High prevalence of anal squamous intraepithelial lesions in HIV-positive men despite the use of highly active antiretroviral therapy.
BACKGROUND
The impact of highly active antiretroviral therapy (HAART) on the natural history of HPV infection and anal squamous intraepithelial lesions (SIL) in HIV-infected men who have sex with men (MSM) is poorly documented. GOAL The goal of this study was to evaluate the prevalence of anal HPV infection and SIL inpatients under HAART.


METHODS
Forty-five HIV-infected protease inhibitor-experienced MSM were enrolled in a cross-sectional study. Each patient provided anal samples for anal cytology, histology, and human papillomavirus (HPV) DNA testing.


RESULTS
The patients had previously received HAART for a median of 32 months. Anal cytology was abnormal in 32 of 45 (71%) patients, including high-grade SIL in 10 patients (22%), low-grade SIL in 19 patients (42%), and atypical squamous cells of undetermined significance in 3 patients (7%). HPV DNA was detected 36/45 men (80%). The prevalence of anal SIL and HPV infection were similar in patients exhibiting a significant increase in CD4+ cell count after HAART initiation compared with those who did not.


CONCLUSIONS
Our results demonstrate a high prevalence of anal SIL, including high-grade SIL, and anal HPV infection in HIV-infected MSM despite immune restoration under HAART.
Piketty
Christophe
C
Department of Immunology, INSERM U 430 and Université Pierre et Marie Curie, Hôpital Européen Georges Pompidou, Paris, France. Christophe.piketty@egp.ap-hop-paris.fr
Darragh
Teresa M
TM
Heard
Isabelle
I
Da Costa
Maria
M
Bruneval
Patrick
P
Kazatchkine
Michel D
MD
Palefsky
Joel M
JM
D000328:Adult; D001003:Anal Canal / Q000473:pathology / Q000821:virology; D023241:Antiretroviral Therapy, Highly Active; D001005:Anus Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000032:analysis; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000235:genetics; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis; D014412:Tumor Virus Infections / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology
D004279:DNA, Viral; D012367:RNA, Viral