title: Hybrid Capture II detection of oncogenic human papillomavirus: a useful tool when evaluating men who have sex with men with atypical squamous cells of undetermined significance on anal cytology.
abstract: OBJECTIVE
  In the cervix and anus, patients with atypical squamous cells of undetermined significance often do not have high-grade squamous intraepithelial lesions. In women with atypical squamous cells of undetermined significance, Hybrid-Capture II testing for oncogenic high-risk human papillomavirus is performed and those without high-risk human papillomavirus often are observed. We endeavored to determine whether Hybrid-Capture II testing would be beneficial in men who have sex with men with atypical squamous cells of undetermined significance.
  
  
  METHODS
  We performed a retrospective chart review of men who have sex with men with atypical squamous cells of undetermined significance who had high-resolution anoscopy and Hybrid-Capture II.
  
  
  RESULTS
  A total of 290 men were identified (mean age, 42 years), and 212 (73 percent) were HIV-negative. High-grade squamous intraepithelial lesions were found in 50 (17 percent): 23 (10 percent) who were HIV-negative and 27 (35 percent) who were HIV-positive men. High-risk human papillomavirus was found in 138 (48 percent); 91 (43 percent) of HIV-negative and 47 (60 percent) of HIV-positive men. The sensitivity, specificity, positive predictive value, and negative predictive value of atypical cells of undetermined significance cytology combined with Hybrid-Capture II were 84, 60, 30, and 95 percent, respectively. There was no significant difference between all men vs. those who were HIV-positive or HIV-negative except for the positive predictive value.
  
  
  CONCLUSIONS
  Hybrid-Capture II testing for high-risk human papillomavirus in men who have sex with men with atypical cells of undetermined significance and referring only those with high-risk human papillomavirus reduces the number who require high-resolution anoscopy by more than half. Five percent with high-grade squamous intraepithelial lesions would be missed.
authors.affiliation: Mt. Sinai School of Medicine, Department of Surgery, New York, New York, USA. segmd@prodigy.net
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Goldstone
authors.forename: Adam Z
authors.initials: AZ
authors.lastname: Kawalek
authors.forename: Robert N
authors.initials: RN
authors.lastname: Goldstone
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Goldstone
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000235:genetics* / Q000302:isolation & purification; D001003:Anal Canal / Q000473:pathology* / Q000821:virology; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D003113:Colonoscopy; D003937:Diagnosis, Differential; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods; D011230:Precancerous Conditions; D011237:Predictive Value of Tests; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis*; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology
chemical_list: D012367:RNA, Viral