Incidence and clearance of anal high-risk Human Papillomavirus infection and their risk factors in men who have sex with men living with HIV

Sci Rep. 2022 Jan 7;12(1):184. doi: 10.1038/s41598-021-03913-5.

Abstract

HIV-infected men who have sex with men (MSM) display the highest prevalence of anal infection by high-risk Human Papillomaviruses (hrHPVs) and incidence of anal carcinoma. Anal specimens were genotyped by the Linear Array. Incidence and clearance of anal infection by hrHPVs, hrHPVs other than HPV16, low-risk HPVs, and four individual types (6,11,16,18) were estimated using a two-state Markov model. Determinants for incidence and clearance were assessed by logistic regression. Overall, 204 individuals were included (median age 42 years, IQR = 34-49). For hrHPVs, incidence and clearance rates were 36.1 × 1000 person-months (p-m) (95% CI 23.3-56.5) and 15.6 × 1000 p-m (95% CI 10.7-23.3), respectively. HPV16 showed a higher incidence than HPV18 (10.2 vs. 7.2 × 1000 p-m). Its clearance was more than twofold lower than that of HPV18 (30.1 vs. 78.2 × 1000 p-m). MSM receiving cART displayed a 68% to 88% decrease in risk of acquiring hrHPVs, hrHPVs other than HPV16, HPV16, and HPV18 (adjusted Hazard Ratio [aHR] 0.13, 95% CI 0.02-0.67; aHR 0.22, 95% CI 0.06-0.78; aHR 0.32, 95% CI 0.12-0.90; aHR 0.12, 95% CI 0.04-0.31, respectively) than patients not treated. A nadir CD4 + count < 200 cells/mm3 significantly reduced the clearance of hrHPVs other than HPV16 (aHR 0.39, 95% CI 0.17-0.90). cART use reduces the risk of acquiring anal infection by hrHPVs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anal Canal / virology*
  • Anti-HIV Agents / therapeutic use
  • Anus Diseases / diagnosis
  • Anus Diseases / epidemiology*
  • Anus Diseases / prevention & control
  • Anus Diseases / virology
  • Coinfection*
  • Drug Therapy, Combination
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • HIV Infections / virology
  • Homosexuality, Male*
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / prevention & control
  • Papillomavirus Infections / virology
  • Prognosis
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Rome / epidemiology
  • Time Factors

Substances

  • Anti-HIV Agents