Feasibility and Acceptability of Anal Self-Sampling for Human Papillomavirus Screening in HIV-Infected Patients

Abstract

Objectives: Anal cancer incidence is increasing among HIV-positive patients. No consensus currently exists for the screening of anal dysplasia. This study aimed at evaluating the feasibility and acceptability of anal self-sampling and assessing the prevalence of human papillomavirus (HPV) types among HIV-positive patients from Marseille University Hospitals. Methods: Between October 2013 and March 2014, during their regular visits for the monitoring of their HIV infection in an HIV outpatient clinical unit of Marseille University Hospitals, patients were asked to self-sample anal swabs for HPV detection. A specimen self-collection kit was provided. HPV detection and genotyping were performed using in-house protocols. The quality of self-sampling was assessed by concurrent cellular quantification in collected samples. Results: The acceptability rate of anal self-sampling was 91%, and 91% of the self-sampled specimens were appropriate for HPV screening. In addition, 76% of the samples were positive for HPV, including 54% of HPV types with oncogenic potential. Conclusions: This study indicates that HPV detection and typing through anal self-sampling is a valuable strategy to screen patients at high risk for anal cancer development. This could allow earlier management of anal lesions and related cancer in patients at high risk for HPV.

Argon plasma versus electrofulguration in the treatment of anal and perianal condylomata acuminata in patients with acquired immunodeficiency virus

“…Moreover, half of the patients presented lesions compatible with LSIL in their cytological evaluations. Regarding division of the genotypes into three categories, the high-risk and low-risk genotypes presented similar occurrence 1,4,6,20 . HPV genotyping, which today is more associated with scientific research than with clinical practice, can individualize patients who might be more susceptible to evolving to carcinoma, due to presence of a high-risk genotype such as types 16 or 18 1,2,4,27 .…”

“…Human papillomavirus (HPV) infection is the sexually transmitted disease most frequently diagnosed in both men and women. The incidence of this disease has been increasing over recent years almost everywhere in the world [1][2][3][4] . An estimated 10 to 20% of the adult sexually active population is infected by HPV, although only 1% presents classic condyloma and 2% present the subclinical disease, which could be diagnosed by means of high-resolution anoscopy [4][5][6][7][8] .…”

“…The incidence of this disease has been increasing over recent years almost everywhere in the world [1][2][3][4] . An estimated 10 to 20% of the adult sexually active population is infected by HPV, although only 1% presents classic condyloma and 2% present the subclinical disease, which could be diagnosed by means of high-resolution anoscopy [4][5][6][7][8] . Young adults are the group with the largest number of cases of infection, reaching rates of 46% among people aged between 20 and 30 years [1][2][3][4]7,9 .…”

“…This is a concerning situation, given the increasing number of cases of anal squamous cell carcinoma (SCC) among these diseased individuals. Tracking programs among this population have led to a concomitant increase in the number of cases diagnosed with condylomata acuminata [1][2][3][4][9][10] .…”

“…Anal carcinoma used to be considered infrequent, but its frequency is growing, especially due to an increase in SCC 11 . At the same time, increased numbers of cases of anogenital infections due to the human papillomavirus, which causes condylomata acuminata, have been observed 3,4,12 .…”