title: The male ScreenING Study: prevalence of HPV-related genital and anal lesions in an urban cohort of HIV-positive men in Germany.
abstract: BACKGROUND
  Human papillomaviruses (HPV) induce condylomata, anogenital cancers and their precursor lesions as anal or penile intraepithelial neoplasia (AIN/PIN). HIV-positive individuals have an increased risk for the development of anogenital HPV-induced lesions.
  
  
  OBJECTIVE
  Estimation of the prevalence of HPV-related anogenital benign and malignant lesions in HIV-infected men attending a screening programme.
  
  
  METHODS
  Four hundred HIV-positive men [98% men who have sex with men (MSM)] were enrolled in this prospective study from 2008 to 2011. All patients received an inspection of the anogenital region, digital rectal examination, high-resolution anoscopy (HRA), anal cytology, anal/penile histology if required, and HPV-typing of anal and penile swabs.
  
  
  RESULTS
  At baseline, 75% (n = 302) of the men had abnormal anal cytological/histological results. 41% presented with low-grade (n = 164), 24% with high-grade anal dysplasia (n = 95) and two men with invasive anal cancer. 2.3% had PIN (n = 9) and one patient had penile cancer at baseline. Throughout the study period, 75% had anal dysplasia (low-grade n = 177, high-grade n = 125), 3.3% (n = 13) had PIN and two further patients developed anal cancer. Within the study period, 52.8% (n = 211) had condylomata (49% anal, 15% penile, 11% anal plus penile condylomata). At baseline, 88.5% of anal and 39.3% of penile swabs were HPV-DNA positive, and 77.8% of anal and 26.5% of penile swabs carried high-risk HPV-types. HPV16 was the most frequent HPV-type.
  
  
  CONCLUSIONS
  HIV-positive MSM have a high risk for HPV-induced condylomata, (pre)malignant anogenital lesions and anogenital cancers. Screening for HPV-induced dysplasia is crucial to avoid progression to invasive carcinomas. Additionally, HPV-vaccination recommendations should be extended to high-risk populations.
authors.affiliation: Department of Dermatology, Venereology and Allergology, Center for Sexual Health and Medicine, Ruhr-University Bochum, Bochum, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Fuchs
authors.affiliation: National Reference Center for Papilloma- and Polyomaviruses, Institute of Virology, Uniklinik Köln, University of Cologne, Koeln, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Wieland
authors.affiliation: Competence Network for HIV/AIDS (KompNet HIV/AIDS), Ruhr-University Bochum, Bochum, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Skaletz-Rorowski
authors.affiliation: Department of Dermatology, Venereology and Allergology, Center for Sexual Health and Medicine, Ruhr-University Bochum, Bochum, Germany.
authors.forename: N H
authors.initials: NH
authors.lastname: Brockmeyer
authors.affiliation: Institute of Cytology, Bonn, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Swoboda
authors.affiliation: Department of Dermatology, Venereology and Allergology, Center for Sexual Health and Medicine, Ruhr-University Bochum, Bochum, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kreuter
authors.affiliation: Competence Network for HIV/AIDS (KompNet HIV/AIDS), Ruhr-University Bochum, Bochum, Germany.|Clinical Trial Centre (ZKS), University of Cologne, Cologne, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Michalik
authors.affiliation: Department of Dermatology, Venereology and Allergology, Center for Sexual Health and Medicine, Ruhr-University Bochum, Bochum, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Potthoff
mesh_terms: D001004:Anus Diseases / Q000821:virology*; D015331:Cohort Studies; D005832:Genital Diseases, Male / Q000821:virology*; D005858:Germany / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000472:pathogenicity*; D015995:Prevalence; D014505:Urban Population