Saturday, March 26, 2016

Incidence, Duration, Persistence & Factors Associated with High-Risk Anal HPV Persistence among HIV-Negative Men Having Sex with Men

Given high rates of anal disease, we investigated the natural history of high-risk anal HPV among a multi-national group of men having sex with men (MSM) aged 18-64 years.

Anal specimens from HIV-negative men from Brazil, Mexico, and the USA were genotyped. Over 2 years, 406 MSM provided evaluable specimens every six months for ≥2 visits. These men were stratified into men having sex only with men (MSOM, n=70) and men having sex with women and men (MSWM, n=336). Persistence was defined as ≥12-months type-specific duration and could begin with either a prevalent or incident infection. Prevalence ratios and 95% confidence intervals were calculated by Poisson regression.

Median follow-up time was 2.1 years. Retention was 82%. Annual cumulative incidence of 9-valent vaccine types was 19% and 8% among MSOM and MSWM, respectively (log rank p-value 0.02). Duration of anal HPV did not differ for MSOM and MSWM and was a median of 6.9 months for HPV-16 after combining men from the two groups. Among men with prevalent high-risk infection (n=106), a total of 36.8%, retained the infection for at least 24 months. For those with prevalent HPV-16 (n=27), 29.6% were persistent for at least 24 months. Persistence of high-risk HPV was associated with number of male anal sex partners and inversely associated with number of female sex partners.

MSM with prevalent high-risk HPV infection should be considered at increased risk for non-transient infection.

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  • 1Center for Infectious Diseases, University of Texas School of Public Health at Houston, Houston, TX, USA.
  • 2Centro de Referência e Treinamento em DST/AIDS São Paulo, Brazil.
  • 3Division of Biostatistics, University of Texas School of Public Health at Houston, Houston, TX, USA.
  • 4Center of Translational Oncology, Instituto do Câncer do Estado de São Paulo - ICESP, São Paulo, Brazil.
  • 5Vanderbilt Institute for Global Health, Nashville, TN, USA.
  • 6Center for Infection Research in Cancer, Moffitt Cancer Center, MRC-CANCONT, Tampa, FL, USA.
  • 7Biostatistics, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
  • 8Instituto Nacional de Salud Pública, Cuernavaca, Mexico and Instituto Mexicano del Seguro Social, Cuernavaca, Mexico.
  • 9Instituto Nacional de Salud Pública, Cuernavaca, México.
  • 10Faculdade de Medicina, Universidade de São Paulo Department of Radiology and Oncology, Centro de Investigação Translacional em Oncologia - ICESP, São Paulo, SP, Brazil.
  • 11Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA.
  •  2016 Mar 8. pii: ciw140.  

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