Interest of cytology combined with Xpert®HPV and Anyplex®II HPV28 Detection human papillomavirus (HPV) typing: differential profiles of anal and cervical HPV lesions in HIV‐infected patients on antiretroviral therapy
Abstract:Co-testing consisting of cytology and HPV typing is a useful screening tool in the HIV-infected population on cART. It allows detection of prevalence differences between anal and cervical HPV-related lesions. As recently recommended, anal examination should be regularly performed especially in HIV-infected MSM but also in HIV-infected women with genital hrHPV lesions.
“…Eight prospective studies [19][20][21][22][23][24][25][26] performed sequential screening of cervical HPV DNA with a mean followup of 3 years (range 6-33 months) and reported hrHPV DNA was positive in 287/1657 (17.3%) of women who underwent follow-up (pooled prevalence was 17.5%, 11-26.9%, I 2 = 93.3) (Table 5).…”
BackgroundWomen living with HIV (WLWH) are at increased risk of human papillomavirus (HPV)‐related cancers. Throughout Europe, there is great heterogeneity among guidelines for screening programmes, access to HPV testing and HPV vaccination. The aim of this systematic review is to summarize available data on screening and prevention measures for HPV‐related anogenital cancers in WLWH across the WHO European Region (WER).MethodsThe systematic review followed the PRISMA guidelines and was registered on Prospero. PubMed, Embase and Web of Science databases were searched to identify available studies, written in English and published between 2011 and 2022. A metanalysis was conducted using random‐effects models to calculate pooled prevalence of HPV. Subgroup analyses were conducted according to country and HPV testing.ResultsThirty‐four articles involving 10 336 WLWH met the inclusion criteria. Studies were heterogenous in their methodology and presentation of results: 73.5% of studies focused on cervical cancer prevention, and only 4.4% on anal cancer; 76.5% of studies conducted HPV testing as a routine part of screening. The prevalence of high‐risk HPV was 30.5–33.9% depending on the detection method used. A total of 77% of WLWH had cervical cytology results reported. Six studies reported the positive association of CD4 cell count <200 cells/μL with HPV prevalence and cervical abnormalities. Anal HPV testing was conducted in <8% of participants. HPV vaccination was completed in 5.6% of women (106/1902) with known vaccination status. There was no information about the vaccination status of the majority of women in the analysed studies (8434/10336).ConclusionData about screening of HPV‐related anogenital cancer in WLWH in Europe are heterogenous and lacking, especially in relation to anal cancer. HPV DNA testing is not routinely done as part of screening for HPV‐related cancer; guidelines should include indications for when to use this test. Low CD4 count is a risk factor for HPV infection and cytological abnormalities. HPV vaccination data are poor and, when available, vaccination rates are very low among WLWH in Europe. This review concludes that significant improvements are required for data and also consistency on guidelines for HPV screening, prevention and vaccination in WLWH.
“…Eight prospective studies [19][20][21][22][23][24][25][26] performed sequential screening of cervical HPV DNA with a mean followup of 3 years (range 6-33 months) and reported hrHPV DNA was positive in 287/1657 (17.3%) of women who underwent follow-up (pooled prevalence was 17.5%, 11-26.9%, I 2 = 93.3) (Table 5).…”
BackgroundWomen living with HIV (WLWH) are at increased risk of human papillomavirus (HPV)‐related cancers. Throughout Europe, there is great heterogeneity among guidelines for screening programmes, access to HPV testing and HPV vaccination. The aim of this systematic review is to summarize available data on screening and prevention measures for HPV‐related anogenital cancers in WLWH across the WHO European Region (WER).MethodsThe systematic review followed the PRISMA guidelines and was registered on Prospero. PubMed, Embase and Web of Science databases were searched to identify available studies, written in English and published between 2011 and 2022. A metanalysis was conducted using random‐effects models to calculate pooled prevalence of HPV. Subgroup analyses were conducted according to country and HPV testing.ResultsThirty‐four articles involving 10 336 WLWH met the inclusion criteria. Studies were heterogenous in their methodology and presentation of results: 73.5% of studies focused on cervical cancer prevention, and only 4.4% on anal cancer; 76.5% of studies conducted HPV testing as a routine part of screening. The prevalence of high‐risk HPV was 30.5–33.9% depending on the detection method used. A total of 77% of WLWH had cervical cytology results reported. Six studies reported the positive association of CD4 cell count <200 cells/μL with HPV prevalence and cervical abnormalities. Anal HPV testing was conducted in <8% of participants. HPV vaccination was completed in 5.6% of women (106/1902) with known vaccination status. There was no information about the vaccination status of the majority of women in the analysed studies (8434/10336).ConclusionData about screening of HPV‐related anogenital cancer in WLWH in Europe are heterogenous and lacking, especially in relation to anal cancer. HPV DNA testing is not routinely done as part of screening for HPV‐related cancer; guidelines should include indications for when to use this test. Low CD4 count is a risk factor for HPV infection and cytological abnormalities. HPV vaccination data are poor and, when available, vaccination rates are very low among WLWH in Europe. This review concludes that significant improvements are required for data and also consistency on guidelines for HPV screening, prevention and vaccination in WLWH.
“…We found a strong association between detection of HPV 16 or 18 at baseline and development of CAs, confirming the role of these genotypes in the pathogenesis of anal dysplasia. The clinical role of anal HPV genotyping in PLWH was widely discussed in the literature, with current studies finding a correlation between HR-HPV and CAs [17,18]. Recently a link was found between HPV-16 or 18 detection and anal dysplasia [19,20].…”
Section: Discussionmentioning
confidence: 99%
“…The method used for HPV detection was the Anyplex II HPV28 Detection (Seegene, Seoul, Republic of Korea) with an ability to detect 28 HPV genotypes (16,18,26,31,33,35,39,45,51,52,53,56,58,59,66,68,69,73,82,11,40,42,43,44,54,6,61,70).…”
The aim of the present study was too investigate prevalence and persistence of human papilloma virus (HPV) and cytological abnormalities (CAs) in the anal swabs of people living with HIV (PLWH): men who have sex with men (MSM), men who have sex with women (MSW) and women (W). Methods: Between March 2010 and January 2019, an anal swab for cytological and HPV genotyping tests was offered to all PLWH attending our clinic. Logistic regression analysis was conducted to identify predictors of infection. Results: In all, 354 PLWH were screened: 174 MSM, 90 MSW and 61 W. Prevalence of at least one high-risk (HR) HPV was higher in MSM (91%) and W (85%) than in MSW (77%) (P < 0.05). Cytological abnormalities were found in 21.1% of the entire population. At multivariable regression analysis a lower risk for HPV infection was found for W than for MSM [odds ratio = 0.24 (95% confidence interval: 0.115-0.513)] and for MSW than for MSM [0.37 (0.180-0.773)] and there was a significantly higher risk of CAs in PLWH with ]. A total of 175 PLWH (103 MSM, 33 MSW and 26 W) had at least one follow-up visit (T1) after a median (interquartile range) follow-up of 3.6 (2.1-5.7) years. The acquisition rate of HR-HPV was high, with 66.7% of PLWH negative for HR-HPV at T0 who became positive at T1 (P < 0.001). The prevalence of CAs was stable (20.6%). A significant association between CAs at T1 and persistence of HPV-16 and/or 18 was found (P < 0.05). Conclusions: HPV 16 and 18 are associated with the presence and development of CAs irrespective of sexual orientation.
“…As was reported in North America and Europe in the 1970s and 1980s, Chinese MSM increasingly use recreational drugs with high risk sexual activity, a syndemic that can further fuel STI transmission 8. Recreational drug use may be a marker of higher sexual risk taking, may disinhibit high-risk sexual behaviour and/or there may be biological facilitation of transmission from a drying of mucosa and epithelial compromise of the penis or anus with prolonged sexual activity 9. As we previously reported,10 recreational drugs such as rush poppers and methamphetamines are used in MSM communities as sexual stimulants.…”
ObjectiveWe investigated syphilis prevalence among men who have sex with men (MSM) in China, as well as potential risk factors. Our principal hypothesis was that syphilis would be associated with the use of recreational drugs such as methamphetamines.MethodsFrom April to October 2013, we used several methods to recruit MSM in Qingdao, collecting demographic/behavioural information via self-administrated questionnaires. Trained health workers collected blood for the Treponema pallidum particle assay (TPPA) with positives confirmed by a toluidine red unheated serum test. We used an unmatched case–control study to identify factors that might predict syphilis infection using multivariable logistic regression.ResultsWe recruited 447 MSM who agreed to participate and who completed syphilis testing. Of 71 (15.9%) syphilis-positive MSM, 44 (62.0%) used drugs. Of 376 (84.1%) syphilis-negative MSM, 186 (49.5%) used drugs. We found a positive association with syphilis for any recreational drug use (crude OR (cOR) 1.7, 95 % CI 1.0 to 2.8), frequent methamphetamine use (cOR 2.4, 95% CI 1.1 to 5.3) and multiple drug use (adjusted OR (aOR) 3.4, 95% CI 1.3 to 9.2). Syphilis-positive men were more likely to have a higher physical depression score (aOR 5.2, 95% CI 1.1 to 24.4), be > 30 years old (aOR 2.7, 95% CI 1.5 to 4.8), report a prior STI (aOR 4.1, 95% CI 2.3 to 7.3) and report a sex party experience (aOR 2.2, 95% CI 1.1 to 4.4).ConclusionsRecreational drug use, depression and high-risk sexual behaviours were associated with syphilis infection among MSM in China. Only a multifaceted approach is likely be effective in control of both syphilis and HIV .
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