Abnormal anal cytology in high-risk human papilloma virus infection in HIV-infected Australians.
OBJECTIVE
To assess the prevalence of abnormal anal cytology and high-risk human papilloma virus (HPV)-type infection in HIV-infected people with a CD4 cell count >300 cells/microl.


METHODS
The clinic-based patient population included 126 HIV-infected people: 124 men who have sex with men, and two women (median age 45 years; CD4 cell count >300 cells/microl). Anal cytology swabs were placed into liquid-based medium for HPV typing by Hybrid Capture-2 assay and cytological assessment, by a single cytopathologist.


RESULTS
106 (84%) participants were infected with high-risk HPV; 17 (14%) had no high-risk types of HPV detected; three (2%) had no HPV assay result because of an inadequate sample. Sixteen (13%) participants had cytological evidence of high-grade squamous intraepithelial (HGSIL) changes, 100% of whom had high-risk HPV types detected, and 13 (10%) had atypical squamous cells of undetermined significance with possible high-grade changes (ASCUS-H), 92% of whom had high-risk HPV types detected. Low-grade changes (LSIL) were detected in 24 (19%) participants, 96% of whom had high-risk HPV types, 32 (25%) had ASCUS with 88% high-risk HPV types, 30 (24%) had normal cytology with 73% high-risk HPV types, and 11 (9%) samples were inadequate for cytological assessment. The odds ratio of participants with high-risk HPV having abnormal anal cytology on anal swab was 5.03 (95% CI 1.45 to 17.39).


CONCLUSIONS
High-risk HPV types are common in this HIV+ population with a CD4 cell count >300 cells/microl. The presence of high-risk HPV types was associated with abnormal anal cytology such as HGSIL and ASCUS-H.
Anderson
J
J
Carlton Clinic, 88 Rathdowne St, Carlton, Melbourne, Vic 3053, Australia.
Hoy
J
J
Hillman
R
R
Gittleson
C
C
Hartel
G
G
Medley
G
G
Basser
R
R
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D000328:Adult; D001004:Anus Diseases / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D018791:CD4 Lymphocyte Count; D005260:Female; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D015995:Prevalence; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology