title: Anal cytology and p16 immunostaining for screening anal intraepithelial neoplasia in HIV-positive and HIV-negative men who have sex with men: a cross-sectional study.
abstract: Summary Akin to cervical cancer in sexually-active women, men who have sex with men (MSM) are predisposed to anal cancers, especially those with HIV co-infection. This cross-sectional study endeavored to assess the prevalence of anal dysplasia using Pap smears and p16 immunostaining amongst Indian MSM. A total of 31 consecutive HIV-positive and 34 HIV-negative MSM, from a cohort of sexually transmitted infection clinic attendees, underwent anal cytological evaluation with Pap smear and p16 staining. Chi square test and coefficient of correlation were used for comparison. Eighteen (27.7%) had abnormal anal cytology; increased in HIV-positive as compared to HIV-negative men (35% versus 20%, p = 0.180). Similarly, both low-grade (25.8% versus 17.6%) and high-grade lesions (8.3% versus 4.8%) were comparable in HIV-positive and HIV-negative group. Thirteen (20%) smears were p16-positive with a sensitivity and specificity for anal dysplasia of 72.3% and 100%, respectively. Anal cytology may be used to screen for anal dysplasia in MSM irrespective of HIV status. Furthermore, the addition of p16, with greater specificity for high-grade lesions, may improve diagnostic accuracy especially for high-grade lesions. A larger study to further corroborate these observations is warranted.
authors.affiliation: Department of Dermatology & STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Shahdara, Delhi, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Arora
authors.affiliation: Department of Dermatology & STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Shahdara, Delhi, India deepikapandhi@rediffmail.com.
authors.forename: Deepika
authors.initials: D
authors.lastname: Pandhi
authors.affiliation: Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Shahdara, Delhi, India.
authors.forename: Kiran
authors.initials: K
authors.lastname: Mishra
authors.affiliation: Department of Dermatology & STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Shahdara, Delhi, India.
authors.forename: Sambit N
authors.initials: SN
authors.lastname: Bhattacharya
authors.affiliation: Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Shahdara, Delhi, India.
authors.forename: Vizodilhou A
authors.initials: VA
authors.lastname: Yhome
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000473:pathology; D001005:Anus Neoplasms / Q000453:epidemiology / Q000473:pathology*; D002278:Carcinoma in Situ / Q000473:pathology*; D003430:Cross-Sectional Studies; D019941:Cyclin-Dependent Kinase Inhibitor p16; D003584:Cytological Techniques / Q000379:methods*; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D018023:HIV Seronegativity; D018451:Homosexuality, Male; D006801:Humans; D007150:Immunohistochemistry; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D015995:Prevalence; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D009363:Neoplasm Proteins
keywords: AIDS; AIN; HIV; HPV; MSM; anal intraepithelial neoplasia; human papillomavirus; men who have sex with men; p16 immunohistochemistry; sexually transmitted infections; transgender