Initial prevalence of anal human papilloma virus infection in liver transplant recipients

Abstract

SummaryAlthough liver transplant recipients are at increased risk of human papilloma virus (HPV)-related anal cancer, limited data are available regarding the initial prevalence of anal HPV infection in this population. Anal swabs collected from 50 liver transplant recipients within the first three postoperative weeks were subjected to real-time polymerase chain reaction for detection of the four HPV genotypes: 6, 11, 16, and 18. Predictors of any, low-risk, and high-risk anal HPV infection were evaluated. Overall, the prevalence of any anal HPV infection was 18.0%, with the corresponding rates for high-and low-risk HPV genotypes being 8.0% and 10.0%, respectively. Infection with any type of anal HPV was higher in patients with hepatitis B virus (HBV) infection (P = 0.027), ≥3 sexual partners (P = 0.031), and alcoholic liver disease (P = 0.063). HBV infection was the only factor significantly associated with high-risk HPV infection (P = 0.038). Male sex (P = 0.050), age ≥52 years (P = 0.016), ≥30 sexual partners (P = 0.003), age at first intercourse ≤18 years (P = 0.045), and time since first intercourse ≥38 years (P = 0.012) were identified as predictors of low-risk HPV infection. These results indicate that HPV vaccination of liver transplant candidates and screening for anal HPV infection in high-risk groups should be considered.

Cervical human papillomavirus infection in the early postoperative period after liver transplantation: Prevalence, risk factors, and concordance with anal infections

“…Nevertheless, such association definitely needs to be considered, given the well‐established role of sexual transmission in spreading of HBV infections, in contrast to extremely low risk of sexual transmission of HCV . Notably, HBV infection has previously been found to be a risk factor for any‐ and high‐risk anal HPV infections in liver transplant recipients . Of note, the presented prevalence rate seems slightly lower than that reported previously for kidney transplant recipients probably due to older age of the patients and the lower number of tested HPV genotypes.…”

“…Higher number of sexual partners has frequently been reported by other authors as a risk factor for cervical HPV infection in a general population, as well as in kidney transplant recipients . Lifetime number of sexual partners of three or more has also been previously identified as a risk factor for anal HPV infection in a population of liver transplant recipients . Accordingly, data on previous sexual activity seem to be of basic importance in evaluating the risk of cervical HPV infection and should be collected in the pretransplant period to aid decisions on screening strategies.…”

“…Cervical and anal HPV infection concurrence rate may be of particular importance due to the proximity of the two anatomic sites. Therefore, the results of the present study were combined with a part of data from a previous study on anal HPV infection in liver transplant recipients . Unfortunately, only 12 patients (24.0% of the study cohort) participated simultaneously in both projects.…”

“…High‐risk HPV infection was defined as the presence of HPV genotypes 16 and/or 18 DNA in the procured cervical swabs. Additional data on the presence of HPV 16 and HPV 18 DNA in samples collected from the anal canal and the perianal area of 12 patients were extracted from the previous study (1WB/NM1/11) . The results of cervical and anal HPV 16 and 18 testing were compared.…”

“…Accordingly, the primary purpose of this study was to provide additional data on the actual prevalence and to identify risk factors for the presence of cervical HPV infection among liver transplant recipients in the immediate postoperative period. The secondary purpose of this study was to assess concurrence and concordance of cervical and anal HPV infections in this population utilizing a part of previously published data on the latter …”