Natural History and Clinical Management of Anal Human Papillomavirus Disease in Men and Women Infected with Human Immunodeficiency Virus

Chin‐Hong, Peter; Palefsky, Joel M.

doi:10.1086/344057

Cited by 280 publications

(208 citation statements)

References 21 publications

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“…Various studies report a prevalence of 36-52% in HIV positive individuals and 8-17% in HIV negative men and women. 21,22 Approximately, a third of our patients with anal biopsies or resections were immunodeficient with an overwhelming majority (90%) being infected with HIV. Although AIN occurs with greater frequency in immunodeficient individuals, AIN lesions from the immunodeficient individuals in our series did not show a greater prevalence of highrisk HPV.…”

Section: Discussionmentioning

confidence: 99%

Human papillomavirus genotypes in anal intraepithelial neoplasia and anal carcinoma as detected in tissue biopsies

et al. 2010

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Human papillomavirus (HPV) infection strongly correlates with the development of anal intraepithelial neoplasias and carcinomas; however, few studies have characterized the distribution of the specific subtypes of the virus in the varying grades of dysplasia. This report characterizes the distribution of HPV 16/18 in surgical specimens with anal intraepithelial neoplasia (AIN) I-III and histological variants of anal carcinoma. A total of 111 anal surgical specimens with no dysplasia (10), AIN I-III (53), and anal carcinomas (48) were evaluated for the presence of high-risk HPV infection and subtyped by nested PCR or the Invader Assay. High-risk virus types were detected in progressively greater number of anal intraepithelial lesions from 56% in low grade to 88% in high grade. Type 16 was the prevalent subtype and was noted in 28% of low grade and 68% of high-grade lesions. Moderate dysplasias showed type 16 in 20%, a prevalence similar to that in low-grade lesions. The non-16/18 subtypes of the virus predominated and were present in 50% of the cases. Most (89%) squamous carcinomas were associated with high-risk viruses, 68% with type 16, a prevalence similar to that noted in highgrade dysplasia. Non-16/18 subtypes were encountered more frequently in squamous carcinomas from immunodeficient individuals (57% cases) as compared with immunocompetent individuals (18% cases). The similarity in the prevalence of type 16 in high-grade dysplasia and squamous carcinomas suggests that anal intraepithelial lesion III is the true precursor of squamous carcinoma and warrants aggressive management. Anal intraepithelial lesions II showed a virus distribution that was similar to low-grade dysplasia. In addition, a subset of these that were associated with type 16 or 18 showed progression, whereas those associated with non-16/18 subtypes regressed, thereby raising the possibility of conservative management for these lesions.

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Section: Discussionmentioning

confidence: 99%

Human papillomavirus genotypes in anal intraepithelial neoplasia and anal carcinoma as detected in tissue biopsies

et al. 2010

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“…Moreover, reductions in smoking among MSM would mitigate risks for health problems that affect them disproportionately; for example, smoking appears to be a potent yet modifiable cofactor in the development of anal cancer. [14][15][16][17][18] Targeting smoking prevention and cessation initiatives among MSM is difficult since only a handful of studies have investigated correlates of smoking among sexual minorities. 3,4,6,11,13 We undertook the present study to determine the prevalence and correlates of smoking in a community-recruited cohort of urban-dwelling Canadian MSM.…”

Section: Introductionmentioning

confidence: 99%

High Prevalence of Smoking Among Urban-Dwelling Canadian Men Who Have Sex with Men

et al. 2006

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A small but consistent literature from the United States suggests increased risk for smoking among lesbians and men who have sex with men (MSM). Few studies have investigated smoking among MSM in other countries where different social norms and restrictions on smoking in public apply. We measured smoking behaviours in a convenience sample of urban-dwelling young Canadian MSM (median age 28 years). We compared the prevalence of smoking among MSM with that among other men in British Columbia (BC) using National Population Health Survey data to compute an age-adjusted standardized prevalence ratio (SPR). Independent predictors of smoking among MSM were identified using adjusted odds ratios (OR) with 95% confidence intervals (CI). Smoking during the previous year was reported by twice as many MSM (54.5% of 354) as other men in BC (25.9%) (SPR=1.94, 95% CI 1.48-2.59), with largest differentials observed among men under 25 years of age. In multivariable analyses, smoking among MSM was significantly associated with younger age (OR 0.94, CI 0.88-1.00 per year), greater number of depressive symptoms (OR 1.12, CI 1.06-1.19 per symptom) and Canadian Aboriginal ethnicity (OR 2.64, CI 1.05-6.60). In summary, MSM in our study were twice as likely to smoke as other men in BC; the greatest differences were observed among the youngest men. The design of effective prevention and cessation programs for MSM will require identification of the age-dependent determinants of smoking initiation, persistence, and attempts to quit.

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“…Durable HIV infection seems to be accompanied by a higher risk for ASIL because the frequency of precursor lesions of anal cancer in HIV-positive patients has shown a tendency to increase since the advent of highly active antiretroviral therapy 2,5,6 .…”

Section: Discussionmentioning

confidence: 99%

“…Patients with HSIL lesions are at an increased risk to develop anal cancer 5 . Nevertheless, depending on the genotype of the infecting HPV, in the presence of infection with multiple HPV types and under immunodepressive conditions, lesions considered to be LSIL at admittance can evolve to HSIL.…”

Section: Introductionmentioning

confidence: 99%

Anal cancer precursor lesions in HIV-positive and HIV-negative patients seen at a tertiary health institution in Brazil

et al. 2011

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Purpose:To investigate the prevalence of anal squamous intraepithelial lesions (ASIL) or anal cancer in patients attended at the Tropical Medicine Foundation of Amazonas. Methods: 344 patients consecutively attended at the institution, in 2007/2008, were distributed in the following strata according to presence/abscense of at risk conditions for anal cancer: Group 1 -HIV-positive men-who-have-sex-with-men (101); Group 2 -HIV-positive females (49); Group 3 -patients without any at risk condition for anal cancer (53); Group 4 -HIV-positive heterosexual men (38); Group 5 -HIV-negative patients, without anoreceptive sexual habits, but with other at risk conditions for anal cancer (45); Group 6 -HIV-negative men-who-have-sex-with-men (26); and Group 7 -HIVnegative anoreceptive females (32). The histopathological results of biopsies guided by high-resolution anoscopy were analyzed by frequentist and bayesian statistics in order to calculate the point-prevalence of ASIL/cancer and observe any eventual preponderance of one group over the other. Results: The point-prevalence of ASIL for all the patients studied was 93/344 (27%), the difference between HIV-positive and negative patients being statistically significant (38.3% versus 13.5%; p < 0.0001). The prevalence of ASIL for each one of the groups studied was: Group 1 = 49.5%, Group 2 = 28.6%, Group 3 = 3.8%, Group 4 = 21.1%, Group 5 = 11.1%, Group 6 = 30.8% and Group 7 = 18.8%. Standard residual analysis demonstrated that ASIL was significantly prevalent in patients of Group 1 and high-grade ASIL in patients of Group 2. The odds for ASIL of Group 1 was significantly higher in comparison to Groups 2, 3, 4, 5 and 7 (p < 0.03). The odds for ASIL of Groups 2, 4 and 6 were significantly higher in comparison to Group 3 (p < 0.03). Conclusions: In the patients studied, ASIL (low and/or high-grade) tended to be significantly more prevalent in HIV-positive patients. Nonetheless, HIV-negative anoreceptive patients also presented great probability to have anal cancer precursor lesions, mainly those of the male gender. Key words: Anal Canal. Anus Neoplasms. Epidemiology. HIV. Anal cancer precursor lesions in HIV-positive and HIV-negative patients seen at a tertiary health institution in BrazilActa Cirúrgica Brasileira -Vol. 26 (1) (101); Grupo 2 -mulheres HIV-positivas (49); Grupo 3 -pacientes sem condição de risco para o câncer anal (53); Grupo 4 -homens heterossexuais HIV-positivos (38); Grupo 5 -pacientes HIV-negativos, sem hábitos sexuais anorreceptivos, mas com outras condições de risco para o câncer anal (45); Grupo 6 -homens-que-fazem-sexo-com-homens HIV-negativos (26); e Grupo 7 -mulheres HIV-negativas, com hábitos sexuais anorreceptivos (32). Os resultados histopatológicos das biópsias anais dirigidas pela colposcopia anal foram analisados por meio de estatística frequentista e bayesiana para a determinação da prevalência-ponto de ASIL/câncer e verificar eventual preponderância estatística de um grupo sobre o outro. Resultados: A prevalência-ponto de ASIL para t...

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Natural History and Clinical Management of Anal Human Papillomavirus Disease in Men and Women Infected with Human Immunodeficiency Virus

Cited by 280 publications

References 21 publications

Human papillomavirus genotypes in anal intraepithelial neoplasia and anal carcinoma as detected in tissue biopsies

Human papillomavirus genotypes in anal intraepithelial neoplasia and anal carcinoma as detected in tissue biopsies

High Prevalence of Smoking Among Urban-Dwelling Canadian Men Who Have Sex with Men

Anal cancer precursor lesions in HIV-positive and HIV-negative patients seen at a tertiary health institution in Brazil

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