Prevalence of Anal Cytologic Abnormalities in a French Referral Population: A Prospective Study with Special Emphasis on HIV, HPV, and Smoking

Etienney, Isabelle; Vuong, Sarra; Daniel, Fady; Mory, Benoît; Taouk, Milad; Sultan, Shahid; Thomas, Christian A.; Bourguignon, Josée; Parades, Vincent de; Meary, Nathalie; Balaton, A.; Atienza, Patrick; Bauër, Pierre

doi:10.1007/s10350-007-9098-y

Cited by 18 publications

(13 citation statements)

References 22 publications

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“…In fact, in our study of HIV‐infected men without a known history of anal condylomata, having anal condylomata was associated with a higher prevalence of high‐grade cytological lesions in the anal canal. This finding is in agreement with that of another study . Furthermore, results from a study of a large urban population of MSM with condylomata requiring surgical excision showed that these patients had a high frequency of occult high‐grade anal intraepithelial neoplasia or anal squamous cell cancer .…”

Section: Discussionsupporting

confidence: 92%

Condylomata, cytological abnormalities and human papillomavirus infection in the anal canal in HIV‐infected men

Darwich

Videla

et al. 2012

HIV Medicine

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BackgroundGenital infections with low-risk (LR) and high-risk (HR) human papillomavirus (HPV) genotypes are associated with ano-genital condylomata and anal squamous cell cancer. HPV-related pathologies in HIV-infected men are a serious concern. In this study, the prevalence of anal condylomata and their association with cytological abnormalities and HPV infection in the anal canal in HIV-infected men [men who have sex with men (MSM) and heterosexuals] were estimated. MethodsThis was a cross-sectional study based on the first visits of patients in the Can Ruti HIV-positive Men (CARH·MEN) cohort. Anal condylomata were assessed by clinical and proctological examination. Samples from the anal canal were collected for HPV genotyping and cytological diagnoses. ResultsA total of 640 HIV-infected men (473 MSM and 167 heterosexuals) were included in the study. The overall prevalence of anal condylomata was 25% [157 of 640; 95% confidence interval (CI) 21-28%]; in MSM it was 28% and in heterosexuals it was 15% [odds ratio (OR) 2.2; 95% CI 1.4-3.5]. In patients with anal condylomata, HPV infection in the anal canal was more prevalent (92% vs. 67% in those without anal condylomata; OR 8.5; 95% CI 3.2-22). This higher HPV prevalence involved at least two HPV genotypes (OR 4.0; 95% CI 2.2-7.1), mainly HR genotypes (OR 3.3; 95% CI 1.7-6.4). Similarly, the cumulative prevalence of HPV-6 and HPV-11 was higher in patients with anal condylomata (63% vs. 19% in those without anal condylomata). Having anal condylomata was associated with higher prevalences of cytological abnormalities (83% vs. 32% in those without anal condylomata; OR 6.9; 95% CI 3.8-12.7) and high-grade squamous intraepithelial lesions (HSILs) (9% vs. 3% in those without anal condylomata; OR 9.0; 95% CI 2.9-28.4) in the anal canal. ConclusionsHIV-infected men with anal condylomata were at risk of presenting HSILs and harbouring multiple HR HPV infections in the anal canal. Although MSM presented the highest prevalence of anal condylomata, heterosexual men also had a clinically important prevalence. Our findings emphasize the importance of screening and follow-up for condylomata in the anal canal in HIV-infected men.

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Section: Discussionsupporting

confidence: 92%

Condylomata, cytological abnormalities and human papillomavirus infection in the anal canal in HIV‐infected men

Darwich

Videla

et al. 2012

HIV Medicine

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“…In addition, other behavioral factors such as smoking, which was found to be associated with low‐grade squamous intraepithelial lesions in this study as in previous studies [Etienney et al, ; Chaves, 2012], could play a role in the development of anal carcinoma [Daling et al, ; Tolstrup et al, ; Kojic et al, ].…”

Section: Discussionsupporting

confidence: 81%

Distribution of human papillomavirus genotypes, assessment of HPV 16 and 18 viral load and anal related lesions in HIV positive patients: A cross‐sectional analysis

Tamalet

Obry-Roguet

Ressiot

et al. 2013

Journal of Medical Virology

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Natural history of anal intraepithelial neoplasia and anal cancer is not fully understood. Factors associated with cytological abnormalities and predictors of progression to high-grade anal intraepithelial neoplasia still deserve investigation. The aim of this cross-sectional study was to assess the prevalence of HPV types, the relationship between HPV genotypes, HPV 16/18 viral load and cytological abnormalities in male and female HIV-infected patients. One hundred and twenty-two (72.6%) patients were infected with HPV, 75 (61%) had multiple HPV infection, and 94 (77%) had high-risk HPV infection. The most frequently identified HPV types were HPV 16 (64%), HPV 6 (39%), HPV 18 (31%), HPV 53 (14.7%), HPV 33 (10.6%), HPV 11 (8.2%), HPV 70 (5.7%), and HPV 61 (4.9%). The HPV types which were most frequently found in combination were HPV 6 + 16 (9.8%), 6 + 16 + 18 (8.2%), 16 + 18 (6.6%), 6 + 18 (4.9%), 16 + 33 (3.3%), 16 + 53 (3.3%). Median HPV16 and 18 viral loads were 6.1 log10 copies/10(6) cells [IQR 5.0-7.3] and 6.1 log10 copies/10(6) cells [IQR 5.7-6.0], respectively. Male gender (P = 0.03, OR: 1.2 [1.0-1.4]) and homo/bisexual transmission routes (P = 0.044, OR: 1.4 [1.0-1.9]) were associated with HPV 16 infection. An HPV 16 viral load cut-off ≥5.3 log10 copies/10(6) cells and a CD4+ cell count ≤200/µl were independent factors associated with abnormal cytology. In the absence of national consensus guidelines, a strict regular follow-up at shorter intervals is recommended for HIV-infected patients with abnormal cytology, especially low grade squamous intraepithelial lesions, an HPV 16 viral load ≥5.3 log/10(6) cells and a CD4+ cell count ≤200/µl.

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“…41 Cigarette smoking is linked to anal cancer and cytologic abnormalities. 42,43 There is some protection against AIN in patients with HIV who have high CD4+ T helper cell counts and controlled viral loads. 25 Male circumcision reduces penile oncogenic HPV infection, markedly reduces the risk of penile cancer and reduces the risk of cervical cancer in female partners.…”

Section: Is Anal Cancer Preventable?mentioning

confidence: 99%

Anal cancer and intraepithelial neoplasia: epidemiology, screening and prevention of a sexually transmitted disease

Medford

Salit

2014

CMAJ

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Prevalence of Anal Cytologic Abnormalities in a French Referral Population: A Prospective Study with Special Emphasis on HIV, HPV, and Smoking

Cited by 18 publications

References 22 publications

Condylomata, cytological abnormalities and human papillomavirus infection in the anal canal in HIV‐infected men

Condylomata, cytological abnormalities and human papillomavirus infection in the anal canal in HIV‐infected men

Distribution of human papillomavirus genotypes, assessment of HPV 16 and 18 viral load and anal related lesions in HIV positive patients: A cross‐sectional analysis

Anal cancer and intraepithelial neoplasia: epidemiology, screening and prevention of a sexually transmitted disease

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