title: Association of HIV Infection With Anal and Penile Low-Risk Human Papillomavirus Infections Among Men Who Have Sex With Men in Amsterdam: The HIV & HPV in MSM Study.
abstract: BACKGROUND
  This study among men who have sex with men (MSM) aimed to (1) assess prevalence of anogenital low-risk human papillomavirus (lrHPV) infections, (2) evaluate associations with HIV infection, and (3) investigate lrHPV concordance.
  
  
  METHODS
  In 2010 to 2011, MSM 18 years or older were recruited in Amsterdam, the Netherlands, and provided anal and penile self-swabs (HIV & HPV in MSM study). Using the HPV SPF10-PCR/DEIA/LiPA25 system, the presence of lrHPV types 6, 11, 34, 40, 42, 43, 44, 53, 54, 66, 68/73, 70, and 74 could be detected. Logistic regression with generalized estimating equations was used to assess the independent effect of HIV on lrHPV infections. The model was repeated for lrHPV subcategories (nononcogenic and weakly oncogenic infections separately). Concordance was defined as detection of the same lrHPV type in both self-swabs of one individual.
  
  
  RESULTS
  A total of 778 MSM were included, of whom 317 (41%) were HIV positive (median CD4 count at enrollment, 530 cells/mm). Prevalence of anal lrHPV was 45% (95% confidence interval [CI], 41%-50%) in HIV-negative MSM and 69% (95% CI, 64%-74%) in HIV-positive MSM. Prevalence of penile lrHPV was 20% (95% CI, 16%-24%) and 37% (95% CI, 31%-42%), respectively. In multivariable analysis, HIV infection was independently associated with anal (adjusted odds ratio [aOR], 1.9; 95% CI, 1.5-2.3) and penile lrHPV (aOR, 2.0; 95% CI, 1.4-2.7). Nononcogenic and weakly oncogenic lrHPV subcategories showed a similar pattern of association. Anal lrHPV infections were strongly associated with the presence of a type-concordant penile infection (aOR, 5.8; 95% CI, 4.4-7.5) and vice versa (aOR, 5.7; 95% CI, 4.4-7.5).
  
  
  CONCLUSIONS
  Anal and penile infections with lrHPV are common in MSM. HIV infection was an independent determinant for lrHPV infections.
authors.affiliation: From the *Cluster of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; †Center for Infection and Immunity Amsterdam (CINIMA), Department of Internal Medicine, Academic Medical Center, Amsterdam, the Netherlands; ‡Epidemiology & Surveillance Department, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, or RIVM), Bilthoven, the Netherlands; §Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; ¶Laboratory for Infectious Diseases and Perinatal Screening, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, or RIVM), Bilthoven, the Netherlands; ∥Department of Internal Medicine, Jan van Goyen Medical Center, Amsterdam, the Netherlands; and **Department of Pathology, VU University Medical Center (VUmc), Amsterdam, the Netherlands.
authors.forename: Camiel A H
authors.initials: CA
authors.lastname: Welling
authors.forename: Sofie H
authors.initials: SH
authors.lastname: Mooij
authors.forename: Marianne A B
authors.initials: MA
authors.lastname: van der Sande
authors.forename: Martijn S
authors.initials: MS
authors.lastname: van Rooijen
authors.forename: Wilma F
authors.initials: WF
authors.lastname: Vermeulen-Oost
authors.forename: Audrey J
authors.initials: AJ
authors.lastname: King
authors.forename: Arne
authors.initials: A
authors.lastname: van Eeden
authors.forename: Daniëlle A M
authors.initials: DA
authors.lastname: Heideman
authors.forename: Ineke G
authors.initials: IG
authors.lastname: Stolte
authors.forename: Maarten F
authors.initials: MF
authors.lastname: Schim van der Loeff
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000821:virology*; D001004:Anus Diseases / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D018451:Homosexuality, Male; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D010409:Penile Diseases / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D010413:Penis / Q000821:virology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors