Publication:
Antiretroviral therapy as a factor protective against anal dysplasia in HIV-infected males who have sex with males.

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Date

2014-03-27

Authors

Hidalgo-Tenorio, Carmen
Rivero-Rodriguez, Mar
Gil-Anguita, Concepción
Lopez De Hierro, Mercedes
Palma, Pablo
Ramírez-Taboada, Jessica
Esquivias, Javier
López-Ruz, Miguel Angel
Javier-Martínez, Rosario
Pasquau-Liaño, Juan

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Public Library of Science
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Abstract

OBJECTIVES Chronic infection with oncogenic HPV genotype is associated with the development of anal dysplasia. Antiretroviral therapy (ART) has been shown to decrease the incidence of cervical carcinoma in women with HIV. We sought to: 1) describe the prevalence and grade of anal dysplasia and HPV infection in our study subjects; 2) analyze the grade of correlation between anal cytology, PCR of high-risk HPV, and histology; 3) identify the factors associated with the appearance of ≥ AIN2 lesions. DESIGN Cross-sectional, prospective study. METHODS A cohort of HIV-positive males (n = 140, mean age  = 37 years) who have sex with males (MSM) had epidemiological, clinical and analytical data collected. Anal mucosa samples were taken for cytology, HPV PCR genotyping, and anoscopy for histological analysis. RESULTS Within the cohort, 77.1% were being treated with ART, 8.5% anoscopy findings were AIN2, and 11.4% carcinoma in situ; 74.2% had high-risk (HR), 59.7% low-risk (LR) HPV genotypes and 46.8% had both. The combination of cytology with PCR identifying HR-HPV better predicts the histology findings than either of these factors alone. Logistic regression highlighted ART as a protective factor against ≥ AIN2 lesions (OR: 0.214; 95%CI: 0.054-0.84). Anal/genital condylomas (OR: 4.26; 95%CI: 1.27-14.3), and HPV68 genotype (OR: 10.6; 95%CI: 1.23-91.47) were identified as risk factors. CONCLUSIONS In our cohort, ART has a protective effect against dysplastic anal lesions. Anal/genital warts and HPV68 genotype are predictors of ≥ AIN2 lesions. Introducing PCR HPV genotype evaluation improves screening success over that of cytology alone.

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MeSH Terms

Medical Subject Headings::Diseases::Immune System Diseases::Immunologic Deficiency Syndromes::HIV Infections::HIV Seropositivity
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Diseases::Virus Diseases::DNA Virus Infections::Papillomavirus Infections
Medical Subject Headings::Anatomy::Digestive System::Gastrointestinal Tract::Intestines::Intestine, Large::Anal Canal
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Urogenital Neoplasms::Genital Neoplasms, Female::Uterine Neoplasms::Uterine Cervical Neoplasms
Medical Subject Headings::Phenomena and Processes::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Sexuality::Homosexuality::Homosexuality, Male
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional Studies
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Therapy, Combination::Antiretroviral Therapy, Highly Active
Medical Subject Headings::Diseases::Digestive System Diseases::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms::Rectal Neoplasms::Anus Neoplasms

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Keywords

Seropositividad para VIH, Masculino, Infecciones por Papillomavirus, Canal Anal, Homosexualidad Masculina, Estudios Transversales, Terapia Antirretroviral Altamente Activa, Neoplasias del Ano

Citation

Hidalgo-Tenorio C, Rivero-Rodriguez M, Gil-Anguita C, Lopez De Hierro M, Palma P, Ramírez-Taboada J, et al. Antiretroviral therapy as a factor protective against anal dysplasia in HIV-infected males who have sex with males. PLoS ONE. 2014 ; 9(3):e92376