Human papillomavirus mRNA testing for the detection of anal high-grade squamous intraepithelial lesions in men who have sex with men infected with HIV.
Currently, screening for anal high-grade squamous intraepithelial lesions (anal HSIL) relies on anal cytology and high-resolution anoscopy. Since this approach has limited sensitivity and specificity for detecting anal HSIL, there is increasing interest in the role of biomarkers for predicting anal HSIL. The aim of this study is to evaluate the diagnostic accuracy of HPV E6/E7-mRNA expression for the detection of anal HSIL in MSM infected with HIV, in comparison to DNA-HR-HPV and anal cytology. This cross-sectional screening study included 101 MSM followed at the HIV-unit of La Paz University Hospital. Intra-anal swabs from patients participating in a screening program including cytology, high-resolution anoscopy and histology were analyzed. HR-HPV-DNA detection was performed by means of the CLART® HPV2 assay (GENOMICA S.A.U., Madrid, Spain). E6/E7-mRNA detection of HR-HPV-types 16, 18, 31, 33, and 45 was performed using the NucliSENS-EasyQ assay (BioMérieux, Marcy ĺEtoile, France). HR-HPV DNA and HPVE6/E7 mRNA were detected in 82% and 57% of the anal smears respectively. Anal cytology screening was abnormal in 70.3%. For the detection of HSIL sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 71.7%, 55.6%, 57.9%, and 69.8% for E6/E7-mRNA testing, respectively, compared to 100%, 31.5%, 55.4%, and 100% for HR-HPV-DNA testing and to 83%, 40.7%, 54.9%, 73.3% of cytology testing. In comparison with the other tests, HPVE6/E7 mRNA testing yielded a lower clinical sensitivity but a higher clinical specificity and PPV for the detection of anal HSIL in MSM infected with HIV.
Department of Dermatology, Hospital Universitario La Paz-IdiPaz, Madrid, Spain.
Elena
E
Sendagorta
Department of Microbiology, Hospital Universitario La Paz-IdiPaz, Madrid, Spain.
Maria P
MP
Romero
Department of Internal Medicine, Hospital Universitario La Paz-IdiPaz, Madrid, Spain.
Jose I
JI
Bernardino
Department of Pathology, Hospital Universitario La Paz, Madrid, Spain.
María J
MJ
Beato
Department of Coloproctology, Hospital Universitario La Paz, Madrid, Spain.
Mario
M
Alvarez-Gallego
Department of Dermatology, Hospital Universitario La Paz-IdiPaz, Madrid, Spain.
Pedro
P
Herranz
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D020869:Gene Expression Profiling / Q000379:methods; D015658:HIV Infections / Q000150:complications; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009856:Oncogene Proteins, Viral / Q000096:biosynthesis* / Q000235:genetics; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000821:virology; D011446:Prospective Studies; D012333:RNA, Messenger / Q000032:analysis* / Q000235:genetics; D012367:RNA, Viral / Q000032:analysis* / Q000235:genetics; D012680:Sensitivity and Specificity; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000175:diagnosis* / Q000821:virology; D055815:Young Adult
D015415:Biomarkers; D009856:Oncogene Proteins, Viral; D012333:RNA, Messenger; D012367:RNA, Viral
Anal HSIL; E6/E7 RNA m; HIV; Human Papillomavirus; anal cytology