High-Risk HPV DNA Test for Screening Anal Lesions in HIV-Positive and Negative Patients

Abstract

The high incidence of anal dysplasia is related to many factors. The infections caused by HPV and HIV seem to be determinants of the following anal Pap smear changes: atypical squamous cells of undetermined significance (ASCUS), low-grade anal intraepithelial neoplasia (LAIN) and high-grade anal intraepithelial neoplasia (HAIN). Highrisk HPV infection is confirmed by the HPV DNA test, using hybrid capture technology. Screening for anal lesions should be complemented with the anal Pap smear protocol and high-resolution anoscopy. The aim of this study was to evaluate the influence of the high-risk HPV DNA test on screening for anal lesions. We evaluated 70 HIV-positive and negative patients who had previously had anal intercourse, at CRT/AIDS São Paulo from January 2013 to December 2013. All of the patients underwent the high-risk HPV DNA test, anal Pap smear protocol and highresolution anoscopy. The anal lesions were treated with 90% trichloroacetic acid (TCA) and 5% imiquimod for 12 weeks. The statistical analysis was performed using hypothesis tests on proportions and the significance level was set at less than 5%. 31 HIV-positive male patients, 19 HIV-negative male patients and 20 HIV-negative female patients were evaluated. 28 HIV-positive patients were positive for the high-risk HPV DNA test and 29 patients were positive for the high-risk HPV DNA test and had anal dysplasia. Our conclusion is that it was more common for HIVpositive patients to be infected with oncogenic HPV and the oncogenic HPV was more frequent in patients with anal dysplasia.