Genotyping of human papillomavirus DNA in anal biopsies and anal swabs collected from HIV-seropositive men with anal dysplasia.
BACKGROUND
Human papillomavirus (HPV) causes anal intraepithelial neoplasia (AIN) in HIV-seropositive men. The detection of HPV genotypes in anal biopsies and swabs was compared.


METHODS
HPV DNA was detected in anal swabs and biopsies obtained concurrently from 154 HIV-seropositive men [31 without AIN, 60 low-grade AIN (AIN-1), 62 high-grade AIN (AIN-2,3), and 1 indeterminate AIN] under or eligible to highly active antiretroviral therapy.


RESULTS
HPV DNA was detected in 24.2% of normal biopsies compared with 93.5% with AIN-2,3 (P < 0.001) and 88.3% with AIN-1 (P < 0.001). The proportion of biopsies containing multiple genotypes was greater in AIN-1 (n = 21, 35.0%; P = 0.002) and AIN-2,3 (n = 38, 58%; P < 0.001) than in normal biopsies (n = 2, 6.5%). The most frequent genotypes in order of frequency were in AIN-2,3 biopsies HPV-16, 18, 58, and 45 and were in AIN-1 biopsies HPV-6, 11, 16, and 39. Controlling for age, CD4 count, and smoking, the presence of high-risk HPV DNA in biopsies [odds ratio (OR) = 50.8, 95% confidence interval (CI): 13.0 to 199.5] but not in swabs (OR = 2.0, 95% CI: 0.6 to 7.0) was associated with AIN-2,3.


CONCLUSIONS
AIN-2,3 was associated with high-risk HPV infection detected in biopsies but not in swabs in men under or starting highly active antiretroviral therapy, possibly due to the presence of HPV foci outside of the neoplastic lesion.
Gohy
Laurent
L
Département de Microbiologie, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
Gorska
Isabella
I
Rouleau
Danielle
D
Ghattas
Georges
G
Pokomandy
Alexandra de
Ad
Vézina
Sylvie
S
Coté
Pierre
P
Macleod
John
J
Allaire
Guy
G
Hadjeres
Rachid
R
Kornegay
Janet R
JR
Franco
Eduardo
E
Coutlée
François
F
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000821:virology; D000293:Adolescent; D000328:Adult; D000368:Aged; D052685:Alphapapillomavirus / Q000235:genetics* / Q000302:isolation & purification; D001004:Anus Diseases / Q000150:complications / Q000821:virology*; D001706:Biopsy; D002278:Carcinoma in Situ / Q000150:complications* / Q000821:virology*; D004279:DNA, Viral; D005838:Genotype; D006679:HIV Seropositivity / Q000150:complications / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000821:virology; D016133:Polymerase Chain Reaction
D004279:DNA, Viral