Anal Human Papillomavirus (HPV) Prevalences and Factors Associated with Abnormal Anal Cytology in HIV-Infected Women in an Urban Cohort from Rio de Janeiro, Brazil

Cambou, Mary Catherine; Luz, Paula M.; Lake, Jordan E.; Levi, José Eduardo; Coutinho, João; Andrade, Angela de; Heinke, Thaís; Derrico, Mônica; Veloso, Valdiléa G.; Friedman, Ruth Khalili; Grinsztejn, Beatriz

doi:10.1089/apc.2014.0166

Cited by 28 publications

(31 citation statements)

References 41 publications

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“…In our study, HIV+ patients presented an altered AC in 42.9% of cases, and the figure was 26.8% in HIV-women. Our result for the HIV+ patients differed from that reported from another Brazilian study performed by Cambou et al (2015), where 30.4% of HIV+ women presented alterations in AC cytology. The difference between the results is likely to be due to the restricted number of samples in our study.…”

Section: Discussioncontrasting

confidence: 99%

“…Collected cells were initially prepared for conventional cytology by directly spreading cells onto a glass slide and immediately immersing the slide in absolute ethanol for fixation. Both anal and cervical cytology was classified according to the Bethesda system (2001) because the anus and cervix have similar histopathologic features (Poggio, 2011;Cambou et al, 2015) The cells remaining in the swab were then collected and immersed in a flask containing 20 mL ThinPrep ® (Hologic, Bedford, MA, USA) refrigerated solution. The samples were processed and analyzed at the Institute of Tropical Medicine of the University of São Paulo.…”

Section: Cytology Colposcopy Anoscopy and Histologymentioning

confidence: 99%

“…As previously described, women with HPV-induced lesions in the LGT are at higher risk of anal SILs (Cambou et al, 2015). For not dealing with a prospective study, it was not conclusive therefore the definition of the cytology role, of HRA and the HPV DNA test on the prevention of AC cancer and the decrease of mortality by this disease.…”

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confidence: 94%

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HPV infection-associated anogenital cyto-colpo-histological findings and molecular typing in HIV-positive women

et al. 2015

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ABSTRACT. HIV and human papillomavirus (HPV) coinfection is increasing, especially in the anal canal (AC) and cervico-vaginal regions.We identified anal epithelium abnormalities related to high-risk HPV (HR-HPV) lesions in the lower genital tracts (LGTs) of HIV-positive women, described the HPV genotypes identified, and assessed the expression of E6/E7 oncogenes in coinfected patients. Ninety-eight women were enrolled in groups combining HIV status and presence or absence of HPV in the LGT. Anal and cervical smears were collected for cytology and HR-HPV assays using Cobas ® and/ or PapilloCheck ® . Samples with highly oncogenic HPV genotypes were confirmed by NucliSENS EasyQ ® . Forty-two HIV-positive (25-52; mean age 39.5) and 56 HIV-negative (18-58; mean age 35.7) patients were included. E2 and C1 groups presented AC alterations (P = 0.002); altered images HPV-associated anogenital cytology in HIV-positive women for high-resolution anoscopy were higher in E1 and C2 (P < 0.001). Of the 29 women with alterations, 41.38% were HIV-negative and 58.62% were HIV-positive (P < 0.001). HIV-positive patients accounted for 29% of the anal high-grade squamous intraepithelial lesions (P = 0.015). The Cobas ® positive result frequency was higher in three AC groups than in the other groups. There was variation in the number of HPV types in the cervicovaginal samples among the study groups (P < 0.001). Anal cytology and anoscopy showed more altered findings in HIV-positive patients with HPV in the LGT. HR-HPV anal infections by various genotypes are common and are associated with cervical infections in HIV-positive patients. E6/E7 expression is apparently more common in the AC of HIV-positive women.

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Section: Discussioncontrasting

confidence: 99%

Section: Cytology Colposcopy Anoscopy and Histologymentioning

confidence: 99%

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HPV infection-associated anogenital cyto-colpo-histological findings and molecular typing in HIV-positive women

et al. 2015

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“…However consistent with the findings of Hessol et al (17), in which women with lower CD4 cell counts were more likely to have detectable oncogenic and non-oncogenic HPV types, a low CD4 nadir was significantly associated with anal HPV detection in the present study. In a study by Cambou et al (32), a significant correlation between a low CD4 nadir and previous CD4 counts was detected, indicating an increased risk for anal dysplasia in HIV-infected women with a history of severe immune devastation. The increased prevalence of HPV infection in HIV-infected individuals seems to be associated with immunosuppression (33).…”

Section: Discussionmentioning

confidence: 94%

Prevalence of human papillomavirus infection of the anal canal in women: A prospective analysis of high-risk populations

et al. 2017

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Abstract. Infection with certain types of human papillomavirus (HPV) has been associated with the development of cervical and anal cancer. Worldwide, the incidence of anal cancer has increased markedly. The present study aimed to evaluate the prevalence of HPV infection of the uterine cervix and anal canal in human immunodeficiency virus (HIV)-and non-HIV-infected risk populations. Cervical and anal HPV swabs and cytology samples were collected from 287 patients at the University Hospital of Munich, Germany between 2011 and 2013. Patients were divided into HIV-negative controls (G1) and two risk groups, including HIV-negative patients with cytological abnormalities of the cervix (G2) and HIV-infected patients (G3). Data, including clinical parameters, were analysed. The risk groups had significantly more positive results for HPV in the anus (71.03 and 83.15% for G2 and G3, respectively), as compared with G1. The predominant HPV genotypes found in the anus were high-risk HPV genotypes, which were significantly correlated with concomittant cervical HPV findings. In the risk groups, a significant association between the cytological findings and HPV detection in the cervix was found, while the results of the anus revealed no significance. The results of the present study suggested that the prevalence of HPV infection in the anal canal of risk populations is high. Furthermore, patients with abnormal cervical cytology results and HIV-infected women, irrespective of their individual cervical findings, may have a risk of concomittant anal high-risk HPV infection. Based on the predominant HPV genotypes found in the study, HPV vaccination could reduce the incidence of anal cancer. Nevertheless, high-risk patients should be intensively screened for anal squamous intraepithelial abnormalities to avoid invasive cancer stages.

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“…23, 24 Our study found a similar prevalence of anal and cervical HR-HPV infection, which is consistent with prior studies. 16, 25 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of Anal HPV and Anal Dysplasia in HIV-Infected Women From Johannesburg, South Africa

Goeieman

Firnhaber

Jong³

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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BACKGROUND Anal cancer is a relatively common cancer among HIV-infected populations. There are limited data on the prevalence of anal high-risk human papillomavirus (HR-HPV) infection and anal dysplasia in HIV-infected women from resource-constrained settings. METHODS A cross-sectional study of HIV-infected women age 25–65 recruited from an HIV clinic in Johannesburg, South Africa. Cervical and anal swabs were taken for conventional cytology and HR-HPV testing. Women with abnormal anal cytology and 20% of women with negative cytology were seen for high resolution anoscopy (HRA) with biopsy of visible lesions. RESULTS Two hundred women were enrolled. Anal HR-HPV was found in 43%. The anal cytology results were negative in 51 (26%); 97 (49%) had low-grade squamous intraepithelial lesions (SIL), 32 (16%) had atypical squamous cells of unknown significance and 19 (9.5%) had high-grade SIL or atypical squamous cells suggestive of high-grade SIL. On HRA, 71 (36%) had atypia or low-grade SIL on anal histology and 17 (8.5%) had high-grade SIL. Overall 31 (17.5%) had high-grade SIL present on anal cytology or histology. Abnormal cervical cytology was found in 70% and cervical HR-HPV in 41%. CONCLUSION We found a significant burden of anal HR-HPV infection, abnormal anal cytology and high-grade SIL in our cohort. This is the first study of the prevalence of anal dysplasia in HIV-infected women from sub-Saharan Africa. Additional studies are needed to define the epidemiology of these conditions, as well as the incidence of anal cancer, in this population.

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Anal Human Papillomavirus (HPV) Prevalences and Factors Associated with Abnormal Anal Cytology in HIV-Infected Women in an Urban Cohort from Rio de Janeiro, Brazil

Cited by 28 publications

References 41 publications

HPV infection-associated anogenital cyto-colpo-histological findings and molecular typing in HIV-positive women

HPV infection-associated anogenital cyto-colpo-histological findings and molecular typing in HIV-positive women

Prevalence of human papillomavirus infection of the anal canal in women: A prospective analysis of high-risk populations

Prevalence of Anal HPV and Anal Dysplasia in HIV-Infected Women From Johannesburg, South Africa

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