scholarly journals High Rates of Anal High-Grade Squamous Intraepithelial Lesions in HIV-Infected Women Who Do Not Meet Screening Guidelines

2016 ◽  
Vol 64 (3) ◽  
pp. 289-294 ◽  
Author(s):  
Michael Gaisa ◽  
Fanny Ita-Nagy ◽  
Keith Sigel ◽  
Yotam Arens ◽  
Mary Ann Hennessy ◽  
...  
Keyword(s):  
Sexual Practices ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Screening Guidelines ◽  
Secondary Screen ◽  
Immunodeficiency Virus ◽  
Anal Cytology ◽  
Receptive Anal Sex ◽  
History Of ◽  
Intraepithelial Lesions

Abstract Background Human immunodeficiency virus (HIV)–infected women have a higher burden of anal high-grade squamous intraepithelial lesions (HSIL) and anal cancer (AC) compared with HIV-uninfected women. Guidelines for AC screening in this population are heterogeneous. Here we report outcomes and risk factors for anal HSIL following implementation of universal AC screening offered to all HIV-infected women. Methods Data from women who underwent AC screening with anal cytology from April 2009 to July 2014 were analyzed. Routine clinical data included anal and cervical cytology, demographic/behavioral data, and high-resolution anoscopy (HRA) results. We evaluated the association of cytology with HRA results, and predictors of HSIL pathology, and compared rates of HSIL pathology among women meeting screening guidelines to those who did not. Results Seven hundred forty-five HIV-infected women were screened with anal cytology. Thirty-nine percent had abnormal anal cytology on initial screen and 15% on secondary screen; 208 women underwent HRA following abnormal anal cytology. HSIL was found in 26% and 18% of anal biopsies following initial and secondary screening, respectively. One woman had AC. Cigarette smoking more than doubled HSIL risk. Among women who underwent AC screening despite not meeting existing guideline criteria, 21% and 10%, respectively, were found to have HSIL on biopsy. Neither meeting criteria for screening nor history of receptive anal sex was significantly associated with HSIL. Conclusions Anal HSIL is common in HIV-infected women. Substantial numbers of HSIL would have been missed by strictly adhering to existing AC screening guidelines. These results support routine screening of all HIV-infected women regardless of human papillomavirus history or sexual practices.

scholarly journals Prevalence of and Risk Factors for Anal High-grade Squamous Intraepithelial Lesions in Women Living with Human Immunodeficiency Virus

2019 ◽  
Vol 70 (8) ◽  
pp. 1701-1707 ◽  
Author(s):  
Elizabeth A Stier ◽  
Shelly Y Lensing ◽  
Teresa M Darragh ◽  
Ashish A Deshmukh ◽  
Mark H Einstein ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
High Resolution ◽  
The United States ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Intraepithelial Lesions

Abstract Background Women living with human immunodeficiency virus (WLHIV) have disproportionately high rates of squamous cell carcinoma of the anus compared with the general population of women. Anal high-grade squamous intraepithelial lesions (HSILs) precede anal cancer, and accurate studies of HSIL prevalence among WLHIV in the United States are lacking. Methods The AIDS Malignancy Consortium 084 study was a multicenter national trial to evaluate the prevalence of and risk factors for anal HSIL in a US cohort. Eligible participants were WLHIV aged ≥18 years with no history of anal HSIL. Study participants had an examination including collection of cervical/vaginal and anal specimens, followed by high-resolution anoscopy with biopsy. Results We enrolled 256 women with evaluable anal pathology. The mean age was 49.4 years, 64% women were non-Hispanic black, 67% were former or current smokers, and 56% reported ever having anal sex with a man. The median CD4 T-cell count was 664 cells/μL. The prevalence of anal histologic HSIL (hHSIL) was 27% (95% confidence interval [CI], 22%–33%). There was a strong concordance (240/254) between local and consensus pathologists for hHSIL vs less than hHSIL (κ = 0.86 [95% CI, .79–.93]). Current CD4 count of ≤200 cells/μL was the strongest predictor of consensus anal hHSIL diagnosis (adjusted odds ratio [aOR], 10.34 [95% CI, 3.47–30.87]). History of anoreceptive intercourse was also associated with hHSIL (aOR, 2.44 [95% CI, 1.22–4.76]). Conclusions The prevalence of anal hHSIL in WLHIV in the United States was 27% in this study where all participants received high-resolution anoscopy and biopsy.

8. Human papillomavirus mRNA testing for the detection of anal high-grade squamous intraepithelial lesions in HIV-positive men who have sex with men

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 573
Author(s):  
Elena Sendagorta Cudós ◽  
Maria P. Romero Gomez ◽  
Beatriz Hernandez Novoa ◽  
Ander Mayor ◽  
Jose I. Bernardino De La Serna ◽  
...  
Keyword(s):  
Predictive Value ◽  
Screening Program ◽  
University Hospital ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Cross Sectional ◽  
Hpv Dna ◽  
Hpv E6 ◽  
Anal Cytology ◽  
Intraepithelial Lesions

Background Currently, screening for anal high-grade squamous intraepithelial lesions (HSIL) relies on anal cytology and high-resolution anoscopy (HRA). Since this approach has limited sensitivity and specificity for detecting anal HSIL, there is increasing interest in the role of biomarkers for predicting anal HSIL. The aim of this study is to evaluate the diagnostic accuracy of HPV E6/E7-mRNA expression for the detection of anal HSIL in MSM HIV-infected patients, in comparison to DNA-HR-HPV and anal cytology. Methods: This cross-sectional screening study included 101 MSM followed at the HIV-unit of La Paz University Hospital. Intra-anal swabs from patients participating in a screening program including cytology, HRA and histology were analysed. HR-HPV-DNA detection was performed by means of the CLART HPV2 assay (GENOMICA SAU.). E6/E7-mRNA detection of HR-HPV types 16, 18, 31, 33 and 45 was performed using the NucliSENS-EasyQ assay (BioMérieux, Marcy l’Etoile, France). Results: HR-HPV DNA and HPV E6/E7 mRNA were detected in 82% and 57% of the anal smears, respectively. Anal cytology screening was abnormal in 70.3%. For the detection of HSIL sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 71.7%, 55.6%, 57.9%, and 69.8% for E6/E7-mRNA testing, respectively, compared with 97.9%, 31.5%, 55.4% and 94.4%, respectively, for HR-HPV DNA testing and 83%, 40.7%, 54.9%, 73.3%, respectively, for cytology testing. Conclusions: In comparison with the other tests, the NucliSENS EasyQ HPV assay yielded a lower clinical sensitivity but a higher clinical specificity and PPV for the detection of anal HSIL in MSM HIV-infected patients.

scholarly journals Anal High-Grade Squamous Intraepithelial Lesions in Human Immunodeficiency Virus–Infected Men

2017 ◽  
Vol 147 (3) ◽  
pp. 315-321 ◽  
Author(s):  
Yuxin Liu ◽  
Xiaofei Wang ◽  
Tamara Kalir ◽  
David Chhieng ◽  
Keith Sigel ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Immunodeficiency Virus ◽  
Intraepithelial Lesions

scholarly journals Screening for Anal Cancer in Women With a History of Vulvar High-Grade Squamous Intraepithelial Lesions

2019 ◽  
Vol 23 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Lily Proctor ◽  
Troy Grennan ◽  
Arianne Albert ◽  
Dianne Miller ◽  
Leslie Sadownik ◽  
...  
Keyword(s):  
Anal Cancer ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
History Of ◽  
Intraepithelial Lesions

Prevalence of Abnormal Anal Cytology and High-Grade Squamous Intraepithelial Lesions Among a Cohort of HIV-Infected Men Who Have Sex With Men

2014 ◽  
Vol 57 (4) ◽  
pp. 475-481 ◽  
Author(s):  
Elena Sendagorta ◽  
Pedro Herranz ◽  
Hector Guadalajara ◽  
Jose Ignacio Bernardino ◽  
Jose María Viguer ◽  
...  
Keyword(s):  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Anal Cytology ◽  
Sex With Men ◽  
Intraepithelial Lesions
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