Anal Intraepithelial Neoplasia in Heterosexual and Homosexual HIV‐Positive Men with Access to Antiretroviral Therapy

Wilkin, Timothy; Palmer, Shaun; Brudney, Karen; Chiasson, Mary Ann; Wright, Thomas

doi:10.1086/424599

Cited by 101 publications

(88 citation statements)

References 33 publications

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“…Anal cytology exams of our group of patients evidenced abnormalities in just 47.6% of the individuals with a lesion at anuscopy, and no HSIL was observed with cytology. The prevalence of abnormal cytology in HIV-positive men varies; whereas Moscicki et al and Wilkin et al found prevalence rates of 41.2% [9] and 48% [21], similar to what we found, Sirena et al reported 75% abnormal cytologies [30].…”

Section: Discussionsupporting

confidence: 90%

“…The patients enrolled in our study were young, with a mean age of 38.4 years, a finding similar to those of Varnai et al and Wilkin et al, who observed that anal lesions mediated by HPV occurred mainly in young individuals, with a mean age of 42.2 years for men with a histological diagnosis of anal lesion [20] and 40 years or less as a risk factor for abnormal anal cytology and biopsy [21].…”

Section: Discussionsupporting

confidence: 87%

“…This favorable immunological profile was a result of their treatment, which not only decreased mortality, but also increased incidence of anal cancer and other HPV-associated diseases due to their longer survival, a finding already described by other authors [11,19,21,22]. The use of HAART does not seem to modify the natural history of HIV-HPV co-infection [4,19,23].…”

Section: Discussionmentioning

confidence: 58%

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Diagnostic methods for prevention of anal cancer and characteristics of anal lesions caused by HPV in men with HIV/AIDS

Pereira¹,

Lacerda²,

Barros³

2008

Braz J Infect Dis

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Abnormalities found with anuscopy under colposcopic vision, anal cytology and anal biopsy were evaluated in 21 men with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) at the Federal University of Pernambuco Hospital in Brazil. Mean age was 38.4 ± 6.0 years, and mean time of HIV infection was 8.3 ± 5.1 years; 95.2% of the patients had been on highly active antiretroviral therapy (HAART) for an average of 6.6 ± 4.5 years. Mean CD4+ cell count was 482.2 ± 173.75 cells/mm 3 , and 80.9% presented a HIV viral load of < 5,000 copies/mL. Reported sexual preference was 52.4% homosexuals, 28.6% bisexuals, and 19.0%heterosexuals; 81% reported having had receptive anal intercourse and 61.9% reported more than 10 sexual partners of the same sex. Results of anuscopy under colposcopic vision revealed 17 (81.0%) low-grade lesions and/or condylomata or micropapillae and four (19.0%) high-grade lesions with or without condylomata. Among the 21 anal cytology examinations, seven (33.3%) revealed low-grade squamous intraepithelial lesions (LSIL); three (14.3%) presented atypical squamous cells of undetermined significance (ASCUS) and 11 (52.4%) were normal. Seventeen patients were submitted to anal biopsy with the following findings: three patients (17.6%) with normal epithelium, one (5.9%) with infection by HPV, three (17.6%) with condylomatas, two (11.8%) with AIN 1, four (23.6%) with AIN 2, three (17.6%) with AIN 3, and one (5.9%) with PAIN 2. Anuscopy under colposcopic vision was found to be useful for detecting anal lesions and for guiding anal biopsies. Anal cytology was less useful, as it underestimated the frequency of lesions.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 58%

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Diagnostic methods for prevention of anal cancer and characteristics of anal lesions caused by HPV in men with HIV/AIDS

Pereira¹,

Lacerda²,

Barros³

2008

Braz J Infect Dis

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“…An epidemiological study conducted in Spain among HPV-infected MSM revealed a high HR-HPV prevalence (74.2%), and 54.2% of cytological atypia, such as LSIL (49.2%), ASCUS (2.5%), and HSIL (2.5%) [4]. Wilkin et al also found that 47% of 85 HIV-infected men had abnormal results: LSIL (24%), ASCUS (18%), and HSIL (6%) [3]. We found a higher rate of cytological abnormalities compared those reported previously, and that ASCUS was the most frequent cytological abnormality.…”

Section: Discussionmentioning

confidence: 97%

“…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.…”

Section: Discussionmentioning

confidence: 97%

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

Yaegashi

Shigehara

Itoda³

et al. 2017

Journal of Infection and Chemotherapy

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Keywords:Human papillomavirus Human immunodeficiency virus Men who have sex with men Anal sample Urine a b s t r a c tBackground: The present study investigated human papillomavirus (HPV) prevalence in anal and urine samples, and evaluated cytological findings among human immunodeficiency virus (HIV)-infected Japanese men who have sex with men (MSM). Methods: A total of 148 patients were enrolled. Anal and urine samples were collected from each participant, and a HPV-DNA test and genotyping were performed using flow-through hybridization. In addition, anal cytology was evaluated based on Papanicolaou staining. Questionnaires regarding lifestyle habits and sexual behavior were obtained. Results:The b-globin gene was positive in 131 (88.5%) anal samples and 139 (94.0%) urine samples. Among the b-globin-positive samples, the HPV prevalence in anal and urine samples was 80.9% and 30.9%, respectively. High-risk HPV (HR-HPV) was detected in 57.3% of anal samples and 20.9% of urine samples. Among 122 adequate cytological samples, anal cytological abnormalities were observed in 99 cases (81.1%). Anal cytological tests revealed that atypical squamous cells of an undetermined significance (ASCUS) were detected in 57 (46.7%) patients, followed by low-grade squamous intraepithelial lesions (SIL) in 35 (28.7%), high-grade SIL in five (4.1%), and atypical squamous cells cannot exclude highgrade SIL (ASC-H) in two (1.6%), respectively. The nadir counts of CD4-positive T-lymphocyte less than 200 mL and anal HR-HPV infection were independent risk factors for anal cytological atypia over ASC-H. Conclusions:The present study demonstrated high HPV prevalence in the anus and urine, and showed a high incidence of anal cytological atypia associated with HR-HPV infections among HIV-infected MSM patients.

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Patient Symptomatology in Anal Dysplasia

et al. 2015

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Anal Intraepithelial Neoplasia in Heterosexual and Homosexual HIV‐Positive Men with Access to Antiretroviral Therapy

Cited by 101 publications

References 33 publications

Diagnostic methods for prevention of anal cancer and characteristics of anal lesions caused by HPV in men with HIV/AIDS

Diagnostic methods for prevention of anal cancer and characteristics of anal lesions caused by HPV in men with HIV/AIDS

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

Patient Symptomatology in Anal Dysplasia

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