Abnormal anal cytology in high-risk human papilloma virus infection in HIV-infected Australians. Issue 2 (19th September 2007)

• Record Type: Journal Article
• Authors: Anderson, J; Hoy, J; Hillman, R; Gittleson, C; Hartel, G; Medley, G; Basser, R
• Is Part Of: Sexually transmitted infections. Volume 84:Issue 2(2008)
• Page Start: 94
• Page End: 96
• Publication Date: 2007-09-19
• Subjects: Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sti.2007.027250
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Objective: To assess the prevalence of abnormal anal cytology and high-risk human papilloma virus (HPV)-type infection in HIV-infected people with a CD4 cell count >300 cells/μl. Methods: The clinic-based patient population included 126 HIV-infected people: 124 men who have sex with men, and two women (median age 45 years; CD4 cell count >300 cells/μl). Anal cytology swabs were placed into liquid-based medium for HPV typing by Hybrid Capture-2 assay and cytological assessment, by a single cytopathologist. Results: 106 (84%) participants were infected with high-risk HPV; 17 (14%) had no high-risk types of HPV detected; three (2%) had no HPV assay result because of an inadequate sample. Sixteen (13%) participants had cytological evidence of high-grade squamous intraepithelial (HGSIL) changes, 100% of whom had high-risk HPV types detected, and 13 (10%) had atypical squamous cells of undetermined significance with possible high-grade changes (ASCUS-H), 92% of whom had high-risk HPV types detected. Low-grade changes (LSIL) were detected in 24 (19%) participants, 96% of whom had high-risk HPV types, 32 (25%) had ASCUS with 88% high-risk HPV types, 30 (24%) had normal cytology with 73% high-risk HPV types, and 11 (9%) samples were inadequate for cytological assessment. The odds ratio of participants with high-risk HPV having abnormal anal cytology on anal swab was 5.03 (95% CI 1.45 to 17.39). Discussion: High-risk HPV types are common in this HIV+ population with a CD4 cell count >300 cells/μl. The presence of high-risk HPV types was associated with abnormal anal cytology such as HGSIL and ASCUS-H.