title: Low- and high-risk human papillomavirus genotype infections in intra-anal warts in HIV-positive men who have sex with men.
abstract: BACKGROUND
  Anogenital warts are often presumed to represent nondysplastic or low-grade anal intraepithelial neoplasia (LGAIN). We previously demonstrated that up to 20% of intra-anal warts in HIV-positive men who have sex with men (MSM) contain regions of high-grade AIN (HGAIN).
  
  
  OBJECTIVE
  To determine the causative human papillomavirus (HPV) types of low- and high- grade dysplastic areas in warts from HIV-positive MSM.
  
  
  METHODS
  A total of 42 intra-anal warts from 41 HIV-positive MSM were graded as nondysplastic, LGAIN or HGAIN. Whole-tissue sections (WTS) were analysed with the SPF10 polymerase chain reaction/LiPA25 HPV genotyping system. If the WTS contained multiple HPV types, dysplastic regions were isolated by laser capture microdissection (LCM) for HPV genotyping.
  
  
  RESULTS
  Overall, 38 of 42 (91%) WTS tested positive for HPV DNA. Of these, 23 (61%) contained a single HPV type and 15 (39%) contained multiple HPV types. All LCM-selected regions contained no more than one HPV type. Ten of 42 (24%) WTS contained HGAIN disease, of which six (60%) were associated with a high-risk HPV (hrHPV) genotype. Twenty-three of 42 WTS contained LGAIN disease, of which two (9%) were associated with hrHPV. AIN lesions containing hrHPV types were identified using p16 staining.
  
  
  CONCLUSIONS
  LGAIN lesions can be caused by high-risk HPV genotypes and vice versa. We therefore recommend routine follow-up and treatment of all dysplastic intra-anal warts for HIV-positive MSM.
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands. m.l.vanheukelom@amc.uva.nl.|Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105AZ, Amsterdam, the Netherlands. m.l.vanheukelom@amc.uva.nl.|Department of Dermatology, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands. m.l.vanheukelom@amc.uva.nl.
authors.forename: M L
authors.initials: ML
authors.lastname: Siegenbeek van Heukelom
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.|Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.
authors.forename: O
authors.initials: O
authors.lastname: Richel
authors.affiliation: Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.|Department of Dermatology, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.|STI Outpatient Clinic, Public Health Service of Amsterdam (GGD Amsterdam), 1018 WT, Amsterdam, the Netherlands.
authors.forename: H J C
authors.initials: HJ
authors.lastname: de Vries
authors.affiliation: DDL Diagnostic Laboratory, 2288 ER, Rijswijk, the Netherlands.
authors.forename: M M
authors.initials: MM
authors.lastname: van de Sandt
authors.affiliation: DDL Diagnostic Laboratory, 2288 ER, Rijswijk, the Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Beck
authors.affiliation: DDL Diagnostic Laboratory, 2288 ER, Rijswijk, the Netherlands.
authors.forename: H A M
authors.initials: HA
authors.lastname: van den Munckhof
authors.affiliation: Department of Pathology, Weill Medical College of Cornell University, New York, NY, 10065, U.S.A.
authors.forename: E C
authors.initials: EC
authors.lastname: Pirog
authors.affiliation: DDL Diagnostic Laboratory, 2288 ER, Rijswijk, the Netherlands.
authors.forename: M N C
authors.initials: MN
authors.lastname: de Koning
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.|Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Prins
authors.affiliation: DDL Diagnostic Laboratory, 2288 ER, Rijswijk, the Netherlands.|Department of Dermatology, The Leiden University Medical Center, 2300 RC, Leiden, the Netherlands.|Department of Dermatology, Roosevelt Clinics, 2321 BL, Leiden, the Netherlands.
authors.forename: K D
authors.initials: KD
authors.lastname: Quint
mesh_terms: D000328:Adult; D001005:Anus Neoplasms / Q000235:genetics* / Q000821:virology; D002278:Carcinoma in Situ / Q000235:genetics* / Q000821:virology; D003218:Condylomata Acuminata / Q000235:genetics*; D004279:DNA, Viral / Q000302:isolation & purification; D005838:Genotype; D006679:HIV Seropositivity / Q000235:genetics* / Q000821:virology; D018451:Homosexuality, Male / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000235:genetics*; D012307:Risk Factors
chemical_list: D004279:DNA, Viral