title: High-grade anal intraepithelial neoplasia among HIV-1-infected men screening for a multicenter clinical trial of a human papillomavirus vaccine.
abstract: OBJECTIVE
  High-grade anal intraepithelial neoplasia (HGAIN) is the precursor lesion to invasive anal cancer. Human papillomavirus (HPV) vaccination holds great promise for preventing anal cancer.
  
  
  METHODS
  We examined 235 HIV-1-infected men screening for participation in a multisite clinical trial of a quadrivalent HPV vaccine. All participants had anal swabs obtained for HPV testing and cytology and high-resolution anoscopy with biopsies of visible lesions to assess for HGAIN.
  
  
  RESULTS
  HPV types 16 and 18 were detected in 23% and 10%, respectively; abnormal anal cytology was found in 56% and HGAIN in 30%. HGAIN prevalence was significantly higher in those with HPV16 detection compared to those without (38% vs 17%; P = .01). Use of antiretroviral therapy and nadir and current CD4+ cell count were not associated with abnormal anal cytology or HGAIN.
  
  
  CONCLUSIONS
  HGAIN is highly prevalent in HIV-infected men. Further studies are needed on treatment and prevention of HGAIN.
authors.affiliation: Division of Infectious Diseases, Weill Cornell Medical College, New York, New York 10011, USA. tiw2001@med.cornell.edu
authors.forename: Timothy
authors.initials: T
authors.lastname: Wilkin
authors.forename: Jeannette Y
authors.initials: JY
authors.lastname: Lee
authors.forename: Shelly Y
authors.initials: SY
authors.lastname: Lensing
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stier
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Goldstone
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Berry
authors.forename: Naomi
authors.initials: N
authors.lastname: Jay
authors.forename: David M
authors.initials: DM
authors.lastname: Aboulafia
authors.forename: Mark H
authors.initials: MH
authors.lastname: Einstein
authors.forename: Alfred
authors.initials: A
authors.lastname: Saah
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Mitsuyasu
authors.forename: Joel M
authors.initials: JM
authors.lastname: Palefsky
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001005:Anus Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D018791:CD4 Lymphocyte Count; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000517:prevention & control*; D015497:HIV-1; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D053918:Papillomavirus Vaccines / Q000276:immunology*; D014611:Vaccination
chemical_list: D053918:Papillomavirus Vaccines