title: Incidence, Duration, Persistence, and Factors Associated With High-risk Anal Human Papillomavirus Persistence Among HIV-negative Men Who Have Sex With Men: A Multinational Study.
abstract: Given high rates of anal disease, we investigated the natural history of high-risk anal human papillomavirus (HPV) among a multinational group of men who have sex with men (MSM) aged 18-64 years.
  
  
  
  Anal specimens from human immunodeficiency virus-negative men from Brazil, Mexico, and the United States were genotyped. Over 2 years, 406 MSM provided evaluable specimens every 6 months for ≥2 visits. These men were stratified into men who have sex only with men (MSOM, n = 70) and men who have sex with women and men (MSWM, n = 336). Persistence was defined as ≥12 months' type-specific duration and could begin with either a prevalent or incident infection. Prevalence ratios and 95% confidence intervals were calculated by Poisson regression.
  
  
  
  Median follow-up time was 2.1 years. Retention was 82%. Annual cumulative incidence of 9-valent vaccine types was 19% and 8% among MSOM and MSWM, respectively (log-rank P = .02). Duration of anal HPV did not differ for MSOM and MSWM and was a median of 6.9 months for HPV-16 after combining men from the 2 groups. Among men with prevalent high-risk infection (n = 106), a total of 36.8%, retained the infection for at least 24 months. For those with prevalent HPV-16 (n = 27), 29.6% were persistent for at least 24 months. Persistence of high-risk HPV was associated with number of male anal sex partners and inversely associated with number of female sex partners.
  
  
  
  MSM with prevalent high-risk HPV infection should be considered at increased risk for nontransient infection.
authors.affiliation: Center for Infectious Diseases, University of Texas School of Public Health at Houston.
authors.forename: Alan G
authors.initials: AG
authors.lastname: Nyitray
authors.affiliation: Centro de Referência e Treinamentoem Doenças Sexualmente Transmissíveis/AIDS, São Paulo, Brazil.
authors.forename: Roberto J
authors.initials: RJ
authors.lastname: Carvalho da Silva
authors.affiliation: Division of Biostatistics, University of Texas School of Public Health at Houston.
authors.forename: Mihyun
authors.initials: M
authors.lastname: Chang
authors.affiliation: Center of Translational Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), Brazil.
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Baggio
authors.affiliation: Vanderbilt Institute for Global Health, Nashville, Tennessee.
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Ingles
authors.affiliation: Center for Infection Research in Cancer,Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors.forename: Martha
authors.initials: M
authors.lastname: Abrahamsen
authors.affiliation: Center for Infection Research in Cancer,Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors.forename: Mary
authors.initials: M
authors.lastname: Papenfuss
authors.affiliation: Biostatistics, School of Public Health, Louisiana State University Health Sciences Center, New Orleans.
authors.forename: Hui-Yi
authors.initials: HY
authors.lastname: Lin
authors.affiliation: Instituto Nacional de Salud Pública.|Instituto Mexicano del Seguro Social, and.
authors.forename: Jorge
authors.initials: J
authors.lastname: Salmerón
authors.affiliation: Instituto Nacional de Salud Pública, Cuernavaca, México; and.
authors.forename: Manuel
authors.initials: M
authors.lastname: Quiterio
authors.affiliation: Instituto Nacional de Salud Pública, Cuernavaca, México; and.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo Department of Radiology and Oncology, Centro de Investigação Translacional em Oncologia, ICESP, Brazil.
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa
authors.affiliation: Center for Infection Research in Cancer,Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
mesh_terms: D000293:Adolescent; D000328:Adult; D000569:Americas / Q000453:epidemiology; D001003:Anal Canal / Q000821:virology; D001004:Anus Diseases / Q000453:epidemiology* / Q000821:virology*; D001727:Bisexuality / Q000706:statistics & numerical data; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology*; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: HPV DNA; anal cancer; anal condyloma; natural history; prospective