International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Syphilis status associated with the natural history of anal HPV infection: An observational cohort study from Xinjiang, China.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Yu Wenhui, He Jingjing, Asilibieke Shulipan, Gao Can, Zhang Zewen, Zhang Guozhen, Yang Heng, Zhang Wenjie, Wu Haoyu, Tian Tian, Dai Jianghong
Аннотация
BACKGROUND: Studies on the association between syphilis positivity on the natural history of HPV infection among men who have sex with men (MSM) are limited. This study aims to assess the impact of syphilis status on the prevalence, incidence, and clearance of anal HPV in MSM.
METHODS: This study utilized data from a prospective cohort of aged 18 years and older HIV-negative MSM conducted in Xinjiang, China, from May 2016 to November 2025. Self-administered questionnaires collected baseline and every 6 months data on demographics and sexual behaviors. Anal swabs were taken for HPV genotyping, and blood samples for syphilis testing. We compared HPV prevalence, incidence, and clearance rate among syphilis positive and syphilis negative MSM. Poisson regression models were used to calculate prevalence ratios (PRs), incidence rate ratios (IRRs), and clearance rate ratios (CRRs).
RESULTS: A total of 743 MSM were included, with a median age of 35 years (IQR: 29-41). Among them, 186 tested positive for syphilis, while 557 tested negative. The syphilis positive MSM exhibited slightly higher prevalence of any HPV, high-risk HPV, low-risk HPV, and 9v HPV compared to the syphilis negative MSM. During follow-up, after adjustment for age, number of sexual partners in the past six months, and other potential confounders, the syphilis positive MSM exhibited significantly higher incidence of any HPV (IRR = 1.37, 95% CI: 1.02-1.84) and low-risk HPV (IRR = 1.53, 95% CI: 1.07-2.2). The clearance rate for any HPV (CRR = 1.35, 95% CI: 1.01-1.81) and high-risk HPV (CRR = 1.71, 95% CI: 1.20-2.43) were also significantly higher among the syphilis positive MSM.
CONCLUSION: Syphilis is a risk factor for HPV prevalence and incidence. Future HPV prevention strategy should adopt an integrated approach that concurrently addresses syphilis and other sexually transmitted infections.
METHODS: This study utilized data from a prospective cohort of aged 18 years and older HIV-negative MSM conducted in Xinjiang, China, from May 2016 to November 2025. Self-administered questionnaires collected baseline and every 6 months data on demographics and sexual behaviors. Anal swabs were taken for HPV genotyping, and blood samples for syphilis testing. We compared HPV prevalence, incidence, and clearance rate among syphilis positive and syphilis negative MSM. Poisson regression models were used to calculate prevalence ratios (PRs), incidence rate ratios (IRRs), and clearance rate ratios (CRRs).
RESULTS: A total of 743 MSM were included, with a median age of 35 years (IQR: 29-41). Among them, 186 tested positive for syphilis, while 557 tested negative. The syphilis positive MSM exhibited slightly higher prevalence of any HPV, high-risk HPV, low-risk HPV, and 9v HPV compared to the syphilis negative MSM. During follow-up, after adjustment for age, number of sexual partners in the past six months, and other potential confounders, the syphilis positive MSM exhibited significantly higher incidence of any HPV (IRR = 1.37, 95% CI: 1.02-1.84) and low-risk HPV (IRR = 1.53, 95% CI: 1.07-2.2). The clearance rate for any HPV (CRR = 1.35, 95% CI: 1.01-1.81) and high-risk HPV (CRR = 1.71, 95% CI: 1.20-2.43) were also significantly higher among the syphilis positive MSM.
CONCLUSION: Syphilis is a risk factor for HPV prevalence and incidence. Future HPV prevention strategy should adopt an integrated approach that concurrently addresses syphilis and other sexually transmitted infections.