Natural History of Anal Papillomavirus Infection in HIV-Negative Men Who Have Sex With Men Based on a Markov Model: A 5-Year Prospective Cohort Study

Zhang, Zewen; Liu, Xi; Liu, Lirong; Xi, Miaomiao; Zhang, Guozhen

doi:10.3389/fpubh.2022.891991

Cited by 5 publications

(11 citation statements)

References 47 publications

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“…In mainland China, Zhang et al. reported that the incidence and clearance rates of anal HPV for any genotype were 53.4 and 50.9/1,000 pms ( 11 ). Zhou et al.…”

Section: Introductionmentioning

confidence: 99%

Incidence, persistence, and clearance of anogenital human papillomavirus among men who have sex with men in Taiwan: a community cohort study

et al. 2023

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BackgroundMen who have sex with men (MSM) have an increased risk of human papillomavirus (HPV) infection. This study aimed to assess the incidence, persistence, and clearance of anogenital HPV infections among MSM and the correlates in a 3-year community cohort study.MethodsFrom 2015 to 2019, MSM were recruited and followed up at 6, 12, 24, and 36 months in Taiwan. Questionnaires and anogenital swabs were collected at baseline and each follow-up visit. Thirty-seven HPV genotypes were tested and genotyped using the linear array HPV genotyping test. The incidence, persistence, and clearance rates of anogenital HPV infection and 95% confidence intervals (CIs) were estimated through Poisson regression. Correlates of the incidence and clearance rates were examined using a generalized estimating equations (GEE) model.ResultsA total of 201 MSM were retained in the cohort study with a median age of 27 years (interquartile range [IQR]: 24–32) at baseline. The incidence, persistence, and clearance rates of any anal HPV infection among MSM were 43.6 (95% CI: 33.7–55.6), 23.4 (17.7–30.2), and 58.3 (45.1–74.1) per 1,000 person months (pms), respectively. The incidence, persistence, and clearance rates of any penile HPV infection among MSM were 26.8 (20.1–34.9), 13.4 (8.0–20.9), and 51.5 (37.8–68.5) pms, respectively. MSM who did not consistently use a condom in receptive sex (adjusted odds ratio [AOR]: 2.06, 95% CIs: 1.14–3.72) were more likely to acquire any anal HPV infection. Age at recruitment (1.05, 1.01–1.09) was positively associated with any penile HPV incidence. MSM with over one sex partner in receptive anal sex (0.53, 0.30–0.94) were less likely to clear any anal HPV infection. MSM who were unemployed/students (0.55, 0.30–0.98) were less likely to clear any penile HPV infection.ConclusionHigh incidence and low clearance of anogenital HPV infection among MSM in the study serve as a reminder that this population needs to be targeted for HPV vaccination. It is essential for MSM to scale up HPV screening and adhere to safe sex.

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“…In mainland China, Zhang et al. reported that the incidence and clearance rates of anal HPV for any genotype were 53.4 and 50.9/1,000 pms ( 11 ). Zhou et al.…”

Section: Introductionmentioning

confidence: 99%

Incidence, persistence, and clearance of anogenital human papillomavirus among men who have sex with men in Taiwan: a community cohort study

et al. 2023

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“…Details of specimen collection and analysis in HPV cohort study have been published elsewhere 22,23 . In brief, anal swabs were obtained for HPV DNA testing from participants at baseline and then every 6 months thereafter.…”

Section: Methodsmentioning

confidence: 99%

“…Details of the methods used in the HPV cohort study have been published elsewhere 22,23 . In summary, MSM in Xinjiang, China were recruited starting from September 1, 2016.…”

Section: Methodsmentioning

confidence: 99%

“…Details of the methods used in the HPV cohort study have been published elsewhere. 22,23 Additionally, individuals who were interested in joining the PrEP study and had not been previously involved in the HPV cohort study were also incorporated into the HPV cohort. Consequently, only a subset of PrEP users (not all) had accessible anal HPV results before and after PrEP initiation.…”

Section: Study Populationmentioning

confidence: 99%

“…Details of specimen collection and analysis in HPV cohort study have been published elsewhere. 22,23 In brief, anal swabs were obtained for F I G U R E 1 Flowchart of this study. HPV, human papillomavirus; MSM, men who have sex with men; PrEP, pre-exposure prophylaxis.…”

Section: Data Sources and Measurementmentioning

confidence: 99%

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Changes in HPV prevalence, incidence, and clearance following the use of HIV pre‐exposure prophylaxis (PrEP) among MSM in Xinjiang, China: An observational cohort study

Tian,

Fu,

et al. 2023

Journal of Medical Virology

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The association between HIV pre‐exposure prophylaxis (PrEP) and the natural history of human papillomavirus (HPV) has not been well documented. Our objective was to evaluate the impact of PrEP on the prevalence, incidence, and clearance of anal HPV among men who have sex with men (MSM). Sexually active, HIV‐negative MSM aged 18 years and older in Xinjiang, China since September 1, 2016, were enrolled in an ongoing observational cohort study of HPV. At baseline and every 6 months, an anal swab was taken to test for HPV and a questionnaire on sociodemographic characteristics and sexual behaviors was collected. Those who consented to receive PrEP were enrolled in an open‐label PrEP intervention study from November 1, 2019, to June 30, 2021. This study analyzed data from participants present in the HPV cohort between November 1, 2019, and June 30, 2021. We compared the prevalence, incidence, and clearance of anal HPV between men who received PrEP (PrEP users) and those who did not (non‐PrEP users), and compared men before and after initiating PrEP. We calculated prevalence ratios (PRs), incidence rate ratios (IRRs), and clearance rate ratios (CRRs) for both comparisons. Of the 870 participants present in the HPV cohort during the period between November 1, 2019, and June 30, 2021, 859 had adequate β‐globin for HPV genotype testing and were included in our study. Among them, 429 were PrEP users, while 430 were non‐PrEP users. Median age was 32 years (interquartile range [IQR]: 26–38). Among PrEP users, 217 were tested for anal HPV before PrEP initiation. PrEP users had lower prevalence of HPV 45, 51, and 54 (PRs: 0.27 [95% CI: 0.09–0.80], 0.42 [0.21–0.85], and 0.41 [0.17–0.99], respectively) and lower clearance of HPV 16 (CRR: 0.31 [0.10–0.91]) compared with non‐PrEP users. PrEP users exhibited lower prevalence of HPV 51 (PR: 0.31 [0.12–0.84]), lower incidence of HPV 6, 11, 16, 39 and 61 (IRRs: 0.34 [0.13–0.90], 0.26 [0.08–0.87], 0.44 [0.21–0.91], 0.21 [0.05–0.93], and 0.19 [0.04–0.82], respectively), as well as higher clearance of HPV 52 (CRR: 2.17 [1.08–4.35]) after PrEP initiation. PrEP use may lower the risk of HPV infection among MSM in Xinjiang, China. Our findings further extend the knowledge of the impact of PrEP on sexually transmitted infections.

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Prevalence of HPV in anal cancer: exploring the role of infection and inflammation

Ebrahimi,

Rasizadeh,

Jafari

et al. 2024

Infect Agents Cancer

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Anal cancer incidence is rising globally, driven primarily by human papillomavirus (HPV) infection. HPV, especially high-risk types 16 and 18, is considered a necessary cause of anal squamous cell carcinoma. Certain populations like people living with HIV, men who have sex with men, inflammatory bowel disease patients, smokers, and those with compromised immunity face elevated risk. Chronic inflammation facilitates viral persistence, cell transformation, and immune evasion through pathways involving the PD-1/PD-L1 axis. HIV coinfection further increases risk by impairing immune surveillance and epithelial integrity while promoting HPV oncogene expression. Understanding these inflammatory processes, including roles of CD8 + T cells and PD-1/PD-L1, could guide development of immunotherapies against anal cancer. This review summarizes current knowledge on inflammation’s role in anal cancer pathogenesis and the interplay between HPV, HIV, and host immune factors.

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Natural History of Anal Papillomavirus Infection in HIV-Negative Men Who Have Sex With Men Based on a Markov Model: A 5-Year Prospective Cohort Study

Cited by 5 publications

References 47 publications

Incidence, persistence, and clearance of anogenital human papillomavirus among men who have sex with men in Taiwan: a community cohort study

Incidence, persistence, and clearance of anogenital human papillomavirus among men who have sex with men in Taiwan: a community cohort study

Changes in HPV prevalence, incidence, and clearance following the use of HIV pre‐exposure prophylaxis (PrEP) among MSM in Xinjiang, China: An observational cohort study

Prevalence of HPV in anal cancer: exploring the role of infection and inflammation

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