title: Factors affecting the prevalence of strongly and weakly carcinogenic and lower-risk human papillomaviruses in anal specimens in a cohort of men who have sex with men (MSM).
abstract: BACKGROUND
  MSM are at higher risk for invasive anal cancer. Twelve human papillomaviruses (HPVs) cause cervical cancer in women (Group 1 high-risk HPVs (hrHPVs)) and 13 HPVs are probable/possible causes (Group 2 hrHPVs) of cervical malignancy. HPVs rarely associated with malignancy are classified as lower-risk HPVs (lrHPVs).
  
  
  METHODS
  Dacron-swab anal-cytology specimens were collected from and data complete for 97% (1262/1296) of Multicenter AIDS Cohort Study (MACS) men tested for HPVs using the Linear Array assay. Multivariate Poisson regression analyses estimated adjusted prevalence ratios for Group 1/2 hrHPVs and lrHPVs, controlling for the effects of age, race, ethnicity, sexual partnerships, smoking; HIV-infection characteristics, treatment, and immune status among HIV-infected men.
  
  
  RESULTS
  HIV-infected men showed 35-90% higher prevalence of Group 1/2 hrHPVs and lrHPVs than HIV-uninfected men, and higher prevalence of multi-Type, and multiple risk-group infections. CD4+ T-cell count was inversely associated with HPV Group 2 prevalence (p<0.0001). The number of receptive anal intercourse (RAI) partners reported in the 24 months preceding HPV testing predicted higher prevalence of Group 1/2 hrHPVs. Men reporting ≥30 lifetime male sex partners before their first MACS visit and men reporting ≥1 RAI partners during the 24 months before HPV testing showed 17-24% and 13-17% higher prevalence of lrHPVs (p-values ≤0.05). Men reporting smoking between MACS visit 1 and 24 months before HPV testing showed 1.2-fold higher prevalence of Group 2 hrHPVs (p = 0.03). Both complete adherence to CART (p = 0.02) and HIV load <50 copies/mL (p = 0.04) were protective for Group 1 hrHPVs among HIV-infected men.
  
  
  CONCLUSIONS
  HIV-infected men more often show multi-type and multi-group HPV infections HIV-uninfected men. Long-term mutual monogamy and smoking cessation, generally, and CART-adherence that promotes (HIV) viremia control and prevents immunosuppression, specifically among HIV-infected MSM, are important prevention strategies for HPV infections that are relevant to anal cancer.
authors.affiliation: School of Nursing, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Dorothy J
authors.initials: DJ
authors.lastname: Wiley
authors.forename: Xiuhong
authors.initials: X
authors.lastname: Li
authors.forename: Hilary
authors.initials: H
authors.lastname: Hsu
authors.forename: Eric C
authors.initials: EC
authors.lastname: Seaberg
authors.forename: Ross D
authors.initials: RD
authors.lastname: Cranston
authors.forename: Stephen
authors.initials: S
authors.lastname: Young
authors.forename: Gypsyamber
authors.initials: G
authors.lastname: D'Souza
authors.forename: Otoniel
authors.initials: O
authors.lastname: Martínez-Maza
authors.forename: Katherine
authors.initials: K
authors.lastname: DeAzambuja
authors.forename: Kristofer
authors.initials: K
authors.lastname: Chua
authors.forename: Shehnaz K
authors.initials: SK
authors.lastname: Hussain
authors.forename: Roger
authors.initials: R
authors.lastname: Detels
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000821:virology*; D001005:Anus Neoplasms / Q000209:etiology / Q000821:virology*; D015658:HIV Infections / Q000150:complications; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000150:complications*; D012307:Risk Factors