The effect of HIV infection on anal and penile human papillomavirus incidence and clearance: a cohort study among MSM. (2nd January 2016)

• Record Type: Journal Article
• Authors: Mooij, Sofie H.; van Santen, Daniëla K.; Geskus, Ronald B.; van der Sande, Marianne A.B.; Coutinho, Roel A.; Stolte, Ineke G.; Snijders, Peter J.F.; Meijer, Chris J.L.M.; Speksnijder, Arjen G.C.L.; de Vries, Henry J.C.; King, Audrey J.; van Eeden, Arne; van der Loeff, Maarten F. Schim
• Is Part Of: AIDS. Volume 30:Number 1(2016)
• Publication Date: 2016-01-02
• Subjects: anal -- clearance -- HIV -- human papillomavirus -- incidence -- MSM -- penile; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000000909
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Objectives: A large portion of anogenital cancers is caused by high-risk human papillomavirus (hrHPV) infections, which are especially common in HIV-infected men. We aimed to compare the incidence and clearance of anal and penile hrHPV infection between HIV-infected and HIV-negative MSM. Design: Analyses of longitudinal data from a prospective cohort study. Methods: MSM aged 18 years or older were recruited in Amsterdam, the Netherlands, and followed-up semi-annually for 24 months. At each visit, participants completed risk-factor questionnaires. Anal and penile self-samples were tested for HPV DNA using the SPF10 -PCR DEIA/LiPA25 system. Effects on incidence and clearance rates were quantified via Poisson regression, using generalized estimating equations to correct for multiple hrHPV types. Results: Seven hundred and fifty MSM with a median age of 40 years (interquartile 35–48) were included in the analyses, of whom 302 (40%) were HIV-infected. The incidence rates of hrHPV were significantly higher in HIV-infected compared with HIV-negative MSM [adjusted incidence rate ratio (aIRR) 1.6; 95% confidence interval (CI) 1.3–2.1 for anal and aIRR 1.4; 95%CI 1.0–2.1 for penile infection]. The clearance rate of hrHPV was significantly lower for anal [adjusted clearance rate ratio (aCRR) 0.7; 95%CI 0.6–0.9], but not for penile infection (aCRR 1.3; 95%CI 1.0–1.7). HrHPV incidence or clearance did not differ significantly by nadir CD4 + cell count. Conclusion: Increased anal and penile hrHPV incidence rates and decreased anal hrHPV clearance rates were found in HIV-infected compared with HIV-negative MSM, after adjusting for sexual behavior. Our findings suggest an independent effect of HIV infection on anal hrHPV infections. Abstract : Supplemental Digital Content is available in the text