Anal squamous intraepithelial lesions are frequent among young HIV‐infected men who have sex with men followed up at the Spanish AIDS Research Network Cohort (CoRIS‐HPV)
The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV‐infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS‐HPV started in 2007, nested in the Spanish AIDS Research Network Coh...
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| Published in | International journal of cancer Vol. 133; no. 5; pp. 1164 - 1172 |
|---|---|
| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Hoboken, NJ
Wiley-Blackwell
01.09.2013
Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0020-7136 1097-0215 1097-0215 |
| DOI | 10.1002/ijc.28102 |
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| Abstract | The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV‐infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS‐HPV started in 2007, nested in the Spanish AIDS Research Network Cohort (CoRIS). Anal liquid cytology testing was performed. High‐risk human papillomavirus (HR‐HPV) infection was determined, and positive samples were genotyped. We analyzed all subjects up to April 2011. Multivariate logistic regression analyses were performed. A total of 551 subjects with baseline anal liquid cytologies were analyzed; 37.0% negative for intraepithelial lesion, 9.0% atypical squamous cells of uncertain significance (ASCUS), 41.0% low‐grade SIL, 4.0% high‐grade SIL and 9.0% inadequate. Prevalence of anal SIL (excluding ASCUS) in valid samples (n = 450) was 54.7% (95% confidence interval [CI] = 49.9–59.3). Globally HR‐HPV prevalence was 81.7% (95% CI = 78.0–85.2). Multiple infections (≥2 HR‐HPV genotypes) were documented in 77.7% (95% CI = 73.1–82.0). The only risk factor associated with anal SIL was the number of HR‐HPV types; MSM with five or more HR‐HPV genotypes had an odds ratio (OR) of anal SIL seven times greater (OR = 7.4; 95% CI = 2.8–19.6) than those with one HR‐HPV genotype. No associations were found for age, educational level, smoking, geographical origin, CD4 T‐cell count, antiretroviral treatment or number of sexual partners. The prevalence of anal SIL in young HIV‐positive MSM is high, and the main risk factor is multiple infections with HR‐HPV types.
What's new?
Anal squamous intraepithelial lesions (SILs) have been implicated as a risk factor for anal cancer in HIV‐positive men who have sex with men (MSM), and now, as detailed in this report, it appears that their development is associated with high risk (HR) human papillomavirus (HPV) genotype burden. Analysis of patients enrolled in the Spanish AIDS Research Network Cohort (CoRIS) revealed a seven‐fold increase in SIL risk for HIV‐positive MSM who had five or more detectable HR‐HPV genotypes. The findings could influence the development of SIL screening programs. |
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| AbstractList | The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV-infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS-HPV started in 2007, nested in the Spanish AIDS Research Network Cohort (CoRIS). Anal liquid cytology testing was performed. High-risk human papillomavirus (HR-HPV) infection was determined, and positive samples were genotyped. We analyzed all subjects up to April 2011. Multivariate logistic regression analyses were performed. A total of 551 subjects with baseline anal liquid cytologies were analyzed; 37.0% negative for intraepithelial lesion, 9.0% atypical squamous cells of uncertain significance (ASCUS), 41.0% low-grade SIL, 4.0% high-grade SIL and 9.0% inadequate. Prevalence of anal SIL (excluding ASCUS) in valid samples (n=450) was 54.7% (95% confidence interval [CI]=49.9-59.3). Globally HR-HPV prevalence was 81.7% (95% CI=78.0-85.2). Multiple infections (≥2 HR-HPV genotypes) were documented in 77.7% (95% CI=73.1-82.0). The only risk factor associated with anal SIL was the number of HR-HPV types; MSM with five or more HR-HPV genotypes had an odds ratio (OR) of anal SIL seven times greater (OR=7.4; 95% CI=2.8-19.6) than those with one HR-HPV genotype. No associations were found for age, educational level, smoking, geographical origin, CD4 T-cell count, antiretroviral treatment or number of sexual partners. The prevalence of anal SIL in young HIV-positive MSM is high, and the main risk factor is multiple infections with HR-HPV types. What's new? Anal squamous intraepithelial lesions (SILs) have been implicated as a risk factor for anal cancer in HIV-positive men who have sex with men (MSM), and now, as detailed in this report, it appears that their development is associated with high risk (HR) human papillomavirus (HPV) genotype burden. Analysis of patients enrolled in the Spanish AIDS Research Network Cohort (CoRIS) revealed a seven-fold increase in SIL risk for HIV-positive MSM who had five or more detectable HR-HPV genotypes. The findings could influence the development of SIL screening programs. [PUBLICATION ABSTRACT] The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV-infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS-HPV started in 2007, nested in the Spanish AIDS Research Network Cohort (CoRIS). Anal liquid cytology testing was performed. High-risk human papillomavirus (HR-HPV) infection was determined, and positive samples were genotyped. We analyzed all subjects up to April 2011. Multivariate logistic regression analyses were performed. A total of 551 subjects with baseline anal liquid cytologies were analyzed; 37.0% negative for intraepithelial lesion, 9.0% atypical squamous cells of uncertain significance (ASCUS), 41.0% low-grade SIL, 4.0% high-grade SIL and 9.0% inadequate. Prevalence of anal SIL (excluding ASCUS) in valid samples (n = 450) was 54.7% (95% confidence interval [CI] = 49.9-59.3). Globally HR-HPV prevalence was 81.7% (95% CI = 78.0-85.2). Multiple infections (≥2 HR-HPV genotypes) were documented in 77.7% (95% CI = 73.1-82.0). The only risk factor associated with anal SIL was the number of HR-HPV types; MSM with five or more HR-HPV genotypes had an odds ratio (OR) of anal SIL seven times greater (OR = 7.4; 95% CI = 2.8-19.6) than those with one HR-HPV genotype. No associations were found for age, educational level, smoking, geographical origin, CD4 T-cell count, antiretroviral treatment or number of sexual partners. The prevalence of anal SIL in young HIV-positive MSM is high, and the main risk factor is multiple infections with HR-HPV types. The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV-infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS-HPV started in 2007, nested in the Spanish AIDS Research Network Cohort (CoRIS). Anal liquid cytology testing was performed. High-risk human papil-lomavirus (HR-HPV) infection was determined, and positive samples were genotyped. We analyzed all subjects up to April 2011. Multivariate logistic regression analyses were performed. A total of 551 subjects with baseline anal liquid cytologies were analyzed; 37.0% negative for intraepithelial lesion, 9.0% atypical squamous cells of uncertain significance (ASCIIS), 41.0% low-grade SIL, 4.0% high-grade SIL and 9.0% inadequate. Prevalence of anal SIL (excluding ASCUS) in valid samples (n = 450) was 54.7% (95% confidence interval [CI] = 49.9-59.3). Globally HR-HPV prevalence was 81.7% (95% CI = 78.0-85.2). Multiple infections (>2 HR-HPV genotypes) were documented in 77.7% (95% CI = 73.1-82.0). The only risk factor associated with anal SIL was the number of HR-HPV types; MSM with five or more HR-HPV genotypes had an odds ratio (OR) of anal SIL seven times greater (OR = 7.4; 95% CI = 2.8-19.6) than those with one HR-HPV genotype. No associations were found for age, educational level, smoking, geographical origin, CD4 T-cell count, antiretroviral treatment or number of sexual partners. The prevalence of anal SIL in young HIV-positive MSM is high, and the main risk factor is multiple infections with HR-HPV types. The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV-infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS-HPV started in 2007, nested in the Spanish AIDS Research Network Cohort (CoRIS). Anal liquid cytology testing was performed. High-risk human papillomavirus (HR-HPV) infection was determined, and positive samples were genotyped. We analyzed all subjects up to April 2011. Multivariate logistic regression analyses were performed. A total of 551 subjects with baseline anal liquid cytologies were analyzed; 37.0% negative for intraepithelial lesion, 9.0% atypical squamous cells of uncertain significance (ASCUS), 41.0% low-grade SIL, 4.0% high-grade SIL and 9.0% inadequate. Prevalence of anal SIL (excluding ASCUS) in valid samples (n = 450) was 54.7% (95% confidence interval [CI] = 49.9-59.3). Globally HR-HPV prevalence was 81.7% (95% CI = 78.0-85.2). Multiple infections (≥2 HR-HPV genotypes) were documented in 77.7% (95% CI = 73.1-82.0). The only risk factor associated with anal SIL was the number of HR-HPV types; MSM with five or more HR-HPV genotypes had an odds ratio (OR) of anal SIL seven times greater (OR = 7.4; 95% CI = 2.8-19.6) than those with one HR-HPV genotype. No associations were found for age, educational level, smoking, geographical origin, CD4 T-cell count, antiretroviral treatment or number of sexual partners. The prevalence of anal SIL in young HIV-positive MSM is high, and the main risk factor is multiple infections with HR-HPV types.The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV-infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS-HPV started in 2007, nested in the Spanish AIDS Research Network Cohort (CoRIS). Anal liquid cytology testing was performed. High-risk human papillomavirus (HR-HPV) infection was determined, and positive samples were genotyped. We analyzed all subjects up to April 2011. Multivariate logistic regression analyses were performed. A total of 551 subjects with baseline anal liquid cytologies were analyzed; 37.0% negative for intraepithelial lesion, 9.0% atypical squamous cells of uncertain significance (ASCUS), 41.0% low-grade SIL, 4.0% high-grade SIL and 9.0% inadequate. Prevalence of anal SIL (excluding ASCUS) in valid samples (n = 450) was 54.7% (95% confidence interval [CI] = 49.9-59.3). Globally HR-HPV prevalence was 81.7% (95% CI = 78.0-85.2). Multiple infections (≥2 HR-HPV genotypes) were documented in 77.7% (95% CI = 73.1-82.0). The only risk factor associated with anal SIL was the number of HR-HPV types; MSM with five or more HR-HPV genotypes had an odds ratio (OR) of anal SIL seven times greater (OR = 7.4; 95% CI = 2.8-19.6) than those with one HR-HPV genotype. No associations were found for age, educational level, smoking, geographical origin, CD4 T-cell count, antiretroviral treatment or number of sexual partners. The prevalence of anal SIL in young HIV-positive MSM is high, and the main risk factor is multiple infections with HR-HPV types. The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV‐infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS‐HPV started in 2007, nested in the Spanish AIDS Research Network Cohort (CoRIS). Anal liquid cytology testing was performed. High‐risk human papillomavirus (HR‐HPV) infection was determined, and positive samples were genotyped. We analyzed all subjects up to April 2011. Multivariate logistic regression analyses were performed. A total of 551 subjects with baseline anal liquid cytologies were analyzed; 37.0% negative for intraepithelial lesion, 9.0% atypical squamous cells of uncertain significance (ASCUS), 41.0% low‐grade SIL, 4.0% high‐grade SIL and 9.0% inadequate. Prevalence of anal SIL (excluding ASCUS) in valid samples (n = 450) was 54.7% (95% confidence interval [CI] = 49.9–59.3). Globally HR‐HPV prevalence was 81.7% (95% CI = 78.0–85.2). Multiple infections (≥2 HR‐HPV genotypes) were documented in 77.7% (95% CI = 73.1–82.0). The only risk factor associated with anal SIL was the number of HR‐HPV types; MSM with five or more HR‐HPV genotypes had an odds ratio (OR) of anal SIL seven times greater (OR = 7.4; 95% CI = 2.8–19.6) than those with one HR‐HPV genotype. No associations were found for age, educational level, smoking, geographical origin, CD4 T‐cell count, antiretroviral treatment or number of sexual partners. The prevalence of anal SIL in young HIV‐positive MSM is high, and the main risk factor is multiple infections with HR‐HPV types. What's new? Anal squamous intraepithelial lesions (SILs) have been implicated as a risk factor for anal cancer in HIV‐positive men who have sex with men (MSM), and now, as detailed in this report, it appears that their development is associated with high risk (HR) human papillomavirus (HPV) genotype burden. Analysis of patients enrolled in the Spanish AIDS Research Network Cohort (CoRIS) revealed a seven‐fold increase in SIL risk for HIV‐positive MSM who had five or more detectable HR‐HPV genotypes. The findings could influence the development of SIL screening programs. The aim of our study was to determine the baseline prevalence of anal squamous intraepithelial lesions (SIL) and associated risk factors in HIV‐infected men who have sex with men (MSM) in a Spanish ongoing multicenter cohort. CoRIS‐HPV started in 2007, nested in the Spanish AIDS Research Network Cohort (CoRIS). Anal liquid cytology testing was performed. High‐risk human papillomavirus (HR‐HPV) infection was determined, and positive samples were genotyped. We analyzed all subjects up to April 2011. Multivariate logistic regression analyses were performed. A total of 551 subjects with baseline anal liquid cytologies were analyzed; 37.0% negative for intraepithelial lesion, 9.0% atypical squamous cells of uncertain significance (ASCUS), 41.0% low‐grade SIL, 4.0% high‐grade SIL and 9.0% inadequate. Prevalence of anal SIL (excluding ASCUS) in valid samples ( n = 450) was 54.7% (95% confidence interval [CI] = 49.9–59.3). Globally HR‐HPV prevalence was 81.7% (95% CI = 78.0–85.2). Multiple infections (≥2 HR‐HPV genotypes) were documented in 77.7% (95% CI = 73.1–82.0). The only risk factor associated with anal SIL was the number of HR‐HPV types; MSM with five or more HR‐HPV genotypes had an odds ratio (OR) of anal SIL seven times greater (OR = 7.4; 95% CI = 2.8–19.6) than those with one HR‐HPV genotype. No associations were found for age, educational level, smoking, geographical origin, CD4 T‐cell count, antiretroviral treatment or number of sexual partners. The prevalence of anal SIL in young HIV‐positive MSM is high, and the main risk factor is multiple infections with HR‐HPV types. What's new? Anal squamous intraepithelial lesions (SILs) have been implicated as a risk factor for anal cancer in HIV‐positive men who have sex with men (MSM), and now, as detailed in this report, it appears that their development is associated with high risk (HR) human papillomavirus (HPV) genotype burden. Analysis of patients enrolled in the Spanish AIDS Research Network Cohort (CoRIS) revealed a seven‐fold increase in SIL risk for HIV‐positive MSM who had five or more detectable HR‐HPV genotypes. The findings could influence the development of SIL screening programs. |
| Author | Amo, Julia Hernández‐Novoa, Beatriz González, Cristina Benito, Amparo Viciana, Pompeyo Trastoy, Mónica Rodríguez, Carmen Ortiz, Marta Romero, Jorge Fontillón, María Torres, Montserrat |
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| Cites_doi | 10.1097/01.qai.0000159669.80207.12 10.1002/ijc.24116 10.1097/OLQ.0b013e31815aba8c 10.1002/cncr.25530 10.7326/0003-4819-149-5-200809020-00004 10.1093/cid/cir064 10.1158/1055-9965.EPI-08-1141 10.1002/ijc.25903 10.1093/infdis/jiq021 10.1136/sti.75.3.172 10.1086/515608 10.1001/jama.285.13.1736 10.1086/424599 10.1353/hpu.2011.0159 10.1002/ijc.23487 10.1097/00042560-199804010-00005 10.1097/QAD.0b013e3283023f78 10.1093/aje/kwm017 10.1097/QAI.0b013e31817aebfe 10.1097/QAD.0b013e328339e592 10.1086/597207 10.1097/01.aids.0000226963.10342.f4 10.1086/514194 10.1097/00042560-199804010-00004 10.1097/01.olq.0000162366.60245.02 10.1002/cncy.21218 10.1056/NEJM199711063371904 10.1097/00126334-200412150-00004 10.1086/656775 10.1086/425906 10.7326/0003-4819-148-10-200805200-00005 10.1002/cncr.25547 10.1097/QAD.0b013e328331d384 10.1111/j.1468-1293.2012.01013.x 10.1097/QAD.0b013e328331f6e2 10.1097/00002030-199403000-00001 10.1093/jnci/92.18.1500 10.1136/sti.2008.034744 10.1097/01.aids.0000181012.62385.4a 10.1136/sti.2009.036707 10.1097/01.OLQ.0000109515.75864.2B 10.1097/00002030-199805000-00011 10.1016/S0140-6736(94)92636-0 10.1007/DCR.0b013e318207039a |
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| Contributor | de Sanjosé, Silvia Benito, Amparo del Amo, Julia Ocampo, Antonio Camino, Xabier Angeles Rodríguez, Ma Sanz, Itziar Torres, Montserrat Mauricio Iribarren, Gustavo Portilla, Irene Rodríguez, Patricia Hernández-Novoa, Beatriz González-Carreró, Joaquín Raposo, Montse García, Federico Vonwichmann, Angel Sendagorta, Elena Rosado, Dacil Ortiz, Marta Herranz, Pedro Miralles, Celia Portilla, Joaquín Carlos, Juan Ochoa, Severo Iribarren, Antonio Peña, Alejandro Rodriguez Da Silva, Alfredo González, Cristina Andrada, Encarna Madrid, Nadia Luis Gómez, Juan Cervero, Miguel |
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| Copyright | Copyright © 2013 UICC 2014 INIST-CNRS Copyright © 2013 UICC. |
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| Keywords | Cytology Papovaviridae Research HPV Papillomavirus Human papillomavirus Cancerology Cervical dysplasia Cohort study Network Squamous intraepithelial lesion Intestinal disease Anorectal disease Human Immunopathology Premalignant lesion Digestive system Retroviridae AIDS Immune deficiency Lentivirus Female genital diseases Infection Virus Anal squamous intraepithelial lesion Anus HIV Follow up study anal Viral disease Young adult Digestive diseases Frequency Human immunodeficiency virus Uterine cervix diseases cytology squamous intraepithelial lesion |
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| References | e_1_2_7_3_7_1 e_1_2_7_3_9_1 e_1_2_7_3_28_1 Palefsky JM (e_1_2_7_3_34_1) 1997; 73 e_1_2_7_3_12_1 e_1_2_7_3_37_1 e_1_2_7_3_14_1 e_1_2_7_3_35_1 e_1_2_7_3_33_1 e_1_2_7_3_10_1 Panther LA (e_1_2_7_3_20_1) 2005; 15 e_1_2_7_3_31_1 e_1_2_7_3_17_1 e_1_2_7_3_19_1 e_1_2_7_3_38_1 e_1_2_7_3_26_1 e_1_2_7_3_47_1 e_1_2_7_3_24_1 e_1_2_7_3_3_1 e_1_2_7_3_22_1 e_1_2_7_3_5_1 e_1_2_7_3_41_1 e_1_2_7_3_8_1 e_1_2_7_3_29_1 e_1_2_7_3_27_1 e_1_2_7_3_51_1 Payam A (e_1_2_7_3_43_1) 2011; 22 e_1_2_7_3_13_1 e_1_2_7_3_36_1 e_1_2_7_3_15_1 e_1_2_7_3_32_1 e_1_2_7_3_11_1 e_1_2_7_3_30_1 Palefsky JM (e_1_2_7_3_49_1) 1994; 7 e_1_2_7_3_16_1 Amo J (e_1_2_7_3_45_1) e_1_2_7_3_18_1 e_1_2_7_3_39_1 Daling JR (e_1_2_7_3_50_1) 1992 e_1_2_7_3_40_1 e_1_2_7_3_25_1 e_1_2_7_3_48_1 e_1_2_7_3_23_1 e_1_2_7_3_46_1 e_1_2_7_3_2_1 e_1_2_7_3_21_1 e_1_2_7_3_44_1 e_1_2_7_3_4_1 e_1_2_7_3_42_1 e_1_2_7_3_6_1 |
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| SubjectTerms | Acquired immune deficiency syndrome Adult AIDS anal Anus Neoplasms - epidemiology Anus Neoplasms - etiology Anus Neoplasms - virology Biological and medical sciences Cancer Cohort Studies Coris cytology Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen Genital cancers HIV HIV Infections - complications Homosexuality, Male HPV Human immunodeficiency virus Human papillomavirus Humans Logistic Models Male Medical research Medical sciences Papillomaviridae - isolation & purification Precancerous Conditions - epidemiology Precancerous Conditions - etiology Precancerous Conditions - virology Prevalence Risk factors squamous intraepithelial lesion Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Tumors |
| Title | Anal squamous intraepithelial lesions are frequent among young HIV‐infected men who have sex with men followed up at the Spanish AIDS Research Network Cohort (CoRIS‐HPV) |
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