title: Anal human papillomavirus infection is associated with HIV acquisition in men who have sex with men.
abstract: OBJECTIVE
  Human papillomavirus (HPV) is a common sexually transmitted agent that causes anogenital cancer and precancer lesions that have an inflammatory infiltrate, may be friable and bleed. Our aim was to determine the association between anal HPV infection and HIV acquisition.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  We recruited 1409 HIV-negative men who have sex with men from a community-based setting in Boston, Denver, New York and San Francisco. We used Cox proportional hazards regression modeling and assessed the independent association of HPV infection with the rate of acquisition of HIV infection.
  
  
  RESULTS
  Of 1409 participants contributing 4375 person-years of follow-up, 51 HIV-seroconverted. The median number of HPV types in HPV-infected HIV-seroconverters was 2 (interquartile range 1-3) at the time of HIV seroconversion. After adjustment for sexual activity, substance use, occurrence of other sexually transmitted infections and demographic variables, there was evidence (P = 0.002) for the effect of infection with at least two HPV types (hazard ratio 3.5, 95% confidence interval 1.2-10.6) in HIV seroconversion.
  
  
  CONCLUSIONS
  Anal HPV infection is independently associated with HIV acquisition. Studies that incorporate high-resolution anoscopy to more accurately identify HPV-associated disease are needed to determine the relationship between HPV-associated disease and HIV seroconversion.
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California 94143, USA. phong@php.ucsf.edu
authors.forename: Peter V
authors.initials: PV
authors.lastname: Chin-Hong
authors.forename: Marla
authors.initials: M
authors.lastname: Husnik
authors.forename: Ross D
authors.initials: RD
authors.lastname: Cranston
authors.forename: Grant
authors.initials: G
authors.lastname: Colfax
authors.forename: Susan
authors.initials: S
authors.lastname: Buchbinder
authors.forename: Maria
authors.initials: M
authors.lastname: Da Costa
authors.forename: Teresa
authors.initials: T
authors.lastname: Darragh
authors.forename: Dana
authors.initials: D
authors.lastname: Jones
authors.forename: Franklyn
authors.initials: F
authors.lastname: Judson
authors.forename: Beryl
authors.initials: B
authors.lastname: Koblin
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Joel M
authors.initials: JM
authors.lastname: Palefsky
mesh_terms: D000328:Adult; D001004:Anus Diseases / Q000821:virology*; D001900:Boston; D006679:HIV Seropositivity / Q000635:transmission / Q000821:virology*; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D030361:Papillomavirus Infections / Q000635:transmission / Q000821:virology; D011230:Precancerous Conditions / Q000821:virology*; D011446:Prospective Studies; D012367:RNA, Viral; D012495:San Francisco
chemical_list: D012367:RNA, Viral