Prevalence and Incidence of Anal and Cervical High-Risk Human Papillomavirus (HPV) Types Covered by Current HPV Vaccines Among HIV-Infected Women in the SUN Study

Kojic, Erna Milunka; Conley, Lois J.; Bush, Timothy J.; Cu‐Uvin, Susan; Unger, Elizabeth R.; Henry, Keith; Hammer, John; Escota, Gerome; Darragh, Teresa M.; Palefsky, Joel M.; Brooks, John T.; Patel, Pragna

doi:10.1093/infdis/jiy087

Cited by 18 publications

(19 citation statements)

References 32 publications

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“…For this reason, none of our subjects have been routine‐vaccinated against HPV. The incidence of condylomata acuminata among PLWH in our cohort and the positive correlation with abnormal cytology suggest that novel prevention strategies for HPV infection, such as vaccination, need to be further evaluated …”

Section: Discussioncontrasting

confidence: 99%

“…Condyloma was used in this study as a clinical surrogate marker for HPV infection. There is increasing evidence for HPV vaccination as a prevention strategy in PLWH . So far, HPV vaccination has only been recommended for girls aged 9–14 since 2006 and for boys aged 9–14 since 2018 in Germany .…”

Section: Discussionmentioning

confidence: 99%

“…There is increasing evidence for HPV vaccination as a prevention strategy in PLWH. [37][38][39][40] So far, HPV vaccination has only been recommended for girls aged 9-14 since 2006 and for boys aged 9-14 since 2018 in Germany. 41 For this reason, none of our subjects have been routine-vaccinated against HPV.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of condylomata acuminata among PLWH in our cohort and the positive correlation with abnormal cytology suggest that novel prevention strategies for HPV infection, such as vaccination, need to be further evaluated. [37][38][39][40] One subject in our study belongs to the rare group of socalled elite controllers. Only about 0.15% of PLWH are elite controllers and manage to suppress HIV RNA without ART.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of anal carcinoma screening in male and female HIV patients at an interdisciplinary HIV therapy centre

Todorova

Schwierzeck

Turek

et al. 2019

Acad Dermatol Venereol

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Background Incidence of anal carcinoma is increased in people living with HIV (PLWH). Due to the improved life expectancy in PLWH, identifying appropriate prevention strategies for non‐AIDS‐defining cancer types such as anal carcinoma has become a priority in managing PLWH today. Objective We aimed to evaluate anal cytology assessment as screening tool for anal dysplasia and/or carcinoma in PLWH, regardless of gender or sexual orientation. Additionally, we investigated the correlation between cancer risk factors and abnormal screening results in our patient cohort. Methods People living with HIV from the Interdisciplinary HIV Centre of the University Hospital rechts der Isar in Munich, Germany (IZAR), were screened for anal carcinoma by single cytobrush examination and anal Papanicolaou (PAP) smear assessment from 2013 to 2015. Patients with abnormal PAP smear result were offered a follow‐up examination after 12 months. Differences between two groups were tested for statistical significance using Student's t‐test and Mann–Whitney U‐test, as appropriate. Results In total, 101 PLWH were included. 26.7% of subjects (n = 27) were PAP IIID, and 9.9% (n = 10) were PAP IVa. Seven female subjects had an abnormal finding at screening. Smoking was significantly associated with abnormal findings at screening (P = 0.005). In addition, our study found an association between sexually transmitted infections (STI) and anal dysplasia. Condylomata acuminata were increased in subjects with PAP IIID/PAP IVa (P = 0.045). Reactive syphilis serology was found to be significantly associated with abnormal screening results (P = 0.016), respectively. Conclusion Our results demonstrate that smoking and two common STIs, condylomata acuminata and syphilis, are risk factors associated with advanced anal intraepithelial neoplasia (AIN) stages in our PLWH cohort. While further analysis is needed to determine diagnostic guidelines concerning AIN in PLWH, these results suggest that interdisciplinary lifestyle prevention strategies are required to reduce the risk factors for AIN in PLWH in an outpatient setting.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of anal carcinoma screening in male and female HIV patients at an interdisciplinary HIV therapy centre

Todorova

Schwierzeck

Turek

et al. 2019

Acad Dermatol Venereol

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“…We calculated the cumulative prevalence, incidence rates and clearance rates for type-specific HPV and grouped HPV types as follows: any HPV types; any oncogenic HPV types (16,18,31,33,35,45,51,52,56,58, 59 and 68) 18 ; any nine-valent vaccine HPV types (9v; 6,11,16,18,31,33,45, 52 and 58); HPV 16/18 and HPV 6/11. We calculated the cumulative prevalence, incidence rates and clearance rates for type-specific HPV and grouped HPV types as follows: any HPV types; any oncogenic HPV types (16,18,31,33,35,45,51,52,56,58, 59 and 68) 18 ; any nine-valent vaccine HPV types (9v; 6,11,16,18,31,33,45, 52 and 58); HPV 16/18 and HPV 6/11.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in the incidence and clearance of anal human papillomavirus infection among heterosexual men and women in Liuzhou, China: An observational cohort study

Wei

Yao

et al. 2019

Intl Journal of Cancer

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Anal cancer is primarily caused by human papillomavirus (HPV) infection in both men and women. However, little is known about the sex differences in the natural history of anal HPV infection in a heterosexual population. From May 2014 to March 2016, perianal/anal canal (PA) swab samples were collected semiannually from 2,302 heterosexual men and 2,371 heterosexual women aged 18–55 years old in Liuzhou, China. The specimens were genotyped for HPV DNA by polymerase chain reaction. The incidence rate ratio (IRR) and clearance rate ratio (CRR) were used to analyze the sex differences of incidence and clearance by Poisson regression, respectively. The incidences of PA oncogenic HPV in men and women were 3.4 per 1,000 person‐months and 8.6 per 1,000 person‐months, respectively, with an IRR of 0.39 (95% confidence interval (CI), 0.29–0.54 for men versus women) (p < 0.0001). The CRR of PA oncogenic HPV infection for men versus women was 1.54 (95% CI, 1.17–2.03) (p = 0.0022). At 12 months, 44% (20/45) of HPV 16/18 infections among women remained positive, whereas no (0/7) infections persisted among men (p = 0.0350). Both the higher incidence and slower clearance of anal carcinogenic HPV infection among women may lead to a higher burden of anal cancer among women than among men in a heterosexual population.

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Natural History of Human Papillomavirus Anal Infection

Donà

Giuliani

2020

Sexually Transmitted Infections

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Prevalence and Incidence of Anal and Cervical High-Risk Human Papillomavirus (HPV) Types Covered by Current HPV Vaccines Among HIV-Infected Women in the SUN Study

Abstract: Anal HR-HPV prevalence was higher than cervical, with lower clearance; incidence was similar. Although prevalence of non-9v HR-HPV was substantial, 9v HR-HPV types were generally more prevalent. These findings support use of nonavalent vaccine in HIV-infected women.

Cited by 18 publications

References 32 publications

Evaluation of anal carcinoma screening in male and female HIV patients at an interdisciplinary HIV therapy centre

Evaluation of anal carcinoma screening in male and female HIV patients at an interdisciplinary HIV therapy centre

Sex differences in the incidence and clearance of anal human papillomavirus infection among heterosexual men and women in Liuzhou, China: An observational cohort study

Natural History of Human Papillomavirus Anal Infection

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