The Effect of HIV Infection on Anal & Penile Human Papillomavirus Incidence & Clearance: A Cohort Study among MSM

A large portion of anogenital cancers is caused by high-risk human papillomavirus (hrHPV) infections, which are especially common in MSM HIV-infected men. We aimed to compare the incidence and clearance of anal and penile hrHPV infection between HIV-infected and HIV-negative MSM.

MSM aged at least 18 years were recruited in Amsterdam, the Netherlands, and followed-up semi-annually for 24 months. At each visit, participants completed risk-factor questionnaires. Anal and penile self-samples were tested for HPV DNA using the SPF10-PCR DEIA/LiPA25 system. Effects on incidence and clearance rates were quantified via Poisson regression, using generalized estimating equations to correct for multiple hrHPV types.

Seven hundred and fifty MSM with a median age of 40 years (interquartile 35-48) were included in the analyses, of whom 302 (40%) were HIV-infected. The incidence rates of hrHPV were significantly higher in HIV-infected compared with HIV-negative MSM [adjusted incidence rate ratio (aIRR) 1.6; 95% confidence interval (CI) 1.3-2.1 for anal and aIRR 1.4; 95%CI 1.0-2.1 for penile infection]. The clearance rate of hrHPV was significantly lower for anal, but not for penile infection. HrHPV incidence or clearance did not differ significantly by nadir CD4 cell count.

Increased anal and penile hrHPV incidence rates and decreased anal hrHPV clearance rates were found in HIV-infected compared with HIV-negative MSM, after adjusting for sexual behavior. Our findings suggest an independent effect of HIV infection on anal hrHPV infections.

Full article at: http://goo.gl/rNHNE3

By: Mooij SH1, Van Santen DK, Geskus RB, Van Der Sande MA, Coutinho RA, Stolte IG, Snijders PJ, Meijer CJ, Speksnijder AG, De Vries HJ, King AJ, Van Eeden A, Van Der Loeff MF.

• 1aDepartment of Infectious Diseases, Public Health Service Amsterdam bDepartment of Internal Medicine, Center for Infection and Immunity Amsterdam (CINIMA) cDepartment of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam dCentre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven eJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht fDepartment of Pathology, Vrije Universiteit-University Medical Center (VUmc) gDepartment of Dermatology, Academic Medical Center hDepartment of Internal Medicine, Jan van Goyen Medical Center iDepartment of Internal Medicine, DC Klinieken Oud Zuid, Amsterdam, the Netherlands.  

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