La circoncision protège de l’herpès et du VPH

Une importante étude américaine montre que la circoncision protège de l’herpès et du virus du papillome humain. Ces résultats montrent que les parents pourraient avoir avantage à faire circoncire leurs bébés, selon un spécialiste montréalais. La Société canadienne de pédiatrie envisage d’ailleurs de réviser ses recommandations sur la circoncision.

circoncision.jpg

Chez les hommes circoncis, la transmission de l’herpès diminue du quart et celle du virus du papillome humain, du tiers. La transmission de la syphilis reste inchangée. L’étude de l’Université John Hopkins et des Instituts nationaux de la santé des États-Unis, publiée dans le New England Journal of Medicine, a suivi pendant deux ans 3400 hommes en Ouganda, dont la moitié se sont fait circoncire au début de l’étude. À la fin, 8% des hommes circoncis avaient attrapé l’herpès, et 18% le VPH.La Société canadienne de pédiatrie va réunir ses comités concernés pour évaluer si les lignes directrices doivent être changées. «Pour le moment, on considère que les aspects négatifs de la circoncision l’emportent sur les aspects positifs», explique Robert Bortolussi, pédiatre néo-écossais qui dirige le comité de la Société sur les maladies infectieuses. «Mais cette étude va peut-être changer les recommandations.»

En éditorial, la revue médicale conclut elle aussi que «la circoncision offre une protection importante et devrait être offerte partout», à tous les parents. Cette phrase fait référence au fait que la circoncision n’est pas partout remboursée par les assurances; notre assurance maladie ne couvre notamment pas cette opération.

Sur son site internet, la Société canadienne de pédiatrie énumère les avantages et les inconvénients de la circoncision, et les seconds l’emportent largement sur les premiers. Notamment, de 2 à 3% des enfants circoncis ont des complications chirurgicales comme des saignements abondants, alors que 0,7% des bébés sont hospitalisés dans leur première année à cause d’une infection urinaire qui peut être évitée par la circoncision, une opération par ailleurs douloureuse.

Le mécanisme par lequel la circoncision protège des MTS est mal connu. «Avec le sida, on sait que la circoncision protège parce que les cellules du prépuce sont particulièrement sensibles au HIV, dit le Dr Wainberg. Mais le mécanisme pour l’herpès et le VPH n’est pas identifié.» La circoncision ne diminue pas la transmission homosexuelle des MTS. (La Presse)

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