Prolonged antiretroviral therapy is associated with fewer anal high-grade squamous intraepithelial lesions in HIV-positive MSM in a cross-sectional study

Libois, Agnès; Feoli, Francesco; Nkuize, Marcel; Delforge, Marc; Konopnicki, Déborah; Clumeck, Nathan; Wit, Stéphane De

doi:10.1136/sextrans-2015-052444

Cited by 21 publications

(17 citation statements)

References 10 publications

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“…14 Interestingly, the incidence of anal cancer among HIV-infected persons persisted despite treatment with antiretroviral therapy, 15 but significantly less anal intraepithelial neoplasias (AINs) 2 and 3 were found in HIV-positive men who were on combination antiretroviral therapy for more than 24 months. 16 In total, these data suggest that the incidence of HPV-induced neoplastic changes is more related to immune status, specifically CD4 status, and anal intercourse rather than gender alone.…”

Section: Epidemiologymentioning

confidence: 83%

Vaccinations for Anal Squamous Cancer: Current and Emerging Therapies

Berry

Glasgow

2018

Clinics in Colon and Rectal Surgery

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Human papillomavirus (HPV) infection is responsible for 4.3% of the global cancer burden. Since 2006, current HPV vaccines have reduced the prevalence of the virus in adolescent girls, reduced the prevalence of genital warts, and been proven to reduce the progression of anal intraepithelial neoplasia in men. Herein, we review the epidemiology, virology, and immunology behind the prophylactic HPV vaccines and current recommendations for its use. We also review future immune therapies being trialed for use against HPV-related cancers including anal cancer.

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Section: Epidemiologymentioning

confidence: 83%

Vaccinations for Anal Squamous Cancer: Current and Emerging Therapies

Berry

Glasgow

2018

Clinics in Colon and Rectal Surgery

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“…Although most studies in the early ART era failed to demonstrate a protective effect of ART against the development and progression of anal dysplasia in HIV-positive MSM, several studies argue in its favor [11,[79][80][81][82]. A significantly lower prevalence of anal HPV infection was observed in HIV-positive MSM receiving ART compared to HIV-positive MSM without ART (0% vs. 12%; p = 0.010) [80].…”

Section: Antiretroviral Treatmentmentioning

confidence: 97%

“…A significantly lower prevalence of anal HPV infection was observed in HIV-positive MSM receiving ART compared to HIV-positive MSM without ART (0% vs. 12%; p = 0.010) [80]. In HIV-positive MSM, initiating ART early can potentially offer protection against the development of anal dysplasia [80][81][82][83]. In addition, ART-related immune system reconstitution in HIV-positive MSM enhances the immune response against HPV infection with seroconversion and increasing titers of anti-HPV antibodies [84].…”

Section: Antiretroviral Treatmentmentioning

confidence: 99%

Prevention of human papillomavirus (HPV)-related tumors in people living with human immunodeficiency virus (HIV)

Poljak

Šterbenc

Lunar

2017

Expert Review of Anti-infective Therapy

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In comparison to their HIV-negative counterparts, people living with HIV (PLWH) have a higher prevalence of human papillomavirus (HPV) infection in various anatomical sites coupled with increased HPV persistence, higher risk of HPV-related tumors, and faster disease progression. Areas covered: Gender-neutral prevention strategies for HPV-related cancers in PLWH discussed: ABC approach, HPV vaccination, antiretroviral treatment (ART), anal cancer screening, and smoking cessation. Gender specific strategies: cervical cancer screening reduces the incidence and mortality of cervical cancer and circumcision might reduce the risk of HPV infections in men. Expert commentary: HPV-related cancer incidence has not declined (e.g. cervical cancer) and has even increased (e.g. anal cancer) in the ART era, demanding an effective HPV prevention strategy. HPV vaccination should be introduced into national prevention programs worldwide immediately because current prophylactic vaccines are safe, tolerable, and immunogenic in PLWH. HPV vaccine efficacy trials in PLWH are essential to determine the most appropriate immunization schedule. The population most at risk of anal cancer is HIV-positive men who have sex with men, who are not protected by herd immunity if only the female population is vaccinated. Unvaccinated PLWH need enhanced surveillance for early detection of HPV-related cancers and their precursors.

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“…These cross-sectional studies suggest that ART has a limited effect on reducing HSIL incidence or inducing HSIL regression. However, in a recently reported cross-sectional study of HIV-infected MSM, being on ART for 2 years or longer was associated with a lower prevalence of anal HSIL (11). …”

Section: Introductionmentioning

confidence: 97%

Human papillomavirus-associated anal and cervical cancers in HIV-infected individuals

Palefsky

2017

Current Opinion in HIV and AIDS

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Purpose of review The incidence of human papillomavirus (HPV)-related cancers has increased (anal cancer) or not declined (cervical cancer) since the introduction of antiretroviral therapy (ART). This article reviews recent data on incidence and prevention efforts for HPV-related cancers in the ART era. Recent findings ART may confer some benefit with respect to reducing the risk of anal HSIL and cancer, but the degree of that benefit appears to be limited. The prevalence of anal HPV infection, anal HSIL and anal cancer remain high among individuals on effective ART. The incidence of cervical cancer is high among HIV-infected women, particularly in countries where there are no organized cervical cancer prevention programs. Efforts are in progress to define optimal screen-and-treat cervical cancer prevention programs in different clinical settings and to define the efficacy of secondary prevention programs for prevention of anal cancer. Summary HPV-related cancers are likely to remain an important problem in HIV-infected men and women for the foreseeable future, even among those on effective ART.

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Prolonged antiretroviral therapy is associated with fewer anal high-grade squamous intraepithelial lesions in HIV-positive MSM in a cross-sectional study

Abstract: Prolonged cART (≥24 months) is associated with fewer anal HSIL.

Cited by 21 publications

References 10 publications

Vaccinations for Anal Squamous Cancer: Current and Emerging Therapies

Vaccinations for Anal Squamous Cancer: Current and Emerging Therapies

Prevention of human papillomavirus (HPV)-related tumors in people living with human immunodeficiency virus (HIV)

Human papillomavirus-associated anal and cervical cancers in HIV-infected individuals

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