Interaction of human immunodeficiency and papilloma viruses: Association with anal epithelial abnormality in homosexual men

Human papillomavirus genotypes in anal intraepithelial neoplasia and anal carcinoma as detected in tissue biopsies

“…Therefore, the increased incidence of AIN in immunodeficient individuals seems to be related to the greater persistence of the virus in these patients. Several studies have reported a two to six times greater prevalence of HPV infection in immunosuppressed patients [23][24][25][26][27][28] and twice the risk of progression from low-grade AIN to high-grade AIN. [27][28][29][30] AIN lesions are known to advance from low-grade to high-grade AIN within 2 years of diagnosis in 36-66% of individuals with progression occurring more rapidly and more frequently in immunodeficient individuals.…”

“…Several studies have reported a two to six times greater prevalence of HPV infection in immunosuppressed patients [23][24][25][26][27][28] and twice the risk of progression from low-grade AIN to high-grade AIN. [27][28][29][30] AIN lesions are known to advance from low-grade to high-grade AIN within 2 years of diagnosis in 36-66% of individuals with progression occurring more rapidly and more frequently in immunodeficient individuals. 27,30 Our study confirms the increasing prevalence of high-risk HPV with worsening dysplasia: 56% of AIN I, 80% of AIN II, and 88% of AIN III, findings earlier reported by Varnai et al 31 32 In our study, six (60%) of AIN II lesions were non-16 high-risk HPV types; five of which on follow-up showed less severe lesions.…”

Natural History of Genital Papillomavirus Infections

“…A T4/T8 ratio of <0.4 was associated with a significantly higher HPV positivity rate of 35.3% compared with only 7.3% in men with a ratio of >1.0 [139], The presence of HPV is strong ly associated with cytological abnormalities in anal smears of homosexual men [137,139] An association between HIV and HPV is currently explained by decreased cellular immunity in HIV-in fected individuals, which increases the risk for the acqui sition of HPV infection and/or the reactivation of latent HPV infection. Synergism between these viruses may be explained by transactivation of the long control region (LCR) by the HIV-1 tat protein which increases HPV 18 E7 expression in HeLa cells [140], This observation needs further clarification, especially since HPV and HIV do not share target cells.…”

“…In men, 31-53% of anal swabs of HIV-positive indi viduals were HPV positive by dot blot hybridization or PCR compared to only 8-29% HPV positives in HIV negative individuals (n = 119) [137,138]. A T4/T8 ratio of <0.4 was associated with a significantly higher HPV positivity rate of 35.3% compared with only 7.3% in men with a ratio of >1.0 [139], The presence of HPV is strong ly associated with cytological abnormalities in anal smears of homosexual men [137,139] An association between HIV and HPV is currently explained by decreased cellular immunity in HIV-in fected individuals, which increases the risk for the acqui sition of HPV infection and/or the reactivation of latent HPV infection.…”

Poorly Differentiated Non-Small Cell Carcinoma of the Lung in Acquired Immunodeficiency Syndrome

“…In addition to these malignancies, there appears to be an increased incidence of cervical and anal carcinomas and intraepithelial neoplasias in patients in fected with HIV [2,3], There have been sporadic reports of HIV-infected individuals presenting with primary lung cancer [4][5][6][7][8][9][10][11][12], This is a case of a young woman with AIDS and poorly differentiated non-small cell carcinoma of the lung. On physical examination, the patient was afebrile with normal vital signs.…”