title: Penile intraepithelial neoplasia is frequent in HIV-positive men with anal dysplasia.
abstract: Anogenital human papillomavirus (HPV)-infection is common in HIV-infected men who have sex with men (HIV+MSM). These patients have a strongly increased risk of HPV-induced anal cancer and its precursor lesion, anal intraepithelial neoplasia (AIN), and a moderately increased risk for penile cancer. Only limited data exist on penile intraepithelial neoplasia (PIN) in HIV+MSM. We determined the prevalence and evaluated the virologic characteristics of PIN and AIN in 263 HIV+MSM. In case of histologically confirmed PIN (and AIN), HPV-typing, HPV-DNA load determination, and immunohistochemical staining for p16(INK4a) were performed. PIN was detected in 11 (4.2%) and AIN in 156 (59.3%) patients. Ten PIN patients also had AIN within the observation period. Four clinical types of PINs could be distinguished. High-risk-alpha-HPV-DNA was found in 10 PIN lesions, with HPV16 being the most frequent type. Infections with multiple HPV-types were common. All high-grade lesions had high-risk-HPV-DNA-loads > or = 1 HPV-copy/beta-globin-gene-copy. Cutaneous beta-HPVs were found in PIN and AIN, but beta-HPV-DNA loads were very low, irrespective of the histological grade. p16(INK4a) Expression was detectable in all PIN lesions and correlated both with the histological grade and with high-risk HPV-DNA loads. In view of the PIN prevalence found in our study, all HIV+MSM should be screened for PIN in addition to AIN screening.
authors.affiliation: Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kreuter
authors.forename: Norbert H
authors.initials: NH
authors.lastname: Brockmeyer
authors.forename: Soenke J
authors.initials: SJ
authors.lastname: Weissenborn
authors.forename: Thilo
authors.initials: T
authors.lastname: Gambichler
authors.forename: Markus
authors.initials: M
authors.lastname: Stücker
authors.forename: Peter
authors.initials: P
authors.lastname: Altmeyer
authors.forename: Herbert
authors.initials: H
authors.lastname: Pfister
authors.forename: Ulrike
authors.initials: U
authors.lastname: Wieland
mesh_terms: D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D001005:Anus Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D004279:DNA, Viral / Q000378:metabolism; D018450:Disease Progression; D006678:HIV / Q000235:genetics; D015658:HIV Infections; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010412:Penile Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D004279:DNA, Viral