Circumcision In HIV Times

A. Orozco-gutierrez, Rosa María Estrada-Velazquez, Fernando Contreras-Velazquez, L. Marroquin-Donday, Cesar Gil-Rosales, C. Calderon-Jimenez, C. Magis-Rodríguez
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Abstract

Circumcision is a procedure that has been used for hundreds of years; its benefits for disease prevention have been mentioned in anecdotal form for many years. In 1980 with the emergence of HIV infection a diminution of cases was observed in circumcised males. We reviewed the studies evolution trying to demonstrate the scientific validity of this observation showing the importance of viral load and mucosal integrity as factors for HIV transmission. In 2008 with the publication of three prospective, randomized trials on 11,054 patients demonstrated the incidence of HIV Infection decrease of 50% with the practice of circumcision. These studies prompted the WHO to recommend circumcision as a primary preventive procedure for prevention of HIV. We reviewed and found evidence of effectiveness on this procedure preventing other diseases as chancroid, syphilis, papilloma virus, chlamydia and herpes; questioning the validity of current recommendations stressing out the need to review them.
艾滋病时代的割礼
割礼是一种已经使用了数百年的手术;它对疾病预防的益处多年来一直以传闻的形式被提及。1980年,随着艾滋病毒感染的出现,割过包皮的男性病例有所减少。我们回顾了这些研究的进展,试图证明这一观察的科学有效性,表明病毒载量和粘膜完整性作为HIV传播因素的重要性。2008年,一项针对11054名患者的前瞻性随机试验表明,包皮环切术降低了50%的艾滋病毒感染率。这些研究促使世界卫生组织推荐包皮环切术作为预防艾滋病毒的初级预防措施。我们回顾并发现了该方法预防其他疾病如软下疳、梅毒、乳头状瘤病毒、衣原体和疱疹的有效性证据;质疑目前建议的有效性,强调有必要对其进行审查。
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