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

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.

Download Full-text

Prevalence of abnormal cervical cytology and HPV DNA positivity among HIV positive women

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193791 ◽

2019 ◽

Vol 8 (9) ◽

pp. 3649

Author(s):

Sunita Malik ◽

Supriti Kumari ◽

Harsha S. Gaikwad ◽

Archana Mishra ◽

Mausumi Bharadwaj

Keyword(s):

Hpv Infection ◽

Cervical Cytology ◽

Hiv Positive ◽

Abnormal Cytology ◽

Cross Sectional ◽

Hpv Dna ◽

Hpv Dna Testing ◽

Abnormal Cervical Cytology ◽

Hiv Positive Women ◽

Relationship Of

Background: The relationship among HIV, HPV, and development of CIN is complex and incompletely understood. Present study is undertaken to find out the prevalence and relationship of abnormal cervical cytology and HPV infection in HIV positive women.Methods: This was a cross-sectional, case control study conducted on 95 HIV seropositive and 95 seronegative women. Specimen was collected from the cervix for HPV DNA testing, subtyping and cytology.Results: HPV DNA positivity was higher in seropositive group (18.6% vs. 7.4%). Premalignant conditions were found only in seropositive group. At CD4 count <249 HPV DNA positivity was 53%, at 250-499 the percentage of HPV DNA positivity was 31% and at >500 HPV DNA positivity was 19%.Conclusions: Prevalence of abnormal cytology and HPV DNA positivity is higher amongst HIV positive women and there is an association between HPV DNA positivity with lower CD4 counts.

Download Full-text

High Prevalence of Human Papillomavirus Infection among Brazilian Pregnant Women with and without Human Immunodeficiency Virus Type 1

Obstetrics and Gynecology International ◽

10.1155/2009/485423 ◽

2009 ◽

Vol 2009 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Emilia Moreira Jalil ◽

Geraldo Duarte ◽

Patrícia El Beitune ◽

Renata Toscano Simões ◽

Patrícia Pereira dos Santos Melli ◽

...

Keyword(s):

Viral Load ◽

Pregnant Women ◽

Prevalence Ratio ◽

Hpv Infection ◽

Cross Sectional Study ◽

Hiv Positive ◽

Hiv Viral Load ◽

Cross Sectional ◽

Hpv Dna ◽

Hiv Negative

Objective. To estimate HPV prevalence among pregnant women from Ribeirão Preto, Brazil, and the possible influence of HIV-1 infection on this prevalence.Methods. A cross-sectional study with 44 HIV-positive and 53 HIV-negative pregnant women was conducted. Cervicovaginal specimens were obtained from all women during gynecologic exam. HPV DNA, low and high risk HPV types, was detected using conventional PCR. Statistical analysis used Student'st-test, Mann-Whitney test, Fischer's Exact test, and prevalence ratios with 95% confidence interval.Results. HIV-positive pregnant women had higher proportion of HPV infection than HIV-negative pregnant women (79.5% versus 58.5%;P<.05). HPV positivity prevalence ratio for HIV-positive women was 1.36 (95% CI 1.04–1.8;P=.03). There was significant association between HIV viral load levels and HPV positivity (P<.05).Conclusions. Our results demonstrate higher HPV positivity in HIV-infected pregnant women. Higher values of HIV viral load were associated with HPV positivity.

Download Full-text

27. Natural history of anal HPV in heterosexual women and risks associated with persistence

Sexual Health ◽

10.1071/shv10n6ab27 ◽

2013 ◽

Vol 10 (6) ◽

pp. 583 ◽

Cited By ~ 1

Author(s):

Anna-Barbara Moscicki ◽

Yifei Ma ◽

Sepideh Farhat ◽

Julie Jay ◽

Evelyn Hanson ◽

...

Keyword(s):

Natural History ◽

Anal Cancer ◽

Cox Regression ◽

Hpv Infection ◽

Hpv 16 ◽

Hpv Dna ◽

Heterosexual Women ◽

Kaplan Meier ◽

Vaginal Sex ◽

History Of

Background Anal cancer is more common in women than in men, yet little is known about the natural history of HPV in women. The objective was to examine the natural history of anal HPV in heterosexual women and to examine risk factors associated with persistence. Methods: Young women participating in a HPV cohort study were seen at 4-month intervals for cervical and anal testing for HPV DNA. The distribution of time to clearance was estimated using the Kaplan–Meier approach, and risks for persistence assessed using Cox regression models. Results: Seventy-five women (mean age 23.5 ± 4.1 years) who tested positive for anal HPV were followed for a mean of 84.5 ± 44.9 months. By 3 years, 82.5% of anal non-16 high risk (HR) HPV, 82.6% of low risk (LR) HPV and 76.2% of HPV16 infections had cleared. By 3 years, only 36.4% of women had become negative for all HPV types. In the multivariable model, concurrent cervical HPV 16 (P = 0.009) or any HR HPV (P = 0.046) detection, weekly alcohol use (P = 0.018), anal touching during sex (P = 0.034), and ever having anal sex (P = 0.06) were associated with HPV 16 persistence. Having a new sex partner (P < 0.001) and condom use during vaginal sex (P = 0.06) were associated with clearance. Similar associations were found for clearance all HR HPV infections. Only concomitant cervical HPV infection was associated with non-16 HR HPV persistence. Conclusions: The majority of anal HPV infections cleared within 3 years. HPV 16 infections were slower to clear than other HR HPV, consistent with its role in anal cancer. Sexual behaviour was associated with persistence, suggesting that education and behavioural interventions may decrease persistence and the risk of anal cancer.

Download Full-text

Anogenital warts contributing to the risk of squamous intraepithelial lesions among HIV-positive women of São Paulo, Brazil

International Journal of STD & AIDS ◽

10.1258/095646203321605503 ◽

2003 ◽

Vol 14 (5) ◽

pp. 309-313 ◽

Cited By ~ 2

Author(s):

Maria Alice G Goncalves ◽

Marcelo N Burattini ◽

Eduardo A Donadi ◽

Eduardo Massad

Keyword(s):

Univariate Analysis ◽

Hpv Infection ◽

Hiv Positive ◽

High Grade ◽

Anogenital Warts ◽

Squamous Intraepithelial Lesions ◽

Cross Sectional ◽

Hpv Dna ◽

Hiv Positive Women ◽

Intraepithelial Lesions

Unsafe sexual practices may expose HIV-positive women to high-grade squamous intraepithelial lesions (SIL) and to infection with oncogenic human papillomavirus (HPV) types. A cross sectional study of 141 HIV-positive women was designed to evaluate risk factors for the development of cervico-vaginal SIL and HPV-DNA detection/typing. Uni- and multivariate forward stepwise analysis was used to determine the relationship between risk variables and HPV infection and between risk behaviour, HPV and HIV infection with development of SIL. Univariate analysis showed that HPV-DNA infection was related to previous and recurrent anogenital warts, male genital warts and cytological alteration. For final multivariate analysis, both HPV type (undetermined- and high-risk, OR=29.3 and 112.0, respectively) were statistically associated ( P=0.019) with high-grade cervico-vaginal SIL. The presence of anogenital warts as well as high- and undetermined-risk HPV infection may alert to cyto/histopathological alterations. These results point out the importance of the use of barrier methods and routine early genitoscopy/treatment for HIV-infected partners.

Download Full-text

Prevalence of Anal Intraepithelial Lesions in Patients with Inflammatory Bowel Disease

Journal of Coloproctology ◽

10.1055/s-0041-1730425 ◽

2021 ◽

Vol 41 (03) ◽

pp. 222-227

Author(s):

Mariane Christina Savio ◽

Rosimeri Kuhl Svoboda Baldin ◽

Norton Luiz Nóbrega ◽

Guilherme Mattioli Nicollelli ◽

Antonio Sérgio Brenner ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Intraepithelial Neoplasia ◽

Female Gender ◽

Anal Intercourse ◽

Receptive Anal Intercourse ◽

Cross Sectional ◽

History Of ◽

Inflammatory Bowel

Abstract Introduction Anal intraepithelial neoplasia (AIN) is a premalignant lesion of the anal canal associated with HPV, with a higher prevalence in immunosuppressed individuals. Patients with inflammatory bowel disease (IBD) are at potential risk for their development, due to the use of immunosuppressants and certain characteristics of the disease. Method This is a prospective, cross-sectional, and interventional study that included 53 patients with IBD treated at a tertiary outpatient clinic, who underwent anal smear for cytology in order to assess the prevalence of AIN and associated risk factors. Results Forty-eight samples were negative for dysplasia and 2 were positive (4%). Both positive samples occurred in women, with Crohn's disease (CD), who were immunosuppressed and had a history of receptive anal intercourse. Discussion The prevalence of anal dysplasia in IBD patients in this study is similar to that described in low-risk populations. Literature data are scarce and conflicting and there is no evidence to recommend screening with routine anal cytology in patients with IBD. Female gender, history of receptive anal intercourse, immunosuppression and CD seem to be risk factors.

Download Full-text

Rationale and design of the Prevent Anal Cancer Self-Swab Study: a protocol for a randomised clinical trial of home-based self-collection of cells for anal cancer screening

BMJ Open ◽

10.1136/bmjopen-2021-051118 ◽

2021 ◽

Vol 11 (6) ◽

pp. e051118

Author(s):

Alan G Nyitray ◽

Vanessa Schick ◽

Michael D Swartz ◽

Anna R Giuliano ◽

Maria E Fernandez ◽

...

Keyword(s):

Anal Canal ◽

Anal Cancer ◽

Sexual Minority ◽

Hiv Positive ◽

Hpv Dna ◽

Sexual Minority Men ◽

Home Based ◽

Exfoliated Cells ◽

Transgender Persons ◽

Minority Men

IntroductionSquamous cell carcinoma of the anus is a common cancer among sexual minority men, especially HIV-positive sexual minority men; however, there is no evidenced-based national screening protocol for detection of anal precancers. Our objective is to determine compliance with annual anal canal self-sampling or clinician-sampling for human papillomavirus (HPV) DNA.Methods and analysisThis is a prospective, randomised, two-arm clinical study to evaluate compliance with annual home-based versus clinic-based HPV DNA screening of anal canal exfoliated cells. The setting is primary care community-based clinics. Recruitment is ongoing for 400 HIV-positive and HIV-negative sexual minority men and transgender persons, aged >25 years, English or Spanish speaking, no current use of anticoagulants other than nonsteroidal anti-inflammatory drugs and no prior diagnosis of anal cancer. Participants are randomised to either receive a swab in the mail for home-based collection of an anal canal specimen at 0 and 12 months (arm 1) or attend a clinic for clinician collection of an anal canal specimen at 0 and 12 months (arm 2). Persons will receive clinic-based Digital Anal Rectal Examinations and high-resolution anoscopy-directed biopsy to assess precancerous lesions, stratified by study arm. Anal exfoliated cells collected in the study are assessed for high-risk HPV persistence and host/viral methylation. The primary analysis will use the intention-to-treat principle to compare the proportion of those who comply with 0-month and 12-month sampling in the home-based and clinic-based arms. The a priori hypothesis is that a majority of persons will comply with annual screening with increased compliance among persons in the home-based arm versus clinic-based arm.Ethics and disseminationThe study has been approved by the Medical College of Wisconsin Human Protections Committee. Results will be disseminated to communities where recruitment occurred and through peer-reviewed literature and conferences.Trial registration numberNCT03489707.

Download Full-text

The characteristics and risk factors of human papillomavirus infection: an outpatient population-based study in Changsha, Hunan

Scientific Reports ◽

10.1038/s41598-021-94635-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Bingsi Gao ◽

Yu-Ligh Liou ◽

Yang Yu ◽

Lingxiao Zou ◽

Waixing Li ◽

...

Keyword(s):

Risk Factors ◽

Protective Factor ◽

Hpv Infection ◽

Population Based ◽

Cross Sectional Study ◽

Categorical Variables ◽

Chi Square ◽

Cross Sectional ◽

Hpv Dna ◽

Test Kit

AbstractThis cross-sectional study investigated the characteristics of cervical HPV infection in Changsha area and explored the influence of Candida vaginitis on this infection. From 11 August 2017 to 11 September 2018, 12,628 outpatient participants ranged from 19 to 84 years old were enrolled and analyzed. HPV DNA was amplified and tested by HPV GenoArray Test Kit. The vaginal ecology was detected by microscopic and biochemistry examinations. The diagnosis of Candida vaginitis was based on microscopic examination (spores, and/or hypha) and biochemical testing (galactosidase) for vaginal discharge by experts. Statistical analyses were performed using SAS 9.4. Continuous and categorical variables were analyzed by t-tests and by Chi-square tests, respectively. HPV infection risk factors were analyzed using multivariate logistic regression. Of the total number of participants, 1753 were infected with HPV (13.88%). Females aged ≥ 40 to < 50 years constituted the largest population of HPV-infected females (31.26%). The top 5 HPV subtypes affecting this population of 1753 infected females were the following: HPV-52 (28.01%), HPV-58 (14.83%), CP8304 (11.47%), HPV-53 (10.84%), and HPV-39 (9.64%). Age (OR 1.01; 95% CI 1–1.01; P < 0.05) and alcohol consumption (OR 1.30; 95% CI 1.09–1.56; P < 0.01) were found to be risk factors for HPV infection. However, the presence of Candida in the vaginal flora was found to be a protective factor against HPV infection (OR 0.62; 95% CI 0.48–0.8; P < 0.001). Comparing with our previous study of 2016, we conclude that the subtype distribution of HPV infection is relatively constant in Changsha. Our data suggest a negative correlation between vaginal Candida and HPV, however, more radical HPV management is required in this area for perimenopausal women and those who regularly consume alcohol.

Download Full-text

How condom use, number of receptive anal intercourse partners and history of external genital warts predict risk for external anal warts

International Journal of STD & AIDS ◽

10.1258/0956462053420176 ◽

2005 ◽

Vol 16 (3) ◽

pp. 203-211 ◽

Cited By ~ 9

Author(s):

D J Wiley ◽

Diane M Harper ◽

David Elashoff ◽

Michael J Silverberg ◽

Christine Kaestle ◽

...

Keyword(s):

Condom Use ◽

Anal Intercourse ◽

Consistent Condom ◽

Prior History ◽

Receptive Anal Intercourse ◽

Protective Effects ◽

Lifetime Number ◽

History Of ◽

Anal Warts ◽

External Genital Warts

Few analytic opportunities have allowed us to evaluate the role that specific sexual acts and male latex condoms play in the acquisition of external anal warts (EAW) using longitudinal data. The acquisition of EAWs occurs from epithelial contact with other HPV-infected surfaces, and hence is dependent upon sexual behaviour. Our objectives were to classify the relative importance of condom use, receptive anal intercourse (RAI) and prior history of EGWs on acquisition of EAWs. The observational Multicenter AIDS Cohort Study followed 2925 men over nine semiannual study visits for behavioural and physical examinations with laboratory testing. The main outcome measure was the occurrence of examiner-diagnosed EAWs in a homosexual population. EAWs were diagnosed among 10% of men studied across 22,157 visits reviewed for this study. Men with history of EGWs were more likely than those previously unaffected to have developed EAWs (cOR = 2.4 (2.0, 2.9)), as were men who reported multiple anoreceptive intercourse partners (e.g., compared with men who reported no RAI partners, men with 1, 2–5, ≥6 RAI partners had crude risk ratios 1.0 (0.8, 1.3), 1.6 (1.2, 2.1), 3.9 (2.7, 5.8), respectively). These relations persisted after other demographic and sexual risk factors were controlled for in the analyses. Consistent condom usage showed no protective effect for EAWs in our crude or adjusted analyses. Patient education messages should be tailored to reflect our uncertainty about the protective nature of condoms for the development of anal warts, but to continue to assert the protective effects of a limited lifetime number of sexual partners and the heightened risk for wart recurrence once infected.

Download Full-text

Food consumption and nutritional status of people living with HIV/AIDS (PLWHA): a case of Thika and Bungoma Districts, Kenya

Public Health Nutrition ◽

10.1017/s1368980009990826 ◽

2009 ◽

Vol 13 (4) ◽

pp. 475-479 ◽

Cited By ~ 9

Author(s):

Elizabeth Nafula Kuria

Keyword(s):

Nutritional Status ◽

Food Consumption ◽

Dietary Habits ◽

Well Being ◽

Hiv Positive ◽

People Living With Hiv ◽

Cross Sectional ◽

Significant Difference ◽

Living With Hiv ◽

Hiv Aids

AbstractObjectiveTo establish the food consumption, dietary habits and nutritional status of people living with HIV/AIDS (PLWHA) and adults whose HIV status is not established.DesignCross-sectional descriptive survey.SettingThika and Bungoma Districts, Kenya.SubjectsA random sample of 439 adults; 174 adults living with HIV/AIDS and 265 adults whose HIV/AIDS status was not established in Thika and Bungoma Districts.ResultsMajority of PLWHA consume foods that are low in nutrients to build up the immune system and help maintain adequate weight, and there is little variety in the foods they consume. More adults who are HIV-positive are undernourished than those whose status is not established. Of the HIV-positive adults, those with a BMI of ≤18·5 kg/m2 were 23·6 % (Thika 20·0 % and Bungoma 25·7 %) while of the adults whose status is not established those with BMI ≤ 18·5 kg/m2 were 13·9 % (Thika 9·3 % and Bungoma 16·7 %).ConclusionsAdults who are HIV-positive are more likely to be undernourished than those whose status is not established, as there is a significant difference (P = 0·000) between the nutritional status (BMI) of PLWHA and those whose HIV/AIDS status is not established. PLWHA consume foods that are low in nutrients to promote their nutritional well-being and health.

Download Full-text

Lack of HPV in pterygium with no evidence of autoinoculation and the role of cytokines in pterygium with dry eye

Scientific Reports ◽

10.1038/s41598-021-82114-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Lita Uthaithammarat ◽

Ngamjit Kasetsuwan ◽

Yuda Chongpison ◽

Pimpetch Kasetsuwan ◽

Usanee Reinprayoon ◽

...

Keyword(s):

Dry Eye ◽

Hpv Infection ◽

Cross Sectional Study ◽

Urine Samples ◽

Vascular Endothelial ◽

Cross Sectional ◽

Hpv Dna ◽

Polymerase Chain ◽

Endothelial Growth Factor

AbstractThis study evaluated human papillomavirus’s (HPV) role in pterygium pathogenesis, its autoinoculation from genitalia to ocular surface, potential cytokines involved, and crosstalk cytokines between pterygium and dry eye (DE). This cross-sectional study enrolled 25 healthy controls (HCs) and 116 pterygium patients. Four subgroups of pterygium and DE were used in cytokine evaluations. Conjunctival and pterygium swabs and first-void urine samples (i.e., genitalia samples) were collected for HPV DNA detection using real-time polymerase chain reaction. Tear cytokines interleukin (IL)-6, IL-18, and vascular endothelial growth factor (VEGF) in tears were evaluated. No HPV DNA was detected in conjunctival or pterygium swabs. No association was found between HPV DNA in urine samples and that from conjunctival or pterygium swabs. Tear VEGF levels were significantly higher in pterygium patients than in HCs, with no markedly different levels between primary and recurrent pterygia. Tear IL-6, IL-18, and tear VEGF were significantly higher in participants with DE, regardless of pterygium status. In conclusion, HPV infection was not a pathogenic factor of pterygia. The hypothesis of HPV transmitting from the genitals to ocular surfaces was nullified. Tear VEGF was involved in both pterygia and DE, whereas tear IL-6 and IL-18 played roles only in DE.

Download Full-text