6 research outputs found
Factors affecting the prevalence of strongly and weakly carcinogenic and lower-risk human papillomaviruses in anal specimens in a cohort of men who have sex with men (MSM)
Background: MSM are at higher risk for invasive anal cancer. Twelve human papillomaviruses (HPVs) cause cervical cancer in women (Group 1 high-risk HPVs (hrHPVs)) and 13 HPVs are probable/possible causes (Group 2 hrHPVs) of cervical malignancy. HPVs rarely associated with malignancy are classified as lower-risk HPVs (lrHPVs). Materials and Methods: Dacron-swab anal-cytology specimens were collected from and data complete for 97% (1262/1296) of Multicenter AIDS Cohort Study (MACS) men tested for HPVs using the Linear Array assay. Multivariate Poisson regression analyses estimated adjusted prevalence ratios for Group 1/2 hrHPVs and lrHPVs, controlling for the effects of age, race, ethnicity, sexual partnerships, smoking; HIV-infection characteristics, treatment, and immune status among HIV-infected men. Results: HIV-infected men showed 35-90% higher prevalence of Group 1/2 hrHPVs and lrHPVs than HIV-uninfected men, and higher prevalence of multi-Type, and multiple risk-group infections. CD4+ T-cell count was inversely associated with HPV Group 2 prevalence (p<0.0001). The number of receptive anal intercourse (RAI) partners reported in the 24 months preceding HPV testing predicted higher prevalence of Group 1/2 hrHPVs. Men reporting ≥30 lifetime male sex partners before their first MACS visit and men reporting ≥1 RAI partners during the 24 months before HPV testing showed 17-24% and 13-17% higher prevalence of lrHPVs (p-values ≤0.05). Men reporting smoking between MACS visit 1 and 24 months before HPV testing showed 1.2-fold higher prevalence of Group 2 hrHPVs (p = 0.03). Both complete adherence to CART (p = 0.02) and HIV load <50 copies/mL (p = 0.04) were protective for Group 1 hrHPVs among HIV-infected men. Conclusions: HIV-infected men more often show multi-type and multi-group HPV infections HIV-uninfected men. Long-term mutual monogamy and smoking cessation, generally, and CART-adherence that promotes (HIV) viremia control and prevents immunosuppression, specifically among HIV-infected MSM, are important prevention strategies for HPV infections that are relevant to anal cancer. © 2013 Wiley et al
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Comparison of 2 anal cytology protocols to predict high-grade anal intraepithelial neoplasia.
ObjectivesNylon-flocked and Dacron swab anal cytology collection procedures were evaluated for detecting high-grade anal intraepithelial neoplasia.Materials and methodsCross-sectional data for 42 HIV-infected and 16 uninfected men who have sex with men have been used. Sequentially collected anal cytology specimens, high-resolution anoscopy, and medical biopsy evaluated the sensitivity and specificity of cytology for predicting high-grade anal intraepithelial neoplasia. Men showing atypical squamous cells (ASC) or more severe findings by cytology were compared with those showing negative for intraepithelial lesions.ResultsThe prevalence of high-grade anal intraepithelial neoplasia was 35% (21/58), and findings were approximately 1.5 times higher among HIV-infected compared with uninfected men. Unsatisfactory cytology was twice as common among Dacron compared with nylon-flocked swab protocol specimens (14% [8/58] vs 7% [4/58]). Sensitivity and specificity for the nylon-flocked protocol cytology showing ASC or more severe findings were 81% (58%-95%) and 73% (50%-89%), respectively. Dacron protocol specimens showed 52% (30%-74%) and 58% (34%-80%) sensitivity and specificity, respectively. Men showing ASC or more severe findings using the nylon-flocked protocol cytology showed 3-fold higher odds for high-grade anal intraepithelial neoplasia compared with men with negative results (p < .05), but no statistically significantly higher odds of high-grade anal intraepithelial neoplasia for men showing ASC or more severe findings compared with those with negative results for Dacron protocol cytology (p > .05).ConclusionsThe nylon-flocked protocol better detects high-grade anal intraepithelial neoplasia than does the Dacron protocol, yields more interpretable results, and classifies men with high-grade anal intraepithelial neoplasia as cytologically abnormal 2.5 times more often, even in this small clinical trial.Clinical trials registration numberNCT00955591
Sociodemographic Characteristics, Sexual Behavior Characteristics, HIV, and Human papillomavirus (HPV) infection Characteristics of 1262 Multicenter AIDS Cohort Study Participants Evaluated for HPV DNA using Anal Swab Specimens.
a<p><i>p</i><0.001, <sup>b</sup><i>p</i> = 0.037, <sup>c</sup><i>p</i><0.001, <sup>d</sup>categories are not mutually exclusive, <sup>e</sup><i>p</i> = 0.062; <sup>f</sup><i>p</i> = 0.138<sup> g</sup><i>p</i><0.001. P-values for comparing HIV+ vs. HIV- were by the Fisher exact test or the Wilcoxon nonparametric test, as appropriate.</p
Comparison of Prevalence Ratios for Group 1 and 2 High-risk and Lower-risk HPVs for 579 HIV-infected Men Enrolled in the Multicenter AIDS Cohort Study Anal Health Sub-study.<sup>a</sup>
<p>Comparison of Prevalence Ratios for Group 1 and 2 High-risk and Lower-risk HPVs for 579 HIV-infected Men Enrolled in the Multicenter AIDS Cohort Study Anal Health Sub-study.<sup>a</sup></p
A–D: Age-specific Prevalence of Group 1 and 2 High-risk HPVs and Lower-risk HPVs for 1262 Men Enrolled in the Multicenter AIDS Cohort Study Anal Health Sub-study.
<p>(A) Virus Type Group-specific Prevalence for All Men. (B–D) Comparison of 579 HIV-infected and 683–Uninfected Men for (B) Group 1 High-risk HPVs, (C) Group 2 High-risk HPVs, and (D) Lower-risk HPVs.</p
HPV-Infection Characteristics Among 1005 MACS MSM Showing One or More HPVs for Single and Multiply Detected HPV-Types.
a<p><i>p</i><0.05 Comparing prevalence of infection for HIV+ to HIV-negative men.</p