Prevalence of & Risk Factors for Anal Oncogenic Human Papillomavirus Infection among HIV-Infected Women in France in the cART Era

BACKGROUND:

Little is known about the type-specific prevalence of anal human papillomavirus (HPV) infection and risk factors for anal high-risk (HR) HPV infection in HIV-infected women.

METHODS:

A cross-sectional study of anal and cervical HPV infection was nested within a gynaecological cohort of HIV-infected women. Specimens were tested for type-specific DNA using Linear Array.

RESULTS:

The study population consisted of 311 women with a median age of 45.3 years, of whom 42.8% originated from sub-Saharan Africa and 96.8% were receiving combination antiretroviral therapy. The median CD4 cell count was 612/mm³ and HIV load was below 50 copies/mL in 84.1%. HR-HPV types were detected in the anal canal in 148 (47.6%) and in the cervix in 82 (26.4%) women. HPV16 was the most prevalent type in both the anal canal (13.2% of women) and the cervix (5.1%). In multivariable analysis, factors associated with prevalent anal HR-HPV infection were CD4 count below 350/mm³ (OR, 2.9;95%CI:1.3-6.5), concurrent cervical lesions (OR, 2.6;95%CI:1.0-4.3), and cervical HR-HPV infection (OR, 1.8;95%CI: 1.0-3.2).

CONCLUSION:

The high prevalence of high-risk HPV types, including HPV16, in the anal canal of HIV-positive women is concerning. Anal cancer screening should be considered for HIV-positive women as part of their routine care.

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By:   Heard I1, Poizot-Martin I2, Potard V3, Etienney I4, Crenn-Hebert C5, Moore C6, Touraine P7, Cubie H6, Costagliola D8; ANRS-C017 VIHGY Study Group.

• 1French Human papillomavirus Reference Laboratory, Institut Pasteur, Paris, France Department of Endocrinology and Reproductive Medicine, IE3M, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique, Hôpitaux de Paris (AP-HP), Paris, France.
• 2Aix Marseille Univ, Sainte-Marguerite Hospital, Immuno-hematology Clinic Unit, Assistance Publique, Hôpitaux de Marseille, Marseille, France Inserm U912, Marseille, France.
• 3Sorbonne Universités, UPMC Univ Paris 06,INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136) F75013, Paris, France INSERM Transfert, Paris, France.
• 4Proctologie unit, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France.
• 5Assistance Publique, Hôpitaux de Paris (AP-HP), HUPNVS, Hôpital Mourier, Colombes, France.
• 6Scottish HPV Reference Laboratory, Edinburgh, UK.
• 7Department of Endocrinology and Reproductive Medicine, IE3M, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique, Hôpitaux de Paris (AP-HP), Paris, France.
• 8Sorbonne Universités, UPMC Univ Paris 06,INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136) F75013, Paris, France. 

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