Human Papillomavirus Infection and Cytologic Abnormalities of the Anus and Cervix Among HIV-Infected Women in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (The SUN Study)

Kojic, Erna Milunka; Cu‐Uvin, Susan; Conley, Lois J.; Bush, Timothy J.; Onyekwuluje, Juanita; Swan, David C.; Unger, Elizabeth R.; Henry, Keith; Hammer, John; Overton, Edgar Turner; Darragh, Teresa M.; Palefsky, Joel M.; Vellozzi, Claudia; Patel, Pragna; Brooks, John T.

doi:10.1097/olq.0b013e3181f70253

Cited by 97 publications

(93 citation statements)

References 38 publications

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“…Nearly one-third of the women had abnormal anal cytologic findings. Consistent with other studies that document an association between abnormal cervical cytology and abnormal anal cytology in HIV-infected women, 16,25,27 we found that cervical cytology ‡ LSIL was positively associated with abnormal anal cytology. Given that the IPEC HIV Women's Cohort participants receive regular cervical Pap smears, the cervical cytology results of our study population might not accurately reflect those of HIV-infected women in Brazil.…”

Section: Discussionsupporting

confidence: 92%

“…15,18,25 While anal HR-HPV 56 and 68 were the second and third most prevalent anal HR-HPV genotypes in our study, the prevalences for both genotypes were < 1% in a 2008 study by Gonçalves et al assessing anogenital HPV among 138 HIV-infected women in São Paulo. 18 Recent studies on anal HPV in HIV-infected women from the United States also document HPV 16 as the most prevalent anal HR-HPV genotype, 15,16,25 although the distribution of other HR-HPV genotypes varies by study. These variations in anal HR-HPV genotype prevalences and differences compared to cervical HR-HPV genotypes among different populations illustrate the diversity of HPV genotypes by region.…”

Section: Discussioncontrasting

confidence: 50%

See 1 more Smart Citation

Anal Human Papillomavirus (HPV) Prevalences and Factors Associated with Abnormal Anal Cytology in HIV-Infected Women in an Urban Cohort from Rio de Janeiro, Brazil

Cambou¹,

Luz

Lake³

et al. 2015

AIDS Patient Care and STDs

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Identifying factors, including human papillomavirus (HPV) genotypes, associated with abnormal anal cytology in HIV-infected women have implications for anal squamous cell cancer (SCC) prevention in HIV-infected women. Anal and cervical samples were collected for cytology, and tested for high-(HR-HPV) and low-risk HPV (LR-HPV) genotypes in a cross-sectional analysis of the IPEC Women's HIV Cohort (Rio de Janeiro, Brazil). Multivariate log-binomial regression models estimated prevalence ratios for factors associated with abnormal anal cytology [ ‡ atypical squamous cells of undetermined significance, (ASC-US)]. Characteristics of the 863 participants included: median age 42 years, 57% non-white, 79% current CD4 + T-cell count > 350 cells/mm 3 , 53% HIV-1 viral load < 50 copies/mL, median ART duration 5.8 years. Fifty-one percent of anal specimens contained ‡ 1 HR-HPV genotype; 31% had abnormal anal cytology [14% ASC-US, 11% low-grade squamous intra-epithelial lesion, (LSIL); 2% atypical squamous cells-cannot exclude high-grade SIL (ASC-H); 4% high-grade SIL/cancer (HSIL + )]. In multivariate analysis, cervical LSIL + , nadir CD4 + T-cell count £ 50 cells/mm 3 , HIV-1 viral load ‡ 50 copies/mL, and anal HPV 6,11,16,18,33, 45, 52, 56, and 58 were associated with ‡ anal ASC-US ( p < 0.05). Abnormal anal cytology and HR-HPV prevalences were high. HIVinfected women with cervical LSIL + , low nadir CD4 + counts, or detectable HIV-1 viral loads should be a particular focus for enhanced anal SCC screening efforts.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 50%

Anal Human Papillomavirus (HPV) Prevalences and Factors Associated with Abnormal Anal Cytology in HIV-Infected Women in an Urban Cohort from Rio de Janeiro, Brazil

Cambou¹,

Luz

Lake³

et al. 2015

AIDS Patient Care and STDs

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“…This alteration was present in women with HPV-induced lesions in the LGT, especially among HIV+ patients. This result was expected and was in accordance with the results reported by other authors who have established a positive relationship between cytological alterations of the LGT and the AC in the HIV+ population (Kojic et al, 2011). In our study, HIV+ patients presented an altered AC in 42.9% of cases, and the figure was 26.8% in HIV-women.…”

Section: Discussionsupporting

confidence: 93%

HPV infection-associated anogenital cyto-colpo-histological findings and molecular typing in HIV-positive women

et al. 2015

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ABSTRACT. HIV and human papillomavirus (HPV) coinfection is increasing, especially in the anal canal (AC) and cervico-vaginal regions.We identified anal epithelium abnormalities related to high-risk HPV (HR-HPV) lesions in the lower genital tracts (LGTs) of HIV-positive women, described the HPV genotypes identified, and assessed the expression of E6/E7 oncogenes in coinfected patients. Ninety-eight women were enrolled in groups combining HIV status and presence or absence of HPV in the LGT. Anal and cervical smears were collected for cytology and HR-HPV assays using Cobas ® and/ or PapilloCheck ® . Samples with highly oncogenic HPV genotypes were confirmed by NucliSENS EasyQ ® . Forty-two HIV-positive (25-52; mean age 39.5) and 56 HIV-negative (18-58; mean age 35.7) patients were included. E2 and C1 groups presented AC alterations (P = 0.002); altered images HPV-associated anogenital cytology in HIV-positive women for high-resolution anoscopy were higher in E1 and C2 (P < 0.001). Of the 29 women with alterations, 41.38% were HIV-negative and 58.62% were HIV-positive (P < 0.001). HIV-positive patients accounted for 29% of the anal high-grade squamous intraepithelial lesions (P = 0.015). The Cobas ® positive result frequency was higher in three AC groups than in the other groups. There was variation in the number of HPV types in the cervicovaginal samples among the study groups (P < 0.001). Anal cytology and anoscopy showed more altered findings in HIV-positive patients with HPV in the LGT. HR-HPV anal infections by various genotypes are common and are associated with cervical infections in HIV-positive patients. E6/E7 expression is apparently more common in the AC of HIV-positive women.

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“…Corroborating these findings, it was observed that the anal HPV infection and its consequent lesions have also high prevalence in HIV-seropositive women, observed by a cross-sectional prospective study with 167 women in the USA, where the prevalence of HPV infection was shown to be similar in the anus (38%) and uterine cervix (33%) (37) . According to De Vuyst et al (38) , most cross-sectional studies shows that prevalence of HPV in the uterine cervix is higher in HIV-seropositive patients than in seronegatives, even after the elimination of bias factors, such as age and sexual behavior.…”

Section: Hiv Infection In Hiv-seropositive Menmentioning

confidence: 67%

Virological and EpidEmiological aspEcts of anal carcinoma: currEnt and futurE challEngEs

Dobao¹,

Cavalcanti²

2013

J bra doenças sex transm

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Human papillomavirus infection, a sexually transmitted disease studied mainly in women due to its link to uterine cervical carcinoma, has become a health problem in men also, mainly by the significant increase of the prevalence and incidence of anal intraepithelial neoplasia and anal carcinoma in specific groups, such as men who have sex with men, HIV-seropositive and immunocompromised. The anal carcinoma, as cervical cancer, is associated with highrisk oncogenic HPV in 90% of cases, with HPV 16 as the predominant, followed by HPV 18. This fact occurs in a moment when there are no management protocols for HPV infection in the anal area, either preventive, diagnostic or therapeutic, and without an unique specialty that embraces the problem of HPV anogenital infection in men as does the gynecology for women, causing a dispersion of expertise. Added to this, there are still many doubts in the medical and general population about prophylactic vaccination for HPV in boys, and the absence of its distribution in a public health scale in most countries that still wait for statistical calculations to justify its use.

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Human Papillomavirus Infection and Cytologic Abnormalities of the Anus and Cervix Among HIV-Infected Women in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (The SUN Study)

Cited by 97 publications

References 38 publications

Anal Human Papillomavirus (HPV) Prevalences and Factors Associated with Abnormal Anal Cytology in HIV-Infected Women in an Urban Cohort from Rio de Janeiro, Brazil

Anal Human Papillomavirus (HPV) Prevalences and Factors Associated with Abnormal Anal Cytology in HIV-Infected Women in an Urban Cohort from Rio de Janeiro, Brazil

HPV infection-associated anogenital cyto-colpo-histological findings and molecular typing in HIV-positive women

Virological and EpidEmiological aspEcts of anal carcinoma: currEnt and futurE challEngEs

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