title: Anal squamous intraepithelial lesions are frequent among young HIV-infected men who have sex with men followed up at the Spanish AIDS Research Network Cohort (CoRIS-HPV).
abstract: The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV-infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS-HPV started in 2007, nested in the Spanish AIDS Research Network Cohort (CoRIS). Anal liquid cytology testing was performed. High-risk human papillomavirus (HR-HPV) infection was determined, and positive samples were genotyped. We analyzed all subjects up to April 2011. Multivariate logistic regression analyses were performed. A total of 551 subjects with baseline anal liquid cytologies were analyzed; 37.0% negative for intraepithelial lesion, 9.0% atypical squamous cells of uncertain significance (ASCUS), 41.0% low-grade SIL, 4.0% high-grade SIL and 9.0% inadequate. Prevalence of anal SIL (excluding ASCUS) in valid samples (n = 450) was 54.7% (95% confidence interval [CI] = 49.9-59.3). Globally HR-HPV prevalence was 81.7% (95% CI = 78.0-85.2). Multiple infections (≥2 HR-HPV genotypes) were documented in 77.7% (95% CI = 73.1-82.0). The only risk factor associated with anal SIL was the number of HR-HPV types; MSM with five or more HR-HPV genotypes had an odds ratio (OR) of anal SIL seven times greater (OR = 7.4; 95% CI = 2.8-19.6) than those with one HR-HPV genotype. No associations were found for age, educational level, smoking, geographical origin, CD4 T-cell count, antiretroviral treatment or number of sexual partners. The prevalence of anal SIL in young HIV-positive MSM is high, and the main risk factor is multiple infections with HR-HPV types.
authors: Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain.
authors: Cristina
authors: C
authors: González
authors: Montserrat
authors: M
authors: Torres
authors: Amparo
authors: A
authors: Benito
authors: Jorge
authors: J
authors: Del Romero
authors: Carmen
authors: C
authors: Rodríguez
authors: María
authors: M
authors: Fontillón
authors: Mónica
authors: M
authors: Trastoy
authors: Pompeyo
authors: P
authors: Viciana
authors: Julia
authors: J
authors: Del Amo
authors: Marta
authors: M
authors: Ortiz
authors: Beatriz
authors: B
authors: Hernández-Novoa
mesh_terms: D000328:Adult; D001005:Anus Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D015331:Cohort Studies; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D016015:Logistic Models; D008297:Male; D027383:Papillomaviridae / Q000302:isolation & purification; D011230:Precancerous Conditions / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D015995:Prevalence
keywords: HIV; HPV; anal; cytology; squamous intraepithelial lesion