Infection With Chlamydia trachomatis Increases the Risk of High-grade Anal Intraepithelial Neoplasia in People Living With Human Immunodeficiency Virus. (4th July 2019)

• Record Type: Journal Article
• Authors: Masiá, Mar; Fernández-González, Marta; García, José A; Padilla, Sergio; García-Payá, Elena; Gutiérrez, Ana; Ortiz de la Tabla, Victoria; García-Abellán, Javier; Agulló, Vanesa; Gutiérrez, Félix
• Is Part Of: Clinical infectious diseases. Volume 70:Number 10(2020)
• Page Start: 2161
• Page End: 2167
• Publication Date: 2019-07-04
• Subjects: Chlamydia trachomatis -- anal cancer -- sexually transmitted infections -- HPV53 -- HPV70; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciz606
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: We aimed to assess the relationship between sexually transmitted infections (STIs)—including a large panel of human papillomavirus (HPV) genotypes—and high-grade anal intraepithelial neoplasia (HGAIN) in men who have sex with men (MSM) who were living with human immunodeficiency virus (HIV). Methods: In a prospective study in an HIV cohort, participants underwent high-resolution anoscopy (HRA) for anorectal swabs collection to investigate STIs and for anal biopsy. Multiplex real-time polymerase chain reactions were performed, detecting several STIs and 28 HPV genotypes. Univariate and multivariate generalized linear models were used to analyze the relationships of variables of interest with HGAIN. Results: There were 145 participants included; in 49, 2 HRAs were performed. Ureaplasma urealyticum (UU) was detected in 25 (17.2%) participants, Chlamydia trachomatis (CT) in 13 (9.0%), Mycoplasma genitalium (MG) in 4 (2.8%), HPV16 in 38 (26.2%), HPV52 in 29 (20%), and HPV53 and HPV42 in 28 (19.3%) participants each. There were 35 (24.1%) subjects diagnosed with HGAIN. In the univariate analysis, HGAIN was associated with CT, UU, MG, HPV16, HPV53, HPV68, and HPV70, and significant interactions were found between CT and HPV16 (odds ratio [OR] 31.0 95% confidence interval [CI] 4.3–221.7) and between UU and HPV16 (OR 8.8, 95% CI 2.1–37.5). In the adjusted model, CT, HPV16, HPV53, HPV70, the CD4+/CD8+ ratio, and the interaction between CT and HPV16 remained independent predictors of HGAIN. HPV16, HPV53, and HPV70 persisted in the second HRA in all the participants with recurrent HGAIN. Conclusions: Coinfection with CT may potentiate the oncogenic capability of HPV16 and increase the risk of HGAIN in people with HIV. HPV53 and HPV70 should be considered among the genotypes associated with HGAIN. Abstract : In men who have sex with men and live with human immunodeficiency virus, coinfection with Chlamydia trachomatis and human papillomavirus (HPV)16 substantially increased the high-grade anal intraepithelial neoplasia risk, compared with either alone: C. trachomatis may enhance HPV's oncogenic potential.