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

Abstract

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.

Prevalence of cervical, oral, and anal human papillomavirus infection in women living with HIV in Denmark – The SHADE cohort study

“…However, anal overall, hr-and lrHPV prevalence, number of genotypes, having all genotypes present targeted by the 9-valent HPV vaccine and presence of ≥1 genotypes targeted in the 2-, 4-and 9-valent HPV vaccines were positively correlated with being cervical HPV positive. The association between concurrent anal and cervical HPV infection supports previous reports [21,45,46].…”

“…The higher prevalence in WLWH of anal compared with cervical hrHPV, is similar to other reports [23,44]. Moreover, anal hrHPV prevalence is higher in WLWH compared with HIV-negative women [45,46]. In WLWH, studies…”

“…have found an overall anal HPV and hrHPV prevalence of 75.3-83.15%[44,45] and 47.6-65.0%, respectively[23,44,45]. Moreover, a third of WLWH presented with multiple anal HPV infections, which is finding consistent with previous research[21,23].…”

Distribution of HPV Genotypes in Patients with a Diagnosis of Anal Cancer in an Italian Region

“…A higher HPV positivity was found in women (11/14, 78.5%), which can probably be explained by a persistent cervical HPV infection, which can increase the risk of anal HPV transmission [32,33]. However, missing information on cervical HPV infection of our female patients cannot confirm that hypothesis.…”

“…were not evaluated; the retrospective data collection hindered a comprehensive collection of key variables. Some statistically significant differences on the lower prevalence of HPV infection in cases of adenocarcinoma [24] and higher prevalence of HPV infection in females than males [32] were expected and not found, likely associated with the poor sample size of a mono-center study.…”