Anal and oral human papillomavirus (HPV) infection in HIV-infected subjects in northern Italy: a longitudinal cohort study among men who have sex with men

Abstract

BackgroundA study including 166 subjects was performed to investigate the frequency and persistence over a 6-month interval of concurrent oral and anal Human Papillomavirus (HPV) infections in Human Immunodeficiency Virus (HIV)-infected men who have sex with men (MSM).MethodsPatients with no previously documented HPV-related anogenital lesion/disease were recruited to participate in a longitudinal study. Polymerase chain reaction (PCR) was performed to detect HPV from oral and anal swabs and to detect Human Herpes Virus 8 (HHV-8) DNA in saliva on 2 separate specimen series, one collected at baseline and the other collected 6 months later. A multivariate logistic analysis was performed using anal HPV infection as the dependent variable versus a set of covariates: age, HIV plasma viral load, CD4+ count, hepatitis B virus (HBV) serology, hepatitis C virus (HCV) serology, syphilis serology and HHV-8 viral shedding. A stepwise elimination of covariates with a p-value > 0.1 was performed.ResultsThe overall prevalence of HPV did not vary significantly between the baseline and the follow-up, either in the oral (20.1 and 21.3%, respectively) or the anal specimens (88.6 and 86.3%). The prevalence of high-risk (HR) genotypes among the HPV-positive specimens was similar in the oral and anal infections (mean values 24.3% and 20.9%). Among 68 patients with either a HR, low-risk (LR) or undetermined genotype at baseline, 75% had persistent HPV and the persistence rates were 71.4% in HR infections and 76.7% in LR infections. There was a lack of genotype concordance between oral and anal HPV samples. The prevalence of HR HPV in anus appeared to be higher in the younger patients, peaking (> 25%) in the 43-50 years age group. A decrease of the high level of anal prevalence of all genotypes of HPV in the patients > 50 years was evident. HHV-8 oral shedding was positively related to HPV anal infection (p = 0.0046). A significant correlation was found between the persistence of HHV-8 shedding and HIV viral load by logistic bivariate analysis (Odds Ratio of HHV-8 persistence for 1-log increase of HIV viral load = 1.725 ± 0.397, p = 0.018).ConclusionsA high prevalence of HPV infection was found in our cohort of HIV-infected MSM, with a negative correlation between anal HPV infection and CD4 cell count.

Human papillomavirus infection is not related with prostatitis-related symptoms: results from a case-control study

“…Men are key to the transmission of HPV to women, but relatively little is known about the natural history of HPV infection in men (3). The prevalence of HPV in males ranges from 7% to 45% (4), but the majority of studies have been conducted on homosexuals, HIV patients or infertile men (5,6). Recently, Klinglmair et al found a high prevalence of HPV infection in a cohort of 250 young males, including children (0-10 years), indicating non-sexual transmission pathways (7).…”

Human papillomavirus prevalence in the anus and urine among HIV-infected Japanese men who have sex with men

“…Conversely, HPV58 and 52, which are common type in Japanese women, were considerably prevalent in the anus of the Japanese MSM population. In addition to HPV6 and 16, HPV51 and 58 were also relatively frequent in South Africa [8], HPV11 and 61 in Italy [7], and HPV53 and 84 in Spain [9]. The distribution of HPV types is likely to slightly differ between different regions and populations.…”

“…Many epidemiological studies have been conducted to investigate anal HPV prevalence among HIV-infected MSM in several countries and regions. Anal HPV prevalence in HPV-infected MSM was 61.0% of 92 patients in the United States [3], 74.2% of 140 in Spain [4], 75.9% of 361 in Japan [5], 82.7% of 133 in Korea [6], 88.6% of 166 in Italy [7], 91.8% of 85 in South Africa [8], and 95.5% of 1439 in Spain [9]. The high prevalence of anal HPV infection observed in the present study is similar to that previously reported in other countries.…”

Neoplasias en pacientes con infección por VIH: Estudio descriptivo de 129 casos en el período 1993-2010

“…La infección por VPH en población infectada por VIH es mucho más frecuente que en población general; así, en mujeres con infección por VIH la prevalencia de co-infección cervical por VPH se multiplica por tres respecto a las sin infección por VIH. Este aumento en la prevalencia es mucho más acusado en varones, especialmente en HSH seropositivos para VIH, donde la prevalencia de infección anal por VPH asciende a 89% en algunas series 45 . Además de una mayor prevalencia, los pacientes infectados por VIH tardan más en aclarar la co-infección por VPH lo que se relaciona al mayor número de procesos neoplásicos asociados a este virus en población seropositiva para VIH.…”