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Human papillomavirus prevalence among men who have sex with men in China: a systematic review and meta-analysis

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Abstract

Human papillomavirus (HPV) infection among men who have sex with men (MSM) in China is underreported. We performed a systematic review and meta-analysis to clarify site-specific HPV prevalence among MSM in China. We searched both English and Chinese databases for all studies published before April 1, 2020, that reported HPV prevalence among MSM in China. Random-effects meta-analysis was used to calculate summary estimates. Thirty-four articles were eligible, where 32, 5, and 2 articles reported HPV prevalence at the anus, penis, and oral cavity, respectively. The estimated prevalence of anal HPV among MSM in China was 85.1% (HIV-positive), 53.6% (HIV-negative), and 59.2% (unknown HIV status), with HPV genotypes being predominated by HPV 6, 11, 16, 18, 52, and 58. Any HPV and high-risk (HR) HPV was more common in northern China, while low-risk HPV was more common in southern China. HPV prevalence increased with age among HIV-negative MSM, from 40.5% (aged < 20 years) to 57.2% (aged ≥ 40 years). High prevalence of any HPV (HIV+: 95.1%; HIV−: 97.7%) and multiple infections (HIV+: 75.9%; HIV−: 41.7%) was found in anogenital warts among MSM. HPV is common among MSM in China. MSM living with HIV and/or anogenital warts were at disproportionate risk for HR HPV. Younger MSM were found to have a lower HPV prevalence. HPV vaccines would have prevented the majority of infections if given before sex debut. HPV at anatomical sites other than the anus, incident HPV infection, and the cost-effectiveness of HPV vaccination in this population are worth further investigation.

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All data generated or analyzed during this study are included in this published article and its supplementary files.

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Acknowledgements

We thank the following authors for sharing their data: Shu-Hsing Cheng (Taipei Medical University, Taipei, Taiwan); Lei Gao (Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China); Jiangping Sun (Chinese Center for Disease Control and Prevention, Beijing, China); Qi Jin (Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China); Han-Zhu Qian (Vanderbilt University School of Medicine, Nashville, USA); Jianghong Dai (Xinjiang Medical University, Urumqi, China); Lanying Li (Shanghai Jiao Tong University, Shanghai, China); Yongxi Zhang (Zhongnan Hospital of Wuhan University, Wuhan, China); Xiaohui Zhang (Guangdong Provincial Dermatology Hospital, Guangzhou, China); and Song Fan (Sun Yat-sen University, Guangzhou, China).

Funding

This study was supported by the Natural Science Foundation of China Excellent Young Scientists Fund [82022064], the Natural Science Foundation of China International/Regional Research Collaboration Project [72061137001], the Natural Science Foundation of China Young Scientist Fund [81703278], the Australian National Health and Medical Research Commission (NHMRC) Early Career Fellowship [APP1092621], the National Science and Technology Major Project of China [2018ZX10721102], the Sanming Project of Medicine in Shenzhen [SZSM201811071], the High Level Project of Medicine in Longhua, Shenzhen [HLPM201907020105], and the National Key Research and Development Program of China [2020YFC0840900]. All funding parties did not have any role in the design of the study or in the explanation of the data.

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Authors and Affiliations

  1. School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China

    Yiguo Zhou, Yi-Fan Lin, Ganfeng Luo, Tanwei Yuan, Yuewei Zhan, Yanxiao Gao & Huachun Zou

  2. NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Lei Gao

  3. School of Public Health, Xinjiang Medical University, Urumqi, China

    Jianghong Dai

  4. Department of Dermatology, Branch of Shanghai First People’s Hospital, Shanghai Jiao Tong University, Shanghai, China

    Lanying Li

  5. School of Public Health, Sun Yat-sen University, Guangzhou, China

    Peiyang Li

  6. Kirby Institute, University of New South Wales, Sydney, Australia

    Huachun Zou

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  1. Yiguo Zhou
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  2. Yi-Fan Lin
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  11. Huachun Zou
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Contributions

This study was conceived and designed by HZ and YZ in consultation with the other authors. YZ and YL were responsible for study retrieval and screening. YZ, TY, and PL were responsible for data compilation and data analysis. All authors have contributed to interpretation of data and study findings. YZ, YL, and GL drafted the manuscript with all authors critically reviewing the paper.

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Zhou, Y., Lin, YF., Gao, L. et al. Human papillomavirus prevalence among men who have sex with men in China: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis 40, 1357–1367 (2021). https://doi.org/10.1007/s10096-021-04229-y

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