title: Prevalence, incidence and predictors of anal high-risk HPV infections and cytological abnormalities in HIV-infected individuals.
abstract: OBJECTIVE
  Our purpose was to investigate prevalence, incidence and risk factors of anal high risk-HPV infections and cytological abnormalities in HIV-positive individuals.
  
  
  METHODS
  A cohort of consecutively enrolled HIV-positive patients underwent, at baseline visit, a sexual behaviors questionnaire, anoscopy, HPV testing and cytological examination. Hybridization and multiplex-PCR were used for DNA detection and typing; HPV E6-E7 mRNA expression was analyzed in HR-HPV+ patients. Logistic regression was used to assess predictors of HR-HPV infection and anal dysplasia.
  
  
  RESULTS
  233 HIV-infected patients were enrolled (81% males, median age 44 years). HR-HPV was detected in 144 anal swabs and showed a positive association with CDC stage C and a negative association with a higher CD4 count and the use of a NNRTI-based antiretroviral regimen. HR-HPV DNA detection and anal warts at baseline were associated to cytological abnormalities; a detectable HIV-RNA independently predicted new onset anal dysplasia at follow-up (incidence 15.4 per 100 patients-year). Incidence of new HR-HPV infection was 44.2 per 100 patients-year.
  
  
  CONCLUSIONS
  The relevance of screening for anal dysplasia in HIV+ patients is emphasized, especially in those with detectable plasma HIV-RNA, anal HR-HPV infection or compromised immunological status.
authors.affiliation: Istituto Clinica Malattie Infettive, Università Cattolica del Sacro Cuore, Largo F.Vito 1, Roma 00168, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Borghetti
authors.affiliation: Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F.Vito 1, Roma 00168, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Cattani
authors.affiliation: Istituto Clinica e Terapia Chirurgica, Università Cattolica del Sacro Cuore, Largo F.Vito 1, Roma 00168, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Maria
authors.affiliation: Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F.Vito 1, Roma 00168, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: D'Onghia
authors.affiliation: Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F.Vito 1, Roma 00168, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Santangelo
authors.affiliation: Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F.Vito 1, Roma 00168, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Marchetti
authors.affiliation: UOC Malattie Infettive Universitarie, Azienda Ospedaliera Universitaria Senese, Viale Mario Bracci 16, Siena 53100, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Farina
authors.affiliation: Istituto Clinica Malattie Infettive, Università Cattolica del Sacro Cuore, Largo F.Vito 1, Roma 00168, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cauda
authors.affiliation: Istituto Clinica Malattie Infettive, Università Cattolica del Sacro Cuore, Largo F.Vito 1, Roma 00168, Italy; UOC Malattie Infettive Universitarie, Azienda Ospedaliera Universitaria Senese, Viale Mario Bracci 16, Siena 53100, Italy. Electronic address: deluca.andrea@fastwebnet.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: De Luca
authors.affiliation: Istituto Clinica Malattie Infettive, Università Cattolica del Sacro Cuore, Largo F.Vito 1, Roma 00168, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Di Giambenedetto
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000473:pathology / Q000821:virology; D001004:Anus Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D015658:HIV Infections; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009857:Oncogenes; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000235:genetics; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012333:RNA, Messenger; D012307:Risk Factors; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014860:Warts
chemical_list: D012333:RNA, Messenger
keywords: Anal dysplasia/carcinoma; Anal warts; CDC stage C; HIV-RNA; High-risk HPV; Non-nucleoside reverse transcriptase inhibitors