title: Human papillomavirus genotype attribution and estimation of preventable fraction of anal intraepithelial neoplasia cases among HIV-infected men who have sex with men.
abstract: BACKGROUND
  The prevention of human papillomavirus (HPV)-induced anal cancer in high-risk populations such as human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) remains an urgent priority, given rising incidence rates despite widespread antiretroviral therapy use.
  
  
  METHODS
  HPV genotypes and anal disease prevalence, by cytology and histopathologic findings, were evaluated among 363 HIV-infected MSM. We modeled fractions of high-grade anal intraepithelial neoplasia (HGAIN) attributable to individual carcinogenic HPV genotypes and estimated the range of the proportion of HGAIN cases potentially preventable by prophylactic HPV vaccines.
  
  
  RESULTS
  HPV16 was the most common genotype overall (26.4% of cases) and among HGAIN cases (55%). Prevalence of multiple (≥ 2) carcinogenic HPV genotypes increased from 30.9% in cases of AIN grade <1 to 76.3% in cases of AIN grade 3 (P(trend) < .001). The fractions of HGAIN cases attributable to carcinogenic HPV16/18 targeted by currently licensed bivalent and quadrivalent HPV vaccines ranged from 12% to 61.5%, and the fractions attributable to carcinogenic HPV16/18/31/33/45/52/58 targeted by an investigational nonavalent HPV vaccine ranged from 39% to 89.4%.
  
  
  CONCLUSIONS
  Our analytical framework allows estimation of HGAIN cases attributable to individual HPV genotypes in the context of multiple concurrent HPV infections, which are very common among HIV-infected MSM. Our results suggest that licensed and investigational HPV prophylactic vaccines have the potential to prevent a substantial proportion of HGAIN cases in this population.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland 20852, USA. vikrant.sahasrabuddhe@nih.gov
authors.forename: Vikrant V
authors.initials: VV
authors.lastname: Sahasrabuddhe
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 J
authors.initials: BJ
authors.lastname: LaMere
authors.forename: Julia C
authors.initials: JC
authors.lastname: Gage
authors.forename: Barbara
authors.initials: B
authors.lastname: Fetterman
authors.forename: Sean
authors.initials: S
authors.lastname: Boyle
authors.forename: Mark
authors.initials: M
authors.lastname: Sadorra
authors.forename: Scott Dahai
authors.initials: SD
authors.lastname: Tang
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Darragh
authors.forename: Nicolas
authors.initials: N
authors.lastname: Wentzensen
mesh_terms: D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D060085:Coinfection; D003430:Cross-Sectional Studies; D005838:Genotype; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology; D053918:Papillomavirus Vaccines; D015995:Prevalence; D012725:Sexual Behavior
chemical_list: D053918:Papillomavirus Vaccines