title: A comparison of human papillomavirus genotype-specific DNA and E6/E7 mRNA detection to identify anal precancer among HIV-infected men who have sex with men.
abstract: BACKGROUND
  Human papillomavirus (HPV) RNA detection is reportedly more specific for the detection of anogenital precancer than HPV DNA but it is unknown whether this is due to detection of RNA or due to HPV genotype restriction.
  
  
  METHODS
  A total of 363 human immunodeficiency virus (HIV)-positive men who have sex with men had two anal cytology samples taken and were evaluated using high-resolution anoscopy and biopsies of visible lesions. Anal specimens were tested for E6/E7 RNA for five carcinogenic HPV genotypes (HPV16, 18, 31, 33, and 45) and tested for the DNA of 13 carcinogenic HPV genotypes.
  
  
  RESULTS
  DNA testing was more likely to be positive than RNA testing (53% vs. 48%; P = 0.02) for the same five HPV genotypes in aggregate. When restricted to five HPV genotypes targeted by the RNA test, the sensitivity to detect anal precancer was the same for DNA and RNA (81%), whereas RNA was more specific than DNA (65% vs. 58%; P = 0.007). In comparison, DNA detection of all 13 carcinogenic HPV genotypes was more sensitive (96% vs. 81%; P = 0.001) but much less specific (65% vs. 33%; P < 0.001) as compared with RNA detection of the five HPV genotypes.
  
  
  CONCLUSIONS
  After controlling for HPV genotypes, RNA was only slightly more specific than DNA detection for anal precancer.
  
  
  CONCLUSIONS
  DNA or RNA testing for a subset of the most carcinogenic HPV genotypes may be useful for distinguishing between those HPV-positive men at higher and lower risk of anal precancer and cancer.
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Castle
authors.forename: Stephen
authors.initials: S
authors.lastname: Follansbee
authors.forename: Sylvia
authors.initials: S
authors.lastname: Borgonovo
authors.forename: Diane
authors.initials: D
authors.lastname: Tokugawa
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Schwartz
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Lorey
authors.forename: Brandon
authors.initials: B
authors.lastname: LaMere
authors.forename: Julia C
authors.initials: JC
authors.lastname: Gage
authors.forename: Barbara
authors.initials: B
authors.lastname: Fetterman
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Darragh
authors.forename: Ana Cecilia
authors.initials: AC
authors.lastname: Rodriguez
authors.forename: Nicolas
authors.initials: N
authors.lastname: Wentzensen
mesh_terms: D000328:Adult; D017677:Age Distribution; D001005:Anus Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000473:pathology* / Q000821:virology; D014408:Biomarkers, Tumor / Q000235:genetics*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D005838:Genotype; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D018451:Homosexuality, Male; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D011230:Precancerous Conditions / Q000235:genetics / Q000473:pathology* / Q000821:virology; D015995:Prevalence; D011379:Prognosis; D012333:RNA, Messenger / Q000032:analysis / Q000235:genetics; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012725:Sexual Behavior
chemical_list: D014408:Biomarkers, Tumor; D004279:DNA, Viral; D012333:RNA, Messenger