| 边举元,杨恒,署丽盼·阿斯力别克,余文慧,王凯,张国珍,戴江红.男男性行为者9价疫苗型人乳头瘤病毒新发感染风险的预测研究[J].中华流行病学杂志,2025,46(1):118-124 |
| 男男性行为者9价疫苗型人乳头瘤病毒新发感染风险的预测研究 |
| A prediction study of the risk of new 9-valent vaccine type human papillomavirus infections in men who have sex with men |
| 收稿日期:2024-06-25 出版日期:2025-01-11 |
| DOI：10.3760/cma.j.cn112338-20240625-00371 |
| 中文关键词: 男男性行为者 人乳头瘤病毒 联合模型 风险预测 |
| 英文关键词: Men who have sex with men Human papillomavirus Combined model Risk prediction |
| 基金项目:科技创新团队“天山创新团队”项目（2022TSYCTD0013）；国家自然科学基金项目（81560539，81860590） |
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| 中文摘要: |
| 目的 了解乌鲁木齐市男男性行为者（MSM）9价疫苗型人乳头瘤病毒（9价型HPV）新发感染的影响因素，构建MSM 9价型HPV新发感染的个体动态预测模型。方法 本研究采取滚雪球方法在乌鲁木齐市招募MSM建立动态队列，2016-2023年对参与者每6个月进行一次随访，收集肛周脱落细胞进行HPV基因分型检测；利用近6个月同性性伴数、近1周肛交次数作为纵向变量分别建立联合模型，利用联合模型分析MSM个体的9价型HPV新发感染影响因素；采用时间依赖性受试者特征曲线下面积（AUC）评价模型在随访时间段的预测效能。基于预测模型，随机选取研究对象2人进行9价型HPV新发感染的个体动态预测。结果 至少有2次随访的MSM 579人被纳入分析。联合模型结果显示，离异/丧偶（HR=1.544，95%CI：1.033~2.233）、性行为方式为被插入（HR=1.366，95%CI：1.053~1.764）、有性病史（HR=1.659，95%CI：1.057~2.558）均会增加9价型HPV新发感染的风险。近6个月同性性伴数联合模型的共享参数结果显示，近6个月同性性伴数每增加2.72人，MSM个体的9价型HPV新发感染风险增加28.2%（HR=1.282，95%CI：1.065~1.540）。时间依赖性AUC结果显示，近6个月同性性伴数的联合模型（0.808 0）预测性能优于近1周肛交次数的联合模型（0.750 0）。基于近6个月同性性伴数的联合模型进行MSM个体动态预测，与真实情况相符。结论 基于近6个月同性性伴数、性行为方式、性病史等风险因素建立的联合模型对于预测乌鲁木齐市MSM 9价型HPV新发感染风险具有较高的准确性，可为MSM 9价型HPV新发感染个体动态预测提供科学依据。 |
| 英文摘要: |
| Objective To understand the factors influencing new infections of 9-valent vaccine-type human papillomavirus (9-valent type HPV) among men who have sex with men (MSM) in Urumqi City and to construct a prediction model of individual dynamics of new infections of 9-valent type HPV among MSM. Methods In this study, a snowball method was adopted to recruit MSM in Urumqi City to establish a dynamic cohort, and participants were followed up every 6 months from 2016 to 2023, and perianal exfoliated cells were collected for HPV genotyping; joint models were established using the number of same-sex sexual partners in the last six months and the number of anal intercourse in the last one week as longitudinal variables, respectively, and joint models were utilized to analyze the influence factors of 9-valent HPV new infections in MSM individuals were analyzed by the joint model; the predictive efficacy of the model in the follow-up period was evaluated by using the time-dependent receiver operating characteristic area under the curve (AUC) values. Based on the prediction model, two study participants were randomly selected for individual dynamic prediction of new-onset HPV infections of 9-valent type types. Results MSM with at least two follow-up visits 579 individuals were included in the analysis. The results of the two joint models showed that being divorced/widowed [hazard ratio (HR)=1.544, 95%CI: 1.033-2.233], having a sexual behavior style of being the inserted party (HR=1.366, 95%CI: 1.053-1.764), and having a history of STDs (HR=1.659, 95%CI: 1.057-2.558) increased the 9-valent types of new HPV infections risk. The results of the shared parameter of the joint model of the number of same-sex partners in the last six months showed that each 2.72 increase in the number of same-sex partners in the last six months was associated with a 28.2% increase in the risk of new 9-valent HPV infections in MSM individuals (HR=1.282, 95%CI: 1.065-1.540). The time-dependent AUC results showed that the joint model for the number of same-sex sexual partners in the last six months (0.808 0) predicted better performance than the joint model for the number of anal intercourse in the last one week (0.750 0). The joint model based on the number of same-sex sexual partners in the last six months for the prediction of MSM individual dynamics was consistent with the real situation. Conclusion The joint model based on the number of same-sex sexual partners in the last six months, sexual behavior, history of STDs, and other risk factors has high accuracy in predicting the risk of new MSM 9-valent HPV infections in Urumqi City, which can provide a scientific basis for the prediction of individual dynamics of new MSM 9-valent HPV infections. |
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