Natural History of Anal Human Papillomavirus Infection in Heterosexual Women and Risks Associated With Persistence

Moscicki, Anna‐Barbara; Ma, Yifei; Farhat, Sepideh; Jay, Julie I.; Hanson, Evelyn; Benningfield, Susanna; Jonte, Janet; Godwin-Medina, Cheryl; Wilson, Robert; Shiboski, Stephen

doi:10.1093/cid/cit947

Cited by 46 publications

(36 citation statements)

References 30 publications

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“…A similar relationship between prevalent and incident HPV infection has been previously reported for anal and cervical HPV in women [22,23] and genital HPV in men [10], and warrants investigation of different clinical procedures for prevalent vs incident anal HPV.…”

Section: Discussionsupporting

confidence: 74%

Incidence, Duration, Persistence, and Factors Associated With High-risk Anal Human Papillomavirus Persistence Among HIV-negative Men Who Have Sex With Men: A Multinational Study

Nyitray¹,

Silva²,

Chang³

et al. 2016

Clin Infect Dis.

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Background. Given high rates of anal disease, we investigated the natural history of high-risk anal human papillomavirus (HPV) among a multinational group of men who have sex with men (MSM) aged 18-64 years.Methods. Anal specimens from human immunodeficiency virus-negative men from Brazil, Mexico, and the United States were genotyped. Over 2 years, 406 MSM provided evaluable specimens every 6 months for ≥2 visits. These men were stratified into men who have sex only with men (MSOM, n = 70) and men who have sex with women and men (MSWM, n = 336). Persistence was defined as ≥12 months' type-specific duration and could begin with either a prevalent or incident infection. Prevalence ratios and 95% confidence intervals were calculated by Poisson regression.Results. Median follow-up time was 2.1 years. Retention was 82%. Annual cumulative incidence of 9-valent vaccine types was 19% and 8% among MSOM and MSWM, respectively (log-rank P = .02). Duration of anal HPV did not differ for MSOM and MSWM and was a median of 6.9 months for HPV-16 after combining men from the 2 groups. Among men with prevalent high-risk infection (n = 106), a total of 36.8%, retained the infection for at least 24 months. For those with prevalent HPV-16 (n = 27), 29.6% were persistent for at least 24 months. Persistence of high-risk HPV was associated with number of male anal sex partners and inversely associated with number of female sex partners.Conclusions. MSM with prevalent high-risk HPV infection should be considered at increased risk for nontransient infection.

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Section: Discussionsupporting

confidence: 74%

Incidence, Duration, Persistence, and Factors Associated With High-risk Anal Human Papillomavirus Persistence Among HIV-negative Men Who Have Sex With Men: A Multinational Study

Nyitray¹,

Silva²,

Chang³

et al. 2016

Clin Infect Dis.

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“…Multivariate analysis in this cohort revealed that HPV infection was related to age, number of sexual partners, smoking, educational level, income, and insurance status [97]. Similar results on the risk of persistent HPV infection have been confirmed in other studies [98,99]. Therefore, populations with these risk factors require more rigorous and continuous monitoring for effective prevention; in these cases, self-sampling may be particularly useful.…”

Section: Discussionsupporting

confidence: 81%

Secondary Prevention of Uterine Cervical Cancer

Sato¹,

Itamochi²

2018

Cervical Cancer - Screening, Treatment and Prevention - Universal Protocols for Ultimate Control

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Secondary prevention by cervical cytology has clearly improved the mortality rate of uterine cervical cancer (CC) by enabling early detection and treatment of high-grade squamous intraepithelial lesion (HSIL) or cervical intraepithelial neoplasia (CIN), which is a precancerous lesion. In the past two decades, HPV-DNA testing, including HPV typing, has clearly brought about positive effects on secondary prevention of CC. However, in practice, CC remains a fatal disease and is the second leading cause of cancer deaths in women aged 20-39 years. Although elucidation of the mechanisms of HPV carcinogenesis and development of a prophylactic vaccine have made CC a preventable disease, eradication of CC is expected to take several decades. Therefore, primary screening to decrease the mortality rate of CC will remain important for a while. In addition, the clinical application of simple biomarkers to stratify HPV-positive women is important for maintenance of medical economy and avoidance of overtreatment in women in the reproductive age. Therefore, the development of an inexpensive therapy or vaccine that can be used worldwide is necessary to overcome cancer deaths due to CC.

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“…It could not be determined how many of the HPV infections were transient. A type-specific clearance of high-and low-risk HPV genotypes in the majority of women over a 5-year mean follow-up detection period was reported (36). The exception was HPV type 16, and concomitant cervical infection with this genotype, which is found in the majority of cervical high-grade dysplasias, was associated with anal HPV persistence (36).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of human papillomavirus infection of the anal canal in women: A prospective analysis of high-risk populations

et al. 2017

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Abstract. Infection with certain types of human papillomavirus (HPV) has been associated with the development of cervical and anal cancer. Worldwide, the incidence of anal cancer has increased markedly. The present study aimed to evaluate the prevalence of HPV infection of the uterine cervix and anal canal in human immunodeficiency virus (HIV)-and non-HIV-infected risk populations. Cervical and anal HPV swabs and cytology samples were collected from 287 patients at the University Hospital of Munich, Germany between 2011 and 2013. Patients were divided into HIV-negative controls (G1) and two risk groups, including HIV-negative patients with cytological abnormalities of the cervix (G2) and HIV-infected patients (G3). Data, including clinical parameters, were analysed. The risk groups had significantly more positive results for HPV in the anus (71.03 and 83.15% for G2 and G3, respectively), as compared with G1. The predominant HPV genotypes found in the anus were high-risk HPV genotypes, which were significantly correlated with concomittant cervical HPV findings. In the risk groups, a significant association between the cytological findings and HPV detection in the cervix was found, while the results of the anus revealed no significance. The results of the present study suggested that the prevalence of HPV infection in the anal canal of risk populations is high. Furthermore, patients with abnormal cervical cytology results and HIV-infected women, irrespective of their individual cervical findings, may have a risk of concomittant anal high-risk HPV infection. Based on the predominant HPV genotypes found in the study, HPV vaccination could reduce the incidence of anal cancer. Nevertheless, high-risk patients should be intensively screened for anal squamous intraepithelial abnormalities to avoid invasive cancer stages.

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Natural History of Anal Human Papillomavirus Infection in Heterosexual Women and Risks Associated With Persistence

Cited by 46 publications

References 30 publications

Incidence, Duration, Persistence, and Factors Associated With High-risk Anal Human Papillomavirus Persistence Among HIV-negative Men Who Have Sex With Men: A Multinational Study

Incidence, Duration, Persistence, and Factors Associated With High-risk Anal Human Papillomavirus Persistence Among HIV-negative Men Who Have Sex With Men: A Multinational Study

Secondary Prevention of Uterine Cervical Cancer

Prevalence of human papillomavirus infection of the anal canal in women: A prospective analysis of high-risk populations

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