title: Betapapillomaviruses in the anal canal of HIV positive and HIV negative men who have sex with men.
abstract: BACKGROUND
  Betapapillomaviruses (β-PV) are etiologically associated with epidermodysplasia verruciformis and a proportion of skin precancerous lesions and cancer, mainly in immunocompromised individuals.
  
  
  OBJECTIVE
  The prevalence and persistence of anal β-PV infection and β-PV type distribution were determined in a cohort of men who have sex with men (MSM). A correlation with HIV-1 infection status and selected demographic and behavioral risk factors were additionally established.
  
  
  METHODS
  A total of 181 anal swabs (135 initial and 46 follow-up swabs) obtained from 135 Slovenian MSMs (17.0% HIV-1 positive) were tested for the presence of 25 different β-PV types using Diassay RHA Kit Skin (beta) HPV assay and, if negative, with an in-house nested M(a)/H(a) PCR.
  
  
  RESULTS
  β-PVs were detected in 88/135 (65.2%) initial anal swabs. Infection with multiple β-PV types was found in 26 samples; the number of β-PVs ranged from 2 to 9. A total of 29 distinct β-PVs were detected: HPV-36 and HPV-38 were the most prevalent, followed by HPV-23, HPV-24, and HPV-93. HIV-1 positive status, promiscuity and use of alkyl nitrites were significantly associated with a higher prevalence of anal β-PV infection. Three partial DNA sequences suggesting putative new HPV types were identified.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first study to investigate and characterize β-PV infections in the anal region. We showed that anal β-PV infection is highly prevalent in the MSM population and that β-PVs can establish persistent infection in the anal region for up to 4.8 years.
authors.affiliation: Department of Surgery, Rožna dolina Surgical Centre, Ljubljana, Slovenia; Department of Proctology, Surgical Centre Zdrav Splet, Maribor, Slovenia.
authors.forename: Boštjan
authors.initials: B
authors.lastname: Mlakar
authors.affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Boštjan J
authors.initials: BJ
authors.lastname: Kocjan
authors.affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Lea
authors.initials: L
authors.lastname: Hošnjak
authors.affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Kristina
authors.initials: K
authors.lastname: Fujs Komloš
authors.affiliation: Slovenj Gradec General Hospital, Department of General and Abdominal Surgery, Slovenj Gradec, Slovenia.
authors.forename: Miloš
authors.initials: M
authors.lastname: Milošević
authors.affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. Electronic address: mario.poljak@mf.uni-lj.si.
authors.forename: Mario
authors.initials: M
authors.lastname: Poljak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000821:virology*; D001004:Anus Diseases / Q000453:epidemiology* / Q000821:virology; D052686:Betapapillomavirus / Q000302:isolation & purification*; D015331:Cohort Studies; D015658:HIV Infections / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D017524:Slovenia / Q000453:epidemiology; D055815:Young Adult
keywords: Anal HPV infection; Betapapillomavirus; HPV type; Men who have sex with men; β-PV