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MSM with HIV show greater rate of abnormal anal cytology
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Data published in The Journal of Infectious Diseases demonstrated that HIV-positive men who have sex with men, and those with persistent high-risk HPV, had a higher incidence of abnormal anal cytology.
“Our analysis of longitudinal data from this large prospective cohort study of HIV-infected MSM, women, and [men who have sex with women (MSW)] has demonstrated a high incidence of abnormal anal cytology, particularly among MSM,” researcher Lois J. Conley, MT, MPH, from the CDC’s National Center for HIV, Hepatitis, STD, and TB Prevention, and colleagues wrote. “As found in our prevalence analysis, anal cancer screening, not just for MSM but for all HIV-infected persons, should be taken into consideration when developing guidelines for the care of HIV-infected individuals, particularly for persons persistently infected with [high-risk HPV (HR-HPV)] types.”
Conley and colleagues used data from The Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN), a prospective observational cohort study of 700 patients with HIV, to evaluate the risk for abnormal anal cytology in this population. Participants were enrolled between March 2004 and June 2006 and followed up through May 2012.
The researchers assessed the participants’ sexual behavior, use of tobacco, alcohol and nonprescription drugs retrieved from audio computer self-assisted interviews issued at baseline and every 6 months. Anorectal swabs were collected annually and analyzed for 37 types of HPV, and cytology was conducted. At baseline, 243 participants had negative anal cytology.
During a median 2.1-year follow-up, 37% of participants developed an abnormal anal cytology, with a 13.9 per 100 person-year incidence rate (95% CI, 11.3-16.9). MSM had a higher rate of abnormal anal cytology than women (P = .019) and MSW (P = .026).
Data from a multivariable analysis of risk factors for incident abnormal anal cytology demonstrated the number of persistent HR-HPV types (adjusted HR = 1.17; CI, 1.01-1.36) were associated with abnormalities. Specifically, persistent HR-HPV types 16 or 18 (adjusted HR = 3.9; CI, 1.78-8.54) and persistent HR-HPV types other than 16 or 18 (adjusted HR = 2.46; 95% CI, 1.31-4.6) were associated with incident abnormalities. – by Jeff Craven
Disclosure: Conley reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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