Association of human immunodeficiency virus and anal human papillomavirus infection among homosexual men.
BACKGROUND
A previous study of men with proctitis, proctocolitis, or enteritis showed an association of anal human papillomavirus (HPV) infection with human immunodeficiency virus (HIV) infection. Because anorectal abnormalities may confound an observed association between anal HPV DNA and HIV seropositivity, the present study was undertaken among consecutive homosexual men seeking HIV serologic testing who were unselected for anorectal symptoms.


METHODS
Consecutive homosexual men underwent a standardized interview, physical examination, and collection of specimens for HIV serologic testing and detection of anal HPV DNA.


RESULTS
Anal HPV DNA was detected in eight (31%) of 26 HIV-seropositive men and in 10 (8%) of 119 HIV-seronegative men (odds ratio, 5.8; 95% confidence interval, 1.1 to 30.1, adjusted for history of sexually transmitted disease, current anorectal symptoms, and age). When men with anorectal symptoms were excluded from the analysis, anal HPV DNA was detected in 27% of seropositive men compared with 8% of seronegative men (odds ratio, 4.4; 95% confidence interval, 1.4 to 13.4). There was no difference between HIV-seropositive and HIV-seronegative men with respect to distribution of type of HPV DNA. Men with group II or III and group IV HIV disease were 4.1 and 10.9 times, respectively, more likely than HIV-seronegative men to have anal HPV DNA detected.


CONCLUSIONS
Because HIV-seropositive men appear to be at increased risk for the detection of anal HPV DNA, the natural course of anal HPV infection should be compared among HIV-seropositive and HIV-seronegative homosexual men.
Critchlow
C W
CW
Department of Biostatistics, University of Washington, Seattle 98195.
Holmes
K K
KK
Wood
R
R
Krueger
L
L
Dunphy
C
C
Vernon
D A
DA
Daling
J R
JR
Kiviat
N B
NB
D001004:Anus Diseases / Q000175:diagnosis* / Q000453:epidemiology; D016009:Chi-Square Distribution; D004279:DNA, Viral / Q000032:analysis; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology; D015528:HIV Seroprevalence; D015497:HIV-1; D006716:Homosexuality / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D009693:Nucleic Acid Hybridization; D016017:Odds Ratio; D027383:Papillomaviridae; D014412:Tumor Virus Infections / Q000175:diagnosis* / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology
D004279:DNA, Viral