title: Human papillomavirus infection in anal intraepithelial lesions from HIV infected Cuban men.
abstract: BACKGROUND
  An association between HPV infection and progression to anal squamous intraepithelial lesions (ASIL) has been established, specifically in high-risk populations such as HIV-infected men. In this population, anal cancer is one of the most common non-AIDS-defining malignancies.
  
  
  METHODS
  A cross-sectional study to detect anal lesions and HPV infection was performed. Anal mucosa samples were collected from 56 HIV-infected men from Cuba. The cytological diagnosis was done according to Bethesda 2001 System. HPV DNA detection was determined by qPCR for six high-risk HPV types and end point PCR for low-risk HPV types (6 and 11). The end point PCR with nucleotide sequencing technique was achieved to detect other genotypes of HPV not included in the qPCR in those samples negative for HPV- 6 and 11 or negative for the six genotypes identified in the qPCR.
  
  
  RESULTS
  Cytological diagnosis identified 53 of 56 (95%) men with abnormal anal cytology. Among those, 26% (14/53) had atypical squamous cells of undetermined significance (ASC-US), 4% (2/53) had atypical squamous cells of undetermined significance cannot exclude high-grade lesions (ASC-H), 64% (34/53) had low-grade squamous intraepithelial lesions (LSIL), and 6% (3/53) had high-grade squamous intraepithelial lesions (HSIL). HPV DNA was detected in 89% (50/56) of men and 79% had at least one of the high-risk HPV types. HPV- 16 was the most common genotype (52%), while HPV-18 was the most frequently detected genotype in men with HSIL. We found statistically significant differences in the HPV viral loads with respect to the cytology results (p= 0.0006) and that the practice of receptive anal sex was a risk factor for anal HPV infection (p= 0.032).
  
  
  CONCLUSIONS
  This study shows a high prevalence of ASIL and high-risk HPV infections in the study group and is the first study showing the distribution of HPV genotypes in HIV infected Cuban men with abnormal anal cytology. This information may be of importance for local decision makers to improve prevention strategies, including the introduction of HPV vaccine in Cuba.
authors.affiliation: Institute of Tropical Medicine "Pedro Kourí", Autopista Novia del Mediodía Km 6 ½, P.O.Box. 601, Marianao 13, La Habana Cuba.
authors.forename: Celia M
authors.initials: CM
authors.lastname: Limia
authors.affiliation: Institute of Tropical Medicine "Pedro Kourí", Autopista Novia del Mediodía Km 6 ½, P.O.Box. 601, Marianao 13, La Habana Cuba.
authors.forename: Yudira
authors.initials: Y
authors.lastname: Soto
authors.affiliation: General Hospital "Enrique Cabrera Cossío", Calzada Aldabó 11117 esquina E, Boyeros, 10800 La Habana Cuba.
authors.forename: Yanara
authors.initials: Y
authors.lastname: García
authors.affiliation: Institute of Tropical Medicine "Pedro Kourí", Autopista Novia del Mediodía Km 6 ½, P.O.Box. 601, Marianao 13, La Habana Cuba.
authors.forename: Orestes
authors.initials: O
authors.lastname: Blanco
authors.affiliation: Institute of Tropical Medicine "Pedro Kourí", Autopista Novia del Mediodía Km 6 ½, P.O.Box. 601, Marianao 13, La Habana Cuba.
authors.forename: Vivian
authors.initials: V
authors.lastname: Kourí
authors.affiliation: General Hospital "Enrique Cabrera Cossío", Calzada Aldabó 11117 esquina E, Boyeros, 10800 La Habana Cuba.
authors.forename: María V
authors.initials: MV
authors.lastname: López
authors.affiliation: Institute of Tropical Medicine "Pedro Kourí", Autopista Novia del Mediodía Km 6 ½, P.O.Box. 601, Marianao 13, La Habana Cuba.
authors.forename: María E
authors.initials: ME
authors.lastname: Toledo
authors.affiliation: Institute of Tropical Medicine "Pedro Kourí", Autopista Novia del Mediodía Km 6 ½, P.O.Box. 601, Marianao 13, La Habana Cuba.
authors.forename: Lissette
authors.initials: L
authors.lastname: Pérez
authors.affiliation: Institute of Tropical Medicine "Pedro Kourí", Autopista Novia del Mediodía Km 6 ½, P.O.Box. 601, Marianao 13, La Habana Cuba.
authors.forename: Yoanna
authors.initials: Y
authors.lastname: Baños
authors.affiliation: Institute of Tropical Medicine "Pedro Kourí", Autopista Novia del Mediodía Km 6 ½, P.O.Box. 601, Marianao 13, La Habana Cuba.
authors.forename: Yaniris
authors.initials: Y
authors.lastname: Caturla
authors.affiliation: Virology Program, I.C.B.M., Faculty of Medicine, University of Chile, Independencia, 1027 Chile.
authors.forename: Francisco
authors.initials: F
authors.lastname: Aguayo
keywords: Anal cancer; Anal squamous intraepithelial lesions; HIV; HPV