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Role of Low-Risk HPV PCR Monoinfection in Screening for HSIL and Anal Cancer in Men Who Have Sex with Men Living with HIV.
| Content Provider | Europe PMC |
|---|---|
| Author | García-Martínez, Carmen María Calle-Gómez, Inmaculada López-Hidalgo, Javier Gómez-Ronquillo, Patricia Omar-Mohamed Balgahata, Mohamed Hidalgo-Tenorio, Carmen |
| Editor | Kazumi, Nakano Watanabe, Toshiki |
| Copyright Year | 2023 |
| Abstract | To determine the value of low-risk human papillomavirus (HPV) PCR to screen for "high-grade anal squamous intraepithelial lesion and anal cancer" (HSIL-plus), rate of patients with low-grade anal squamous intraepithelial lesion (LSIL) progressing to HSIL-plus, and progression-related factors. Prospective, longitudinal study of consecutive MSM-LHIV attended between May 2010 and December 2021 and followed for 43 months (IQR: 12-76). HIV-related variables were gathered at baseline, performing anal cytology for HPV detection/genotyping, thin-layer cytological study, and high-resolution anoscopy (HRA). Follow-up was annual when HRA was normal or LSIL, and post-treatment in cases of HSIL-plus, re-evaluating sexual behavior, viral-immunological status, and HPV infection of anal mucosa. The 493 participants had mean age of 36 years: CD4 nadir < 200 cells/uL in 23.1%, virological failure in 4.1%, and tetravalent HPV vaccine > 5 years earlier in 15%. HSIL-plus was ruled out in patients with monoinfection by low-risk HPV genotype and normal cytology (100% sensitivity, 91.9% specificity, PPV 2.9%, and NPV 100%). Progression from LISL to HSIL-plus occurred in 4.27% of patients within 12 months (IQR: 12-12): risk factors were acquisition of high-risk (HR: 4.15; 95% CI: 1.14-15.03) and low-risk (HR: 3.68 95% CI: 1.04-12.94) HPV genotypes, specifically genotype 6 (HR: 4.47, 95% CI: 1.34-14.91), and history of AIDS (HR: 5.81 95% CI: 1.78-18.92). Monoinfection by LR-HPV genotypes in patients with normal cytology is not associated with anal cancer or precursor lesions. Progression from LSIL to HSIL-plus, observed in <5% of patients, was related to acquisition of HR and LR HPV genotypes, especially 6, and a history of AIDS. |
| Journal | International Journal of Molecular Sciences [Int J Mol Sci] |
| Volume Number | 24 |
| DOI | 10.3390/ijms24065642 |
| PubMed Central reference number | PMC10056681 |
| Issue Number | 6 |
| PubMed reference number | 36982714 |
| e-ISSN | 14220067 |
| Language | English |
| Publisher | Molecular Diversity Preservation International (MDPI) |
| Publisher Date | 2023-03-15 |
| Access Restriction | Open |
| Subject Keyword | human immunodeficiency virus (HIV) men who have sex with men living with HIV (MSM-LHIV) human papillomavirus (HPV) non-AIDS-defining diseases anal canal |
| Content Type | Text |
| Resource Type | Article |
| Subject | Physical and Theoretical Chemistry Molecular Biology Spectroscopy Catalysis Computer Science Applications Medicine Inorganic Chemistry Organic Chemistry |
