title: Prevalence of and Risk Factors for Anal Oncogenic Human Papillomavirus Infection Among HIV-Infected Women in France in the Combination Antiretroviral Therapy Era.
abstract: BACKGROUND
  Little is known about the type-specific prevalence of anal human papillomavirus (HPV) infection and risk factors for anal high-risk (HR) HPV infection in human immunodeficiency virus (HIV)-infected women.
  
  
  METHODS
  A cross-sectional study of anal and cervical HPV infection was nested within a gynecological cohort of HIV-infected women. Specimens were tested for type-specific DNA using a polymerase chain reaction-based assay.
  
  
  RESULTS
  The study population consisted of 311 women with a median age of 45.3 years, of whom 42.8% originated from sub-Saharan Africa and 96.8% were receiving combination antiretroviral therapy. The median CD4(+)cell count was 612/μL, and the HIV load was <50 copies/mL in 84.1%. HR-HPV types were detected in the anal canal in 148 women (47.6%) and in the cervix in 82 (26.4%). HPV-16 was the most prevalent type in both the anal canal (13.2% of women) and the cervix (5.1%). In multivariable analysis, factors associated with prevalent anal HR-HPV infection were CD4(+)count <350/μL (odds ratio, 2.9; 95% confidence interval, 1.3-6.5), concurrent cervical lesions (2.6; 1.0-4.3), and cervical HR-HPV infection (1.8; 1.0-3.2).
  
  
  CONCLUSIONS
  The high prevalence of HR-HPV types, including HPV-16, in the anal canal of HIV-positive women is concerning. Anal cancer screening should be considered for HIV-positive women as part of their routine care.
authors.affiliation: French Human Papillomavirus Reference Laboratory, Institut Pasteur Department of Endocrinology and Reproductive Medicine, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique, Hôpitaux de Paris.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Heard
authors.affiliation: Aix Marseille Univ, Sainte-Marguerite Hospital, Immuno-hematology Clinic Unit, Assistance Publique, Hôpitaux de Marseille Inserm U912, Marseille.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Poizot-Martin
authors.affiliation: Sorbonne Universités, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique INSERM Transfert, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris.
authors.forename: Valérie
authors.initials: V
authors.lastname: Potard
authors.affiliation: Proctologie Unit, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Etienney
authors.affiliation: Assistance Publique, Hôpitaux de Paris, Hôpital Mourier, Colombes, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Crenn-Hebert
authors.affiliation: Scottish HPV Reference Laboratory, Edinburgh, United Kingdom.
authors.forename: Catherine
authors.initials: C
authors.lastname: Moore
authors.affiliation: Department of Endocrinology and Reproductive Medicine, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique, Hôpitaux de Paris.
authors.forename: Philippe
authors.initials: P
authors.lastname: Touraine
authors.affiliation: Scottish HPV Reference Laboratory, Edinburgh, United Kingdom.
authors.forename: Heather
authors.initials: H
authors.lastname: Cubie
authors.affiliation: Sorbonne Universités, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique.
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000821:virology*; D001004:Anus Diseases / Q000150:complications / Q000453:epidemiology / Q000821:virology; D002584:Cervix Uteri / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
keywords: HIV-positive women; HPV; anal canal; cervical