Fatores dietéticos e persistência da infecção por HPV em homens

Abstract

Background: HPV infections are the most common among sexually transmitted diseases. Although most frequently transitory, persistent oncogenic-type HPV infection may progress to a precursor lesion and, if not correctly treated, to cancer. The dissemination of HPV tends to be universal in sexually active individuals. Men, besides being in risk to cancer, in special penile and anal cancer, can be the spreader of this virus to women, contributing to the infection, and hence the cervical cancer. However, little is known about this infection in men. Some studies discuss the possible relation between diet and the risk of HPV and the role of food in persistent infections. Food and nutrients could influence carcinogenesis process by affecting nutritional status, susceptibility to infection and by acting in the probability of infection turning persistent and progressing to neoplastic lesions, besides altering DNA repair and stability.Objective: Investigate the relation of selected nutrients and HPV persistent infection in men of São Paulo, Brazil. Methods: The study population consisted of 1,248 men from the Brazilian cohort of HIM study, aged from 18 to 70 years old, whose answered a quantitative food frequency questionnaire (FFQ) in the baseline. The FFQ was developed and validated for the study population and afterwards calibrated and energy-adjusted. The U Mann-Whitney test was used to assess differences in the medians of nutrient intake between men with persistent and non-persistent infection. The association of dietary intake and persistent HPV infection was assessed in multivariate logistic models. Two independent multivariate logistic regression models were developed, one for oncogenic HPV persistent infection and other for nononcogenic HPV persistent infection. By treating categorical nutrient variables as continuous, it was possible to perform tests for trends. INTRODUÇÃOEntre as doenças sexualmente transmissíveis (DST), as infecções por papilomavírus humano (HPV) são as mais comuns no mundo (TROITTIER, 2006;MINISTÉRIO DA SAÚDE, 2013). Mesmo que muito frequentes, são, em geral, transitórias, e se resolvem espontaneamente pelo sistema imunológico na maioria dos casos (STANLEY, 2008, WILLIAMS et al., 2011 WHO, 2014 WILLIAMS et al., 2011; IARC, 2012 (MINISTÉRIO DA SAÚDE, 2015b; INCA, 2015) Estima-se que entre 25% e 50% da população feminina e por volta de 50% da população masculina mundial tenha alguma infecção por HPV (INCA, 2015), e que cerca de 80% das pessoas adquiram algum tipo de HPV em 15 algum momento da vida (INCT-HPV, 2013). No Brasil, acredita-se que existam cerca de 10 milhões de pessoas contaminadas pelo HPV (GIRALDO et al., 2008; INCT-HPV, 2013) e, a cada ano, 685,4 mil novas pessoas são infectadas por algum tipo do vírus (BRASIL, 2014).A disseminação do HPV tende a ser universal entre os indivíduos sexualmente ativos, sendo que o homem, além do risco de câncer anal, peniano e da orofaringe, pode ser um importante fator propagador desse vírus entre as mulheres, contribuindo para a infecção...