title: HIV-1 infection, but not syphilis or HBV infection, is a strong risk factor for anorectal condyloma in Asian population: a prospective colonoscopy screening study.
abstract: OBJECTIVE
  To investigate the association between anorectal precancerous lesions, including condyloma, and sexually transmitted infections (STI) in Asian population.
  
  
  METHODS
  This prospective study enrolled 2677 patients who underwent high-resolution colonoscopy for anorectal cancer screening. Anorectal lesions were diagnosed based on endoscopic findings and confirmed by biopsy. The association of HIV-1 infection, syphilis, and HBV infection with anorectal lesion was estimated by multivariate logistic regression. In HIV-1-infected patients (n=244), anal canal HPV-DNA was screened and genotyped.
  
  
  RESULTS
  Although no malignancy was identified, anorectal condyloma was diagnosed in 32 (1.2%) male patients. 41% of anorectal condyloma cases had no specific lower GI symptoms. Multivariate analysis identified HIV-1 infection, but not syphilis or HBV infection, as an independent significant factor for condyloma (OR: 176.5, 95%CI 22.52-1383, p<0.001). In HIV-1 infected patients, positive type 16/18 HPV-DNA (OR: 4.766, 95%CI 1.838-12.36, p=0.001), lower CD4 cell count (per 100/μl decrement, OR: 1.056, 95%CI 1.056-1.587, p=0.013), and current smoking (OR: 3.828, 95%CI 1.486-9.857, p=0.005) were independently associated with anorectal condyloma.
  
  
  CONCLUSIONS
  HIV-1 infection, but not syphilis or HBV infection, was identified as a strong risk for anorectal condyloma. Anal HPV 16/18 was highly prevalent in patients with HIV-1 infection, especially in those with condyloma.
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan; Center for AIDS Research, Kumamoto University, Kumamoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishijima
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan. Electronic address: nnagata_ncgm@yahoo.co.jp.
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Nagata
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Sekine
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kishida
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Aoki
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Hamada
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Yazaki
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Katsuji
authors.initials: K
authors.lastname: Teruya
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan; Center for AIDS Research, Kumamoto University, Kumamoto, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Gatanaga
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Kikuchi
authors.affiliation: Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Igari
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Akiyama
authors.affiliation: The Research Center for Hepatitis and Immunology, Department of Gastroenterology and Hepatology.
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Uemura
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan; Center for AIDS Research, Kumamoto University, Kumamoto, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oka
mesh_terms: D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D044466:Asian People; D003113:Colonoscopy; D003218:Condylomata Acuminata / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012002:Rectal Diseases / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000150:complications; D013587:Syphilis / Q000150:complications
keywords: Anorectal condyloma; Colonoscopy; HIV-1 infection; Human papillomavirus; Screening anorectal precancerous lesions