CONHIV14 - HIV-related Infections, Co-infections and Cancers, etc. – Part three - page 11

P130
HUMAN PAPILLOMAVIRUS ANAL INFECTION AND ANAL CYTOLOGY IN
HIV-INFECTED AND HIV-UNINFECTED MEN WHO HAVE SEX WITH MEN
A.Latini
1
, M.G. Donà
1
, L. Ronchetti
2
, A. Giglio
3
, D. Moretto
3
, M. Colafigli
1
, V. Laquintana
2
, M. Frasca
1
,
M. Zaccarelli
4
, A. Antinori
4
, A. Cristaudo
1
, M. Giuliani
1
Introduction
Results (1)
Demographic characteristics
Overall, 180 HIV-infected and 438 HIV-uninfected
MSM were enrolled. Their median age was 41 yrs
(IQR 33-47) and 32 yrs (IQR 27-39), respectively.
Participants of both groups were mostly Caucasian
(92.2% and 97.0%, respectively).
HPV prevalence
Overall, 72.4% of the HIV-uninfected MSM were
positive for HPV at anal level. However, HPV
prevalence was significantly higher among the
HIV-infected individuals (93.3%, p<0.0001). More
than half of the HIV-uninfected MSM harbored
HR-HPVs (56.0%),
but these types were
significantly more common among HIV-infected
MSM (80.5%, p<0.0001). HPV 16 and/or 18
infection displayed a high prevalence in both
groups (22.4% and 31.1%, respectively; p=0.02).
HIV-infected participants were more likely to have
a multiple infection in comparison with HIV-
uninfected MSM (76.1% vs. 48.2%, p<0.0001).
Results (3)
Anal Cytology
Anal cytological abnormalities were found in
46.1% of the HIV-infected MSM, whereas
29.4% of the HIV-uninfected counterpart had
abnormal cytology (p=0.0002).
Atypical squamous cells of undetermined
significance (ASC-US) was the most frequent
report among those with abnormal cytology for
both populations.
Although at a low prevalence, H-SILs were
exclusively observed among the HIV-infected
participants (1.2%).
Aims
There is a growing interest in estimating the burden
of anal HPV infection in MSM, especially those
HIV-infected, and in clarifying the utility of AC
screening protocols
For these reasons, we enrolled HIV-infected and -
uninfected MSM, with the aim to assess:
the prevalence and genotype-specific
distribution of anal HPV infection;
the presence of anal cytological abnormalities;
the differences between the two populations
regarding anal HPV infection and abnormal
cytology.
Conclusions
HIV-infected MSM showed a significantly
higher rate of anal HPV infection and
abnormal cytology, than the HIV-
uninfected counterpart, confirming that
HIV-1 infection poses a significant risk
for anal HPV infection as well as for
cellular abnormalities. Screening for anal
cancer and vaccination strategies for the
prevention of HPV infection should be
considered for this population.
Methods
Enrollment
All participants were recruited among attendees of
the HIV/STI Unit of the San Gallicano
Dermatological Institute (Rome, Italy). HIV-
infected MSM were recruited from March 2011 to
March 2014, while HIV-uninfected MSM were
recruited from August 2009 to December 2012
among individuals participating in a screening
program for HIV-1 and other Sexually Transmitted
Infection (COROH Project).
Anal sample collection
Anal samples were collected using a sterile Dracon
swab inserted into the anal canal up to 4 cm. The
cells were dispersed in 20 ml of PreservCyt
(Hologic).
Cytology
Liquid-based cytologic slides were obtained using
the Thinprep 2000 processor (Hologic). Anal
cytology was classified according to the Bethesda
2001 guidelines.
HPV testing
The Linear Array HPV Genotyping test (Roche
Diagnostics) was used. HPV16, 18, 26, 31, 33, 35, 39,
45, 51, 52, 53, 56, 58, 59, 66, 67, 68, 69, 70, 73 and 82
were considered as High-risk (HR) types. HPV 6,
11, 40, 42, 54, 55, 61, 62, 64, 71, 72, 81, 83, 84, CP6108
and IS39 were considered as Low-risk (LR) types.
Anal cancer (AC) represents one of the most
common tumors in individuals with HIV-1
infection
AC incidence has been greatly increasing over the
last decades, despite the introduction of the
antiretroviral therapy (cART)
85% of AC cases can be attributed to Human
Papillomavirus (HPV) infection
AC incidence is particularly high in men who have
sex with men (MSM), and is twice as high in those
HIV-1 infected (up to 131 cases per 100,000 p-y)
In Europe, no standardized guidelines have been
defined for a programmatic, periodical AC
screening for HIV-infected individuals, and anal
cytology is rarely included in their clinical
management
Results (2)
HPV type-specific prevalence
HPV16 was the most common genotype in both
populations (23.3% among HIV-infected MSM and
17.6% among HIV-uninfected ones). HPV6 was the
most frequent LR type in both groups of
individuals (21.1% for HIV-infected and 9.8% for
HIV-uninfected MSM).
Low-risk
High-risk
Low-risk
High-risk
Contact info:
1 HIV/STI UNIT, San Gallicano Dermatologic Institute, (IRCCS), Rome, Italy
2 Pathology Department, Regina Elena National Cancer Institute (IRCCS), Rome, Italy
3 Clinical Pathology and Microbiology Department, San Gallicano Dermatologic Institute, (IRCCS)
4 National Institute for Infectious Diseases, Lazzaro Spallanzani, (IRCCS), Rome, Italy
1...,2,3,4,5,6,7,8,9,10 12
Powered by FlippingBook