4. High prevalence of anal HPV infection among HIV-positive male subjects in the absence of anal intercourse

Eugenio Nelson Cavallari; Gabriella d’Ettorre; Giancarlo Ceccarelli; Sara Serafini; Alessandra Pierangeli; Alessio Impagnatiello; Tommaso Ascoli Bertoli; Luigi Bianchi; Guido Antonelli; Vincenzo Vullo; Marileda Indinnimeo

doi:10.1071/SHv10n6ab4

RESEARCH ARTICLE

4. High prevalence of anal HPV infection among HIV-positive male subjects in the absence of anal intercourse

Eugenio Nelson Cavallari ^A , Gabriella d’Ettorre ^A , Giancarlo Ceccarelli ^A , Sara Serafini ^A , Alessandra Pierangeli ^B , Alessio Impagnatiello ^C , Tommaso Ascoli Bertoli ^A , Luigi Bianchi ^A , Guido Antonelli ^B , Vincenzo Vullo ^A and Marileda Indinnimeo ^C

+ Author Affiliations

- Author Affiliations

^A Public Health and Infectious Diseases Department, ‘Sapienza’ University of Rome, Rome, Italy.

^B Department of Virology, ‘Sapienza’ University of Rome, Rome, Italy.

^C Department of Surgery ‘Valdoni’, ‘Sapienza’ University of Rome, Rome, Italy.

Sexual Health 10(6) 571-571 https://doi.org/10.1071/SHv10n6ab4
Published: 22 November 2013

Abstract

Background: The risk of progression to cancer from HPV infection is increased in HIV-positive subjects. Anal HPV infection is a concern among men who have sex with men (MSM), especially in the setting of HIV infection. Methods: Cross-sectional study including 62 HIV-positive injection drug users (IDUs) without history of receptive anal intercourse and 110 HIV-positive MSM. All patients were receiving HAART with HIV-RNA <37 copies/mL. Patients answered a self-administered questionnaire investigating their sexual habits. Participants underwent anal brushing collecting samples for cytology examination (Bethesda 2001 criteria for cervical cytology) and high resolution anoscopy collecting samples for histological classification. HPV-DNA polymerase chain reaction (PCR) identification was performed. Results: Of the IDUs, 62.5% showed CD4 nadir <200 cell/mmc compared with 12% of MSM (P < 0.05), the actual CD4+ T-cells count did not show a statistical difference. HPV-DNA PCR tested positive in 52% of IDUs and 69% of MSM (P < 0.05). Presence of high-risk genotypes did not show significant difference between the groups (38% of IDUs and 31% of MSM). LSIL prevalence was higher among MSM than IDUs (38% v. 23%), HSIL was higher among IDUs than MSM (26% v. 21%). The prevalence of anal cancer was similar in the two populations (3% in each group). All patients, except for men presenting with anal cancer, were completely asymptomatic. Conclusions: Anal HPV infection and anal SIL may be acquired in the absence of anal intercourse in HIV-infected men. The prevalence of HSIL is high among HIV-positive IDUs. All HIV-infected men, regardless of history of anal intercourse, should be considered for anal cytology screening.