Anal human papillomavirus infection is associated with HIV acquisition in men who have sex with men

Abstract

Objective Human papillomavirus (HPV) is a common sexually transmitted agent that causes anogenital cancer and precancer lesions that have an inflammatory infiltrate, may be friable and bleed. Our aim was to determine the association between anal HPV infection and HIV acquisition. Design A prospective cohort study. Methods We recruited 1409 HIV-negative men who have sex with men recruited from a community-based setting in Boston, Denver, New York and San Francisco. We used Cox proportional hazards regression modeling and assessed the independent association of HPV infection with the rate of acquisition of HIV infection. Results Of 1409 participants contributing 4375 person-years of follow-up, 51 HIV-seroconverted. The median number of HPV types in HPV-infected HIV-seroconverters was 2 (interquartile range 1–3) at the time of HIV seroconversion. After adjustment for sexual activity, substance use, occurrence of other sexually transmitted infections and demographic variables, there was evidence (P░=░0.002) for the effect of infection with at least two HPV types (hazard ratio 3.5, 95% confidence interval 1.2–10.6) in HIV seroconversion. Conclusion Anal HPV infection is independently associated with HIV acquisition. Studies that incorporate high-resolution anoscopy to more accurately identify HPV-associated disease are needed to determine the relationship between HPV-associated disease and HIV seroconversion.

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

“…131 Anal HPV infection was independently associated with HIV acquisition in the single included study that assessed anal infection among MSM. 132 Considerable uncertainty surrounds the natural history of HPV infection and clinical utility of testing among MSM at present. Thus regular testing for HPV in MSM is not recommended.…”

Prevalence, Incidence and Risk Factors for Acquisition of Herpes Simplex Virus Type 2 among Fishermen on the Shores of Lake Victoria in Kisumu County, Kenya

“…Therefore, the observed association between persistent HR HPV and new HSV-2 infection warrant further studies and should be interpreted with caution. However, several studies have found that HPV infection increases the risk for HIV acquisition by 1.8 -3.5 times [32]- [34]. Lissouba et al (2013) in their meta-analysis review found that HR HPV infection was associated with almost a 2-fold increased risk for incident HIV infection, while LR HPV infection had only a borderline association [35].…”

Inmunización contra el virus de papiloma humano en Perú. Más allá del cáncer de cérvix

“…2,3 La infección por VPH en HSH se asocia con una incidencia en cán-cer anal de 17 veces más que en los heterosexuales; 4 además de que su incidencia es más alta que las tasas de cáncer de cérvix en las mujeres, 5,6 pues estos últimos tienden a regresar a la normalidad después de los 30 años de edad. Ocurre lo contrario con los HSH, pues están en riesgo de lesiones anales y orofaringeas asociadas con VPH de células escamosas intraepiteliales a lo largo de su vida.…”

“…Junior Smith Torres-Román, Est Med, (1,2) jstorresroman@gmail. Políticas públicas en salud basadas en la evidencia.…”