Prevalence, Incidence, and Clearance of Anal High-Risk Human Papillomavirus Infection among HIV-Infected Men in the SUN Study

Pragna Patel, Tim Bush, Erna Milunka Kojic, Lois Conley, Elizabeth R. Unger, Teresa M. Darragh, Keith Henry, John Hammer, Gerome Escota, Joel M. Palefsky, John T. Brooks

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background. The natural history of anal human papilloma virus (HPV) infection among human immunodeficiency virus (HIV)-infected men is unknown. Methods. Annually, from 2004 to 2012, we examined baseline prevalence, incidence, and clearance of anal HPV infection at 48 months, and associated factors among HIV-infected men. Results. We examined 403 men who have sex with men (MSM) and 96 men who have sex with women (MSW) (median age 42 years for both, 78% versus 81% prescribed cART, median CD4+ T-lymphocyte cell count 454 versus 379 cells/mm3, and 74% versus 75% had undetectable viral load, respectively). Type 16 prevalence among MSM and MSW was 38% versus 14% (P < .001), and incidence 24% versus 7% (P = .001). Type 18 prevalence was 24% versus 8% (P < .001), and incidence 13% versus 4% (P = .027). Among MSM and MSW, clearance of prevalent HPV 16 and HPV 18 was 31% and 60% (P = .392), and 47% and 25% (P = .297), respectively. Among MSM, receptive anal sex (with or without a condom) was associated with persistent HPV 16 (OR 2.24, P < .001). Conclusions. MSM had higher prevalence and incidence of HPV than MSW, but similar clearance. Receptive anal sex may predict cancer risk among HIV-infected MSM.

Original languageEnglish
Pages (from-to)953-963
Number of pages11
JournalJournal of Infectious Diseases
Volume217
Issue number6
DOIs
StatePublished - Mar 5 2018

Keywords

  • Anal cytology
  • HIV
  • HPV
  • Human immunodeficiency virus
  • Human papillomavirus

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    Patel, P., Bush, T., Kojic, E. M., Conley, L., Unger, E. R., Darragh, T. M., Henry, K., Hammer, J., Escota, G., Palefsky, J. M., & Brooks, J. T. (2018). Prevalence, Incidence, and Clearance of Anal High-Risk Human Papillomavirus Infection among HIV-Infected Men in the SUN Study. Journal of Infectious Diseases, 217(6), 953-963. https://doi.org/10.1093/infdis/jix607