Incidence & Clearance of Anal High-Risk Human Papillomavirus in HIV-Positive Men Who Have Sex with Men

Background: To estimate incidence and clearance of high-risk human papillomavirus (HR-HPV), and their risk factors, in men who have sex with men (MSM) recently infected by HIV in Spain; 2007–2013.

Methods: Multicenter cohort. HR-HPV infection was determined and genotyped with linear array. Two-state Markov models and Poisson regression were used.

Results: We analysed 1570 HR-HPV measurements of 612 MSM over 13 608 person-months (p-m) of follow-up. Median (mean) number of measurements was 2 (2.6), median time interval between measurements was 1.1 years (interquartile range: 0.89–1.4). Incidence ranged from 9.0 [95% confidence interval (CI) 6.8–11.8] per 1000 p-m for HPV59 to 15.9 (11.7–21.8) per 1000 p-m for HPV51. HPV16 and HPV18 had slightly above average incidence: 11.9/1000 p-m and 12.8/1000 p-m. HPV16 showed the lowest clearance for both ‘prevalent positive’ (15.7/1000 p-m; 95% CI 12.0–20.5) and ‘incident positive’ infections (22.1/1000 p-m; 95% CI 11.8–41.1). More sexual partners increased HR-HPV incidence, although it was not statistically significant. Age had a strong effect on clearance (P-value < 0.001) due to the elevated rate in MSM under age 25; the effect of HIV-RNA viral load was more gradual, with clearance rate decreasing at higher HIV-RNA viral load (P-value 0.008).

Conclusion: No large variation in incidence by HR-HPV type was seen. The most common incident types were HPV51, HPV52, HPV31, HPV18 and HPV16. No major variation in clearance by type was observed, with the exception of HPV16 which had the highest persistence and potentially, the strongest oncogenic capacity. Those aged below 25 or with low HIV-RNA- viral load had the highest clearance.

Below:  In the combined analysis, none of the variables had a statistically significant effect on HR-HPV incidence; P-values for the effect of age, CD4⁺ cell count and HIV-RNA viral load were 0.17, 0.49 and 0.55, respectively

Full article at:  http://goo.gl/yf2DCI

By:  Geskus, Ronald B.^a,b,*; González, Cristina^c,d,*; Torres, Montserrat^e; Del Romero, Jorge^f; Viciana, Pompeyo^g; Masiá, Mar^h; Blanco, José R.ⁱ; Iribarren, Mauricio^j; De Sanjosé, Silvia^d,k; Hernández-Novoa, Beatriz^l; Ortiz, Marta^e,†; Del Amo, Julia^c,d,†; CoRIS-HPV Study Group

^aPublic Health Service of Amsterdam

^bAcademic Medical Center, Amsterdam, The Netherlands

^cNational Center of Epidemiology, Institute of Health Carlos III, Madrid

^dCIBERESP

^eNational Center of Microbiology, Institute of Health Carlos III. Madrid

^fSanitary Center Sandoval, Madrid

^gVirgen del Rocío University Hospital, Sevilla

^hElche University Hospital, Alicante

ⁱSan Pedro –CIBIR Hospital, Logroño, La Rioja

^jXeral de Vigo University Hospital, Vigo

^kCatalan Institute of Oncology, Barcelona

^lRamón y Cajal University Hospital-IRYCIS, Madrid, Spain.

^*Ronald B. Geskus and Cristina González contributed equally to the writing of this manuscript.

^†Marta Ortiz and Julia Del Amo are senior authors and have equally contributed to this manuscript.

Correspondence to Julia del Amo, National Center of Epidemiology, Institute of Health Carlos III, Av. Monforte de Lemos no 5, CP: 28029 Madrid, Spain. Tel: +34 91 822 21 42; fax: +34 91 387 75 13; e-mail: jdamo@isciii.es

Received 14 January, 2014

Revised 27 June, 2014

Accepted 2 July, 2014

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