses of data from a randomised trial in Rakai, Uganda
authorTobian, Aaron AR, Dr ; Kong, Xiangrong ; Wawer, Maria J, Prof ; Kigozi, Godfrey, MBChB ; Gravitt, Patti E ; Serwadda, David, Prof ; Eaton, Kevin P ; Nalugoda, Fred ; Quinn, Thomas C, Prof ; Gray, Ronald H, Prof
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abstractSummary 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.
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