Anal cytological abnormalities are poor predictors of high-grade intraepithelial neoplasia amongst HIV-positive men who have sex with men

Sexual Health ◽  
2013 ◽  
Vol 10 (1) ◽  
pp. 9 ◽  
Author(s):  
Leon P. Botes ◽  
Sarah Pett ◽  
Andrew Carr ◽  
Debbie Marriott ◽  
David A. Cooper ◽  
...  
Keyword(s):  
Intraepithelial Neoplasia ◽  
Hiv Positive ◽  
High Grade ◽  
Histological Findings ◽  
Squamous Intraepithelial Lesions ◽  
Atypical Cells ◽  
Sex With Men ◽  
Intraepithelial Lesions ◽  
General Community ◽  
Undetermined Significance

Background Although anal squamous cell carcinomas (ASCC) are rare in the general community, rates of ASCC among HIV-positive men who have sex with men (MSM) approach those of major cancers in the general community, such as colorectal and lung cancers. Anal cytology and high-resolution anoscopy (HRA) have been proposed as methods for the diagnosis of high-grade anal intraepithelial neoplasia (HGAIN), the precursor of ASCC. To determine the prevalence of anal disease among HIV-positive MSM, we investigated anal cytological and histological findings in men from a large HIV clinic in Sydney, Australia. Methods: This was a single-centre study conducted between October 2008 and January 2010. Participants self-collected cytology specimens, and those yielding abnormal cytology results of atypical cells of undetermined significance, atypical cells of undetermined significance – possibly high-grade (ASC-H) and high-grade squamous intraepithelial lesions (HSIL) were offered HRA. In addition, of those yielding low-grade squamous intraepithelial lesions results, a systematically selected group (25%) were offered HRA. Results: Of the 1339 HIV-positive MSM who attended the clinic during the study period, 291 (31.8%) were finally included in the study, 262 yielded technically satisfactory cytological results and 101 (36.7%) participants underwent HRA. HGAIN was identified in 55 (54.5%) of the 101 men undergoing HRA. HGAIN was diagnosed in 28 (52.7%) without cytological ASC-H or HSIL results. Conclusions: Despite the poor correlation between anal cytological and histological findings, high levels of HGAIN were identified in HIV-positive MSM attending this clinical service.

scholarly journals Virological and serological predictors of anal high-grade squamous intraepithelial lesions among HIV-positive men who have sex with men

2018 ◽  
Vol 5 ◽  
pp. S9 ◽  
Author(s):  
Elske Marra ◽  
Matthijs L. Siegenbeek van Heukelom ◽  
Annemiek Leeman ◽  
Tim Waterboer ◽  
Chris J.L.M. Meijer ◽  
...  
Keyword(s):  
Hiv Positive ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Sex With Men ◽  
Intraepithelial Lesions ◽  
Hiv Positive Men

scholarly journals Cryotherapy for Intra- and Perianal High-Grade Squamous Intraepithelial Lesions in HIV-Positive Men who have Sex with Men

2017 ◽  
Vol 19 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Matthijs L. Siegenbeek van Heukelom ◽  
Karien C. M. Gosens ◽  
Jan M. Prins ◽  
Henry J. C. de Vries
Keyword(s):  
Hiv Positive ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Sex With Men ◽  
Intraepithelial Lesions ◽  
Hiv Positive Men

Anal intraepithelial neoplasia among HIV-positive men who have sex with men

Sexual Health ◽  
2015 ◽  
Vol 12 (6) ◽  
pp. 563
Author(s):  
José A. Mata-Marín ◽  
Jorge Hernández-Figueroa ◽  
Gloria Huerta-García ◽  
Jorge Sandoval-Ramírez ◽  
Miguel Pichardo-Farfán ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
High Risk ◽  
Intraepithelial Neoplasia ◽  
Risk Groups ◽  
Hiv Positive ◽  
High Grade ◽  
Common Cause ◽  
Screening Programs ◽  
Sex With Men ◽  
Intraepithelial Lesions

Neoplasia is the second most common cause of mortality in HIV patients. The prevalence of anal cancer among men who have sex with men (MSM) has continued to increase since the introduction of antiretroviral therapy. We screened 94 HIV-infected MSM patients. We found high-grade squamous intraepithelial lesions (HSIL) in six of the patients. The calculated prevalence of HSIL was 6.4% (95% confidence interval: 2.9–13.2). The study and implementation of screening programs for high-risk groups is a priority.

Response factors associated with electrocautery treatment of intra-anal high-grade squamous intraepithelial lesions in a population of HIV-positive men who have sex with men

2021 ◽  
pp. 095646242110170
Author(s):  
Irene Fuertes ◽  
Ross Cranston ◽  
Elisa de Lazzari ◽  
Leonardo Rodriguez-Carunchio ◽  
José L Blanco
Keyword(s):  
Response To Treatment ◽  
Hiv Positive ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Response Factors ◽  
Serious Adverse Events ◽  
Anal Squamous Cell Carcinoma ◽  
Sex With Men ◽  
Intraepithelial Lesions ◽  
Hiv Positive Men

Background: Ablative treatment of anal high-grade squamous intraepithelial lesions (HSIL) reduces the risk of progression to anal squamous cell carcinoma. Objectives: To identify factors that influence the response to treatment of anal HSIL by electrocautery ablation (ECA) in a population of HIV-positive men who have sex with men (MSM). Design: Retrospective study of ECA treatment response in a prospectively followed anal dysplasia cohort. HIV-positive MSM diagnosed with anal HSIL were included. Demographic and HIV data were recorded. Response to treatment was assessed by biopsy after at least 18 months of follow-up. Results: One hundred and twenty-eight HSILs in 91 men were included in this study. The overall response rate at 18 months was 70.3%. The number of electrocautery sessions required (2 ECA sessions vs 1: adjusted odds ratio [aOR] = 0.36 (95%CI 0.13-1.01); >=3 sessions vs 1: aOR = 0.10 (95%CI 0.04-0.29); p < 0.001]) and the history of previous HPV-related anal pathology (previous anal lesions vs no previous lesions AOR = 2.83 (95%CI 1.14-7.02), p = 0.024) were independently associated with response at 18 months. No serious adverse events were reported. Conclusions: Consideration should be given to alternative therapies in patients with unresolved HSIL after 1 ECA treatment.

scholarly journals Relationship between the Cervical Microbiome, HIV Status, and Precancerous Lesions

mBio ◽  
2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Cameron Klein ◽  
Daniela Gonzalez ◽  
Kandali Samwel ◽  
Crispin Kahesa ◽  
Julius Mwaiselage ◽  
...  
Keyword(s):  
Hiv Positive ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Cervical Lesions ◽  
Cervical Cancers ◽  
Bacterial Microbiome ◽  
Bacterial Richness ◽  
Intraepithelial Lesions ◽  
Hiv Negative

ABSTRACT Nearly all cervical cancers are causally associated with human papillomavirus (HPV). The burden of HPV-associated dysplasias in sub-Saharan Africa is influenced by HIV. To investigate the role of the bacterial microbiome in cervical dysplasia, cytobrush samples were collected directly from cervical lesions of 144 Tanzanian women. The V4 hypervariable region of the 16S rRNA gene was amplified and deep sequenced. Alpha diversity metrics (Chao1, PD whole tree, and operational taxonomic unit [OTU] estimates) displayed significantly higher bacterial richness in HIV-positive patients (P = 0.01) than in HIV-negative patients. In HIV-positive patients, there was higher bacterial richness in patients with high-grade squamous intraepithelial lesions (HSIL) (P = 0.13) than those without lesions. The most abundant OTUs associated with high-grade squamous intraepithelial lesions were Mycoplasmatales, Pseudomonadales, and Staphylococcus. We suggest that a chronic mycoplasma infection of the cervix may contribute to HPV-dependent dysplasia by sustained inflammatory signals. IMPORTANCE HPV is known to be the causal agent in the majority of cervical cancers. However, the role of the cervical bacterial microbiome in cervical cancer is not clear. To investigate that possibility, we collected cervical cytobrush samples from 144 Tanzanian women and performed deep sequencing of bacterial 16S rRNA genes. We found that HIV-positive patients had greater bacterial richness (P = 0.01) than HIV-negative patients. We also observed that women with high-grade squamous intraepithelial lesions (HSIL) had greater cervical bacterial diversity than women with cytologically normal cervices. Data from our precise sampling of cervical lesions leads us to propose that Mycoplasma contributes to a cervical microbiome status that promotes HPV-related cervical lesions. These results suggest a greater influence of the bacterial microbiota on the outcome of HPV infection than previously thought.

scholarly journals Determinants of high-grade anal intraepithelial lesions in HIV-positive men having sex with men

2018 ◽  
Vol 5 ◽  
pp. S3
Author(s):  
Isabelle Etienney ◽  
Laurent Siproudhis ◽  
Lionel Piroth ◽  
Isabelle Poizot-Martin ◽  
Sylvie Radenne ◽  
...  
Keyword(s):  
Hiv Positive ◽  
High Grade ◽  
Sex With Men ◽  
Intraepithelial Lesions ◽  
Hiv Positive Men
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