High Prevalence and Genotype Diversity of Anal HPV Infection among MSM in Northern Thailand

Abstract

BackgroundHPV infection is common and may cause cancer among men who have sex with men (MSM). Anal HPV infection (HPV+) was found in 85% of HIV-positive (HIV+) and 59% of HIV-negative (HIV-) MSM in Bangkok, central Thailand. As little is known about HPV in this group in northern Thailand, we studied MSM subgroups comprised of gay men (GM), bisexual men (BM), and transgender women (TGW).MethodsFrom July 2012 through January 2013, 85 (42.5% of 200) GM, 30 (15%) BM, and 85 (42.5%) TGW who practiced receptive anal intercourse were recruited after informed consent, followed by self-assisted computer interview, HIV testing, and anal swabs for HPV genotyping.ResultsOf 197 adequate specimens, the overall prevalence of any HPV was 157 (80%). Prevalence was 89% (76/85) in GM, 48% (14/29) in BM, and 81% (67/83) in TGW. The most common high-risk types were HPV16 (27% of 197), HPV58 (23%), and HPV51 (18%). Prevalence of high-risk types was 74% in 85 GM, 35% in 29 BM, and 71% in 83 TGW. Prevalence of any HPV type, or high-risk type, was 100% and 94%, respectively, among 48 HIV+ MSM, 70% and 54% among 120 HIV- MSM. Of the 197 specimens, 36% (70) had HPV types 16 and/or 18 in the bivalent vaccine, compared to 48% (95) with ≥1 of types 16/18/06/11 in the quadrivalent, 56% (111) for 16/18/31/33/45/52/58 in the 7-valent, and 64% (126) for 16/18/31/33/45/52/58/06/11 in the 9-valent. HIV+, GM, and TGW were independently associated with HPV infection.ConclusionsWe found higher rates of both any HPV and high-risk types than previous studies. Among the heretofore unstudied TGW, their equivalent HPV rates were comparable to GM. Current and investigational HPV vaccines could substantially protect GM, BM, and TGW from the serious consequences of HPV infection especially among HIV + MSM.

Prevalence of Anal Human Papillomavirus Infection and Risk Factors among HIV-positive Patients in Tokyo, Japan

“…In this study, the single most frequently detected type was HPV-58 (30.2%) in HIV-infected MSM. Supindham et al recently reported that HPV-58 infection rate was 29% in HIV-infected MSM in Northern Thailand [ 32 ], which is quite similar to the rate in our study. They also showed a lower rate of HPV-58 (18%) in non-HIV-infected MSM compared with HIV-infected MSM [ 32 ].…”

“…Supindham et al recently reported that HPV-58 infection rate was 29% in HIV-infected MSM in Northern Thailand [ 32 ], which is quite similar to the rate in our study. They also showed a lower rate of HPV-58 (18%) in non-HIV-infected MSM compared with HIV-infected MSM [ 32 ]. In another study in Bangkok, Phanuphak et al reported that the HPV-58 infection rate was significantly higher in HIV-positive MSM (10.8%) than in HIV-negative MSM (4.9%) [ 33 ].…”

Cancer in Transgender People: Evidence and Methodological Considerations

“…Among over 40 types of HPV, at least 13 are considered high risk with respect to their carcinogenic potential (22).…”

“…A number of studies of both transgender and nontransgender people indicate that HPV and HPV-related anal squamous intraepithelial lesions are more common in human immunodeficiency virus-infected individuals (22,27,28). Human immunodeficiency virus infections are common among transgender people, particularly transwomen who have some of the highest laboratory-confirmed prevalence estimates in the world (29).…”

British HIV Association Guidelines on the Use of Vaccines in HIV‐Positive Adults 2015

“…Men and women with HIV infection show an increased risk and rate of HPV acquisition and persistence, frequent carriage of multiple HPV types, and an increased risk of HPV‐related disease including rapidly progressive malignancies . HPV carriage rates and overall disease risk increase at low CD4 cell counts.…”