Japanese HIV-infected Men who Have Sex with Men Screened for Anal Intraepithelial Neoplasia

Itoda, Ichiro; Kitamura, Hiroshi

doi:10.11150/kansenshogakuzasshi.85.658

Cited by 1 publication

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“…The relationships among history of condyloma, duration of ART treatment, and number of receptive anal intercourse without condom were examined. Smoking history and status, Brinkmann index, and condyloma history were evaluated because they were associated with APS outcome in the previous study 9 but not with AIN exacerbation in the current study.…”

Section: Discussionmentioning

confidence: 95%

High-resolution anoscopy for the diagnosis and treatment of human papillomavirus-related anal intraepithelial neoplasia in human immunodeficiency virus-seropositive men who have sex with men in Japan

Kitamura¹,

Itoda²,

Okodo³

et al. 2022

JCPCR

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Background: In the US and Europe, human immunodeficiency virus (HIV)-seropositive patients who do not have acquired immunodeficiency syndrome (AIDS) and have human papillomavirus (HPV) infection in the anal canal have a significantly increased risk of developing anal cancer. Examination and ablation using high-resolution anoscope (HRA) are widely performed for the treatment of high-grade anal intraepithelial neoplasm (HGAIN), a precancerous condition. The increasing risk of anal cancer by HPV is a concern also in Japan and other Asian countries, but systematic examination and treatment is lacking. Therefore, we performed the first prospective single-arm study of tissue biopsy and HRA treatment in Japan. Methods:From April 2016 to March 2020 at Kyorin University Hospital and cooperating institutions, we performed anal Pap smears on 125 HIV-seropositive men who have sex with men (MSM) and conducted HRA and tissue biopsy. Additionally, in the case of HGAIN, we conducted ablation.Results: Among the tissue samples, 43.2% were positive for atypical cells. Fifty-two patients gave consent and underwent HRA and tissue biopsy; low-grade (LG)AIN was identified in 14 patients and HGAIN was identified in 38 patients. Seven patients in the HGAIN group did not consent to abrasion. A total of 105 cumulative HRAs were analyzed for association with independent variables (degree of AIN, high-risk HPV genotype, and patient data). There were significant associations between worse AIN and both the presence of genotype 16 or 68 and the number of receptive anal intercourse without condoms. No cancer was detected in this study. Conclusion:Together with the risk factors, HRA is useful for the early detection of highgrade precancerous lesions.

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Section: Discussionmentioning

confidence: 95%