Prevalence and risk factors for anal human papillomavirus infection in human immunodeficiency virus (HIV)-positive and high-risk HIV-negative women.
Little is known about the epidemiology of anal human papillomavirus (HPV) infection in women. We studied 251 human immunodeficiency virus (HIV)-positive and 68 HIV-negative women for the presence of anal HPV by use of polymerase chain reaction (PCR) and hybrid capture. Medical and behavioral risk factors were evaluated; 76% of HIV-positive and 42% of HIV-negative women were found to have anal HPV DNA via analysis by PCR (relative risk [RR], 1.8; 95% confidence interval [CI], 1.3-2.5). Among 200 women for whom there were concurrent anal and cervical HPV data, anal HPV was more common than cervical HPV in both HIV-positive (79% vs. 53%) and HIV-negative women (43% vs. 24%). By multivariate analysis of HIV-positive women, CD4(+) cell counts </=200 cells/mm(3), compared with counts >500 cells/mm(3) (RR, 1.4; 95% CI, 1.1-1.5), and cervical HPV infection (RR, 1.3; 95% CI, 1.1-1.4) were associated with anal HPV infection. Women >45 years old had reduced risk, compared with women <36 years old (RR, 0.80; 95% CI, 0.50-0.99), as did African American women (RR, 0.86; 95% CI, 0.72-1.0), compared with white women. Anal HPV infection is underrecognized in HIV-positive and high-risk HIV-negative women.
Palefsky
J M
JM
Departments of Laboratory Medicine, Medicine, and Stomatology, University of California, San Francisco, CA 94143-0100, USA. joelp@medicine.ucsf.edu
Holly
E A
EA
Ralston
M L
ML
Da Costa M
Greenblatt
R M
RM
D000328:Adult; D001003:Anal Canal / Q000821:virology; D001004:Anus Diseases / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D002584:Cervix Uteri / Q000821:virology; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications*; D018023:HIV Seronegativity; D015497:HIV-1 / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D002577:Uterine Cervical Diseases / Q000150:complications / Q000453:epidemiology / Q000821:virology; D019562:Viral Load
D004279:DNA, Viral; D012367:RNA, Viral