P2.45 High burden of persistent oncogenic hpv infection in high-risk, hiv-negative men who have sex with men using a novel hpv e6/e7 mrna assay. (8th July 2017)

• Record Type: Journal Article
• Authors: Grennan, Troy; Smieja, Marek; Chernesky, Max; Nath, Ronita; Jang, Dan; Schnubb, Alex; Tan, Darrell H
• Is Part Of: Sexually transmitted infections. Volume 93(2017)Supplement 2
• Page Start: A87
• Page End: A87
• Publication Date: 2017-07-08
• Subjects: Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2017-053264.221
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Introduction: Persistent infection with high-risk human papillomavirus (hrHPV) is a necessary step in anal cancer's pathogenesis. With no universally-accepted guidelines on screening, and given the suboptimal performance of cytology, anal HPV testing is increasingly recognised as an important, adjunctive screening tool for anal cancer precursors. mRNA-based HPV assays targeting the E6/7 oncogenes are emerging as more specific tests for persistent HPV than the traditionally-used DNA-based tests. No data exists on serial monitoring of anal hrHPV in MSM using this novel assay. The objectives of this study are to describe HPV prevalence/persistence rates in a sample of high-risk, HIV-negative MSM enrolled in a PrEP demonstration project. Methods: Participants were drawn from PREPARATORY-5, which recruited HIV-negative MSM with high HIV risk as determined by a score of ≥10 on the HIV Incidence Risk Index for MSM (HIRI-MSM) and a history of condomless receptive anal sex in the prior 6 months. Anal samples were tested for hrHPV via the mRNA-based Aptima HPV Assay at baseline, months 6 and 12. Logistic regression was used to assess characteristics associated with hrHPV infection. Results: 43 participants were recruited, with median age 33 years (IQR 28–37). 10 (23%) were current smokers, and median HIRI-MSM score was 28 (IQR 19.5–35.5). 24 (56%) participants had hrHPV at any timepoint, and 15 (35%) had persistent hrHPV, defined as hrHPV isolated at two different timepoints. In multivariable logistic regression, current smoking status (OR=9.2, 95%CI=1.16–72.59, p=0.03) and HIRI-MSM score (OR: 1.2 per 1-point increase, 95%CI=1.03–1.33, p=0.01) were associated with hrHPV infection. Conclusion: Using a novel HPV E6/E7 mRNA assay with higher specificity for persistent infection, this study demonstrated a high burden of overall and persistent hrHPV infection in high-risk, HIV-negative MSM. These findings support the inclusion of MSM at high risk of sexual HIV acquisition when considering interventions related to the prevention and screening of anal cancer precursors.