HPV genotypes detected in the oropharyngeal mucosa of HIV-infected men who have sex with men in Northern Italy

The aim of this study was to investigate the epidemiological profile of HPV oropharyngeal infections in HIV-infected men who have sex with men. A total of 135 subjects were enrolled at the L. Sacco University Hospital (Milan, Italy) to evaluate their HPV oropharyngeal infection status at baseline and at a follow-up visit at least 12 months later. HPV DNA was detected from oropharyngeal swabs using an in-house nested PCR that amplifies a segment of the L1 gene. The PCR products were then sequenced and genotyped. A greater percentage of high-risk genotypes was identified compared to low-risk genotypes (13\ub77% vs. 6\ub79%, P < 0\ub705), and two uncommon alpha-HPV genotypes were detected, i.e. HPV-102 and HPV-114. HPV infection prevalence was 24\ub74% and the cumulative incidence was 24\ub71%. During the follow-up period, one case of HPV infection (HPV-33) persisted, while the overall rate of infection clearance was 58\ub73%. HPV oropharyngeal infection was widespread in the cohort examined, and most of the infections were transient and cleared within 12 months. These results may help to clarify the role of HPV in the oropharynx and may also improve our understanding of the need to implement preventive strategies in at-risk populations

Human Papillomavirus typing in a cohort of HIV-1-infected men in Milan, Italy

Objective: Highly onchogenic 16 and 18-HPV genotypes are the major cause of cervical cancers in women. Anal intraepithelial neoplasia (AIN), increasingly reported in HIV infected patients, is less characterized than cervical disease. This study want to focus the spectrum of human papillomaviruses in a cohort of HIV+ men. Methods: HIV/HPV co-infected male patients were recruited. Anal Pap smear, Hybrid-capture-II HPV test and HPV genotyping were performed. Tissue biopsies were collected in case of acetic white lesions or warts on high resolution anoscopy, unsatisfactory, ASC-US or ASC-H cytology. Results: Among the 172 samples amplified by PCR primers MY09/11, Pap smear was negative in 11.62%, L-SIL in 70.34%, H-SIL in 11.62%, ASC-US in 1.74%, and inadequate in 5.81%. Hybrid-capture-test was negative in 4.07%, LR were found in 12.79%, HR in 19.77% and HR/LR in 59.3%. The association of cytology/hybrid capture identified 98.25% of the samples positive on PCR. Histology on 98 patients was neg in 22.45%, AIN-1 in 70.41% and AIN 2-3 in 6.12%. In 1 case invasive cancer was demonstrated. HPV type specific prevalence of the 30 different HPV genotypes identified was 31.97% for HPV-6, 30.8% for HPV-16, 28.49% for HPV-11, 8.14% for HPV-58 and HPV-30. HPV-18 was found in 6 patients (3.49%). Multiple HPV genotypes were identified in 81 patients. Discussion: HPV 16-18, reported as the cause of >75% of all cervical carcinoma world wide, are reported with variable rates in anal carcinoma of HIV infected patients. According to a recent meta-analysis on HPV types among HIV infected women we observed a broader range of HPV genotypes, a high proportion of other than 16 serotypes, and higher proportion of multiple infections in HIV infected men compared to the reported rates in general population. Coinfection with multiple types of human papillomavirus should be monitored in view of type specific cancer protection of anti HPV vaccines

Anal HPV genotypes and related displasic lesions in Italian and foreign born high-risk males

Anal intraepithelial neoplasia and anal cancer are closely related to infection from high-risk Human Papilloma Virus (HPV) genotypes. Since HPVs involved in disease progression are reported to vary by geographical regions, this study focuses on HPV genotypes spectrum in 289 males attending a Sexual Transmitted Diseases (STD) unit according to their nationality. Anal cytology, Digene Hybrid Capture Assay (HC2) and HPV genotyping were evaluated in 226 Italian (IT) and 63 foreign born (FB) subjects, recruited between January 2003 and December 2006. FB people were younger (median 32y-IQR 27-35 vs 36y-IQR 31-43, respectively; Mann-Whitney test p < 0.0001) and had a higher rate of abnormal results (>= atypical squamous cells of undetermined significance (ASCUS)) on anal cytology (95.0% vs 84.04%) (p = 0.032; OR 3.61; 95% CI 1.04-1.23). HPV-16 is by far the most common genotype found in anal cytological samples independently from nationality while differences in distribution of other HPV genotypes were observed. The probability of infection from high-risk HPVs was higher in FB (OR 1.69; 95% CI 1.07-2.68) and is due to a higher rate of HPV-58 (OR 4.98; 95% CI 2.06-12.04), to a lower rate of HPV-11 (OR 0.35: 95% Cl 0.16-0.77), to the presence of other high-risk genotypes (HPV-45, HPV-66, HPV-69). Multiple infections rate was high and comparable between IT and FB people. The relative contribution of each HPV genotype in the development of pre-neoplastic disease to an early age in the FB group cannot be argued by this study and more extensive epidemiological evaluations are needed to define the influence of each genotype and the association with the most prevalent high-risk HPVs on cytological intraepithelial lesions development