HPV Seroconversion Following Anal and Penile HPV Infection in HIV-Negative and HIV-Infected MSM

Mooij, Sofie H.; Landén, Olivia; Klis, Fiona R.M. van der; Sande, Marianne A. B. van der; Melker, Hester E. de; Xiridou, Maria; Eeden, Arne van; Heijman, Titia; Speksnijder, A.G.C.L.; Snijders, Peter J.F.; Loeff, Maarten F. Schim van der

doi:10.1158/1055-9965.epi-14-0199

Cited by 14 publications

(21 citation statements)

References 33 publications

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“…In contrast, previous HPV serological surveys of MSM have included older, more sexually experienced men where the great majority of men are found to have prevalent anal HPV infection . Mooij et al . reported data on HPV seroconversion following incident HPV DNA infection in MSM.…”

Section: Discussionmentioning

confidence: 98%

“…18 In contrast, previous HPV serological surveys of MSM have included older, more sexually experienced men where the great majority of men are found to have prevalent anal HPV infection. [15][16][17]25,26 Mooij et al 27 reported data on HPV seroconversion following incident HPV DNA infection in MSM. That study included much older MSM (median age: 38 years for HIV-negative MSM, 47 for HIV-positive MSM) where 38% were HIV-infected.…”

Section: Discussionmentioning

confidence: 99%

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Antibody responses following incident anal and penile infection with human papillomavirus in teenage men who have sex with men

et al. 2016

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Men who have sex with men (MSM) are at risk for human papillomavirus (HPV)-related anal cancer. Few data exist on antibody responses following incident anogenital infection with HPV in teenage MSM. A cohort of 200 MSM aged 16-20 years from Melbourne, Australia were assessed at baseline, 3, 6 and 12 months. At each visit anal and penile swabs were collected for HPV DNA and serum for HPV antibodies for genotypes 6, 11, 16 and 18 (Merck's Multiplex Assays using Luminex). The main outcome, seroconversion, was defined as the detection of HPV antibodies following a negative antibody result for the same HPV type at baseline. The seroincidence rates for HPV types 6, 11, 16 and 18 were: 19 (95% CI 12-26), 7 (3-12), 4 (1-8) and 6 (3-11) per 100 person-years, respectively. Men who experienced incident anal HPV infections from types 6/11 were significantly more likely to develop serum antibodies to the same HPV type(s) than those who experienced incident anal infections from types 16/18 [73 vs. 18%, odds ratio (OR) 5 15, 95% CI: 2-118]. The median time between incident anal HPV infection and seroconversion for HPV 6, 11, 16 and 18 was: 91, 38, 161 and 182 days, respectively. Antibody responses against HPV types 6/11 were significantly more likely to occur following incident anal compared with incident penile infection with HPV types 6/11 (OR 5 6, 95% CI: 2-21). The likelihood of antibody responses following anogenital HPV infections depends on the HPV type and site of infection.Human papillomavirus (HPV) infection is common among men who have sex with men (MSM) and a cause of anogenital warts as well as anal cancer.1 Anal cancers are overrepresented among HIV positive MSM.2 Anogenital warts are most commonly caused by HPV types 6 and 11. The majority of anal cancers are caused by HPV types 16 and some anal cancers are caused by HPV types 18. In men the quadrivalent HPV vaccine is effective at preventing infection with HPV types 6, 11, 16 and 18 and related anogenital lesions. 3With high coverage of the target population HPV vaccination should help to prevent anal cancer. 4 Data suggest that in some populations of MSM the incidence of anal cancer has increased.5 This includes increases in the incidence of anal cancer among HIV positive MSM despite the greater uptake of anti-retroviral treatment (ART) which has been associated with a fall in other HIV-associated cancers. 6,7 Data from the US National Cancer Institute show that the 5-year survival for patients diagnosed with anal cancer to be 65.7% with poorer outcomes for more advanced cancers. 8Although only a proportion of anogenital HPV infections elicit a serum antibody response, antibodies following natural Key words: human papillomavirus (HPV), men who have sex with men, seroprevalence, seroincidence, antibody Abbreviations: AIN: anal intraepithelial neoplasia; ART: anti-retroviral treatment; CI: confidence intervals; HPV: human papillomavirus; IQR: interquartile range; MSM: men who have sex with men; OR: odds ratio; SEER: surveillance, epidemiology, and end results pro...

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Antibody responses following incident anal and penile infection with human papillomavirus in teenage men who have sex with men

et al. 2016

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“…Overall seroconversion rates were highest for HPV6 (19%), whereas only 4% and 3% of men seroconverted within 36 months after infection with HPV16 and HPV18, respectively [51]. Seroconversion rates are slightly higher in HIV-positive MSM compared to HIV-negative heterosexual men (18% vs. 13%, p = 0.1); however, anti-HPV antibody levels are mostly low, leaving men susceptible to recurrent HPV infections [50,51].…”

Section: Hpv Vaccinationmentioning

confidence: 94%

“…This is even more dramatic in men, in whom type-specific seroconversion rates after incident anogenital HPV infection range from 8% to 19% [49][50][51]. The anatomic site of HPV infection and differences in immune response to specific HPV types further affects seroconversion rates [50,51]. A total of 19%, 6%, and 0% of men studied seroconverted to at least one HPV type after incident genital, anal, and oral HPV infection, respectively.…”

Section: Hpv Vaccinationmentioning

confidence: 97%

“…Depending on the HPV type, approximately 54-69% of women with anogenital HPV infection seroconvert; however, their anti-HPV antibody levels are low and provide only partial protection against recurrent HPV infection with the same HPV type [47,48]. This is even more dramatic in men, in whom type-specific seroconversion rates after incident anogenital HPV infection range from 8% to 19% [49][50][51]. The anatomic site of HPV infection and differences in immune response to specific HPV types further affects seroconversion rates [50,51].…”

Section: Hpv Vaccinationmentioning

confidence: 99%

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Prevention of human papillomavirus (HPV)-related tumors in people living with human immunodeficiency virus (HIV)

Poljak

Šterbenc

Lunar

2017

Expert Review of Anti-infective Therapy

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In comparison to their HIV-negative counterparts, people living with HIV (PLWH) have a higher prevalence of human papillomavirus (HPV) infection in various anatomical sites coupled with increased HPV persistence, higher risk of HPV-related tumors, and faster disease progression. Areas covered: Gender-neutral prevention strategies for HPV-related cancers in PLWH discussed: ABC approach, HPV vaccination, antiretroviral treatment (ART), anal cancer screening, and smoking cessation. Gender specific strategies: cervical cancer screening reduces the incidence and mortality of cervical cancer and circumcision might reduce the risk of HPV infections in men. Expert commentary: HPV-related cancer incidence has not declined (e.g. cervical cancer) and has even increased (e.g. anal cancer) in the ART era, demanding an effective HPV prevention strategy. HPV vaccination should be introduced into national prevention programs worldwide immediately because current prophylactic vaccines are safe, tolerable, and immunogenic in PLWH. HPV vaccine efficacy trials in PLWH are essential to determine the most appropriate immunization schedule. The population most at risk of anal cancer is HIV-positive men who have sex with men, who are not protected by herd immunity if only the female population is vaccinated. Unvaccinated PLWH need enhanced surveillance for early detection of HPV-related cancers and their precursors.

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Antibodies against HPV16E6 oncoprotein in the Swiss HIV cohort study: Kinetics and anal cancer risk prediction

Combes

Clifford

Günthard

et al. 2019

Intl Journal of Cancer

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Our aim was to describe HPV16E6 antibody kinetics prior to anal cancer in people living with HIV/AIDS (PLWHA) and evaluate the possible contribution of HPV16E6 serology to anal cancer risk prediction. For 91 persons diagnosed with anal cancer in the Swiss HIV Cohort Study , serial serum/plasma samples were tested for HPV16E6 antibodies using multiplex serology, supplemented with samples from 1,356 participants without anal cancer. Anal cancer incidence was estimated for PLWHA from 40 years-old in the cART era, stratified by HPV16E6 serostatus. HPV16E6 seroprevalence was 23.3% in samples <2 years prior to anal cancer diagnosis and decreased with increasing time prior to cancer: 16.7% at 2-4 years, 4.4% at 5-9, and 7.0% at ≥10 years. Of 25 individuals with anal cancer who were HPV16E6-seropositive at any time during follow-up, the majority (n = 18) remained seropositive in all samples after seroconversion, whereas for seven cases, seropositivity was transitory. Among individuals with anal cancer, HPV16E6 seroprevalence was marginally higher in women vs. men who have sex with men (adjusted OR = 4.3, 95% CI: 1.1, 17.2) and in older participants (adjusted OR = 6.2, 95% CI: 1.1, 34.8 for cases diagnosed at ≥55 vs. <45 years). Anal cancer incidence was 402/100,000 person-years in HPV16E6-positive vs. 82/100,000 in HPV16E6-negative PLWHA (incidence rate ratio = 4.9, 95% CI: 1.3, 13.1). In conclusion, HPV16E6 serology, despite its low sensitivity, allows characterization of a group of individuals with very high anal cancer incidence and may have a place in secondary prevention in groups at high risk for anal cancer such as PLWHA.Additional Supporting Information may be found in the online version of this article.

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HPV Seroconversion Following Anal and Penile HPV Infection in HIV-Negative and HIV-Infected MSM

Cited by 14 publications

References 33 publications

Antibody responses following incident anal and penile infection with human papillomavirus in teenage men who have sex with men

Antibody responses following incident anal and penile infection with human papillomavirus in teenage men who have sex with men

Prevention of human papillomavirus (HPV)-related tumors in people living with human immunodeficiency virus (HIV)

Antibodies against HPV16E6 oncoprotein in the Swiss HIV cohort study: Kinetics and anal cancer risk prediction

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