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Chambers C, Deeks SL, Sutradhar R, Cox J, de Pokomandy A, Grennan T, Hart TA, Lambert G, Moore DM, Grace D, Grewal R, Jollimore J, Lachowsky N, Nisenbaum R, Ogilvie G, Sauvageau C, Tan DHS, Coutlée F, Burchell AN. Vaccine Effectiveness Against 12-Month Incident and Persistent Anal Human Papillomavirus Infection Among Gay, Bisexual, and Other Men Who Have Sex With Men. J Infect Dis 2023; 228:89-100. [PMID: 36655513 PMCID: PMC10304758 DOI: 10.1093/infdis/jiad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/29/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Real-world evidence of human papillomavirus (HPV) vaccine effectiveness (VE) against longitudinal outcomes is lacking among gay, bisexual, and other men who have sex with men (GBM). We compared 12-month incidence and persistence of anal HPV infection between vaccinated and unvaccinated GBM. METHODS We recruited GBM aged 16-30 years in Montreal, Toronto, and Vancouver, Canada, from 2017 to 2019. Participants were followed over a median of 12 months (interquartile range, 12-13 months). Participants self-reported HPV vaccination and self-collected anal specimens for HPV DNA testing. We calculated prevalence ratios (PR) for 12-month cumulative incidence and persistence with ≥1 quadrivalent vaccine type (HPV 6/11/16/18) between vaccinated (≥1 dose at baseline) and unvaccinated participants using a propensity score-weighted, modified Poisson regression. RESULTS Among 248 participants, 109 (44.0%) were vaccinated at baseline, of whom 62.6% received 3 doses. PRs for HPV 6/11/16/18 were 0.56 (95% confidence interval [CI], .24-1.31) for cumulative incidence and 0.53 (95% CI, .25-1.14) for persistence. PRs were 0.23 (95% CI, .05-1.03) and 0.08 (95% CI, .01-.59) for incidence and persistence, respectively, among participants who received their first dose at age ≤23 years and 0.15 (95% CI, .03-.68) and 0.12 (95% CI, .03-.54) among participants who were sexually active for ≤5 years before vaccination. CONCLUSIONS Findings support national recommendations for HPV vaccination at younger ages or soon after sexual debut.
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Affiliation(s)
- Catharine Chambers
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Shelley L Deeks
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Government of Nova Scotia, Halifax, Nova Scotia, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rinku Sutradhar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada
| | - Joseph Cox
- McGill University Health Centre - Research Institute, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
- Direction Régionale de Santé Publique de Montréal, Montréal, Québec, Canada
| | - Alexandra de Pokomandy
- McGill University Health Centre - Research Institute, Montréal, Québec, Canada
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Troy Grennan
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trevor A Hart
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Gilles Lambert
- Direction Régionale de Santé Publique de Montréal, Montréal, Québec, Canada
| | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Jody Jollimore
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Nathan Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Rosane Nisenbaum
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Gina Ogilvie
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chantal Sauvageau
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | | | - François Coutlée
- Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Ann N Burchell
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
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2
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Zhou X, Tian T, Lu Z, Yu YF, Li Y, Zhou Y, Lin YF, Strong C, Zou H. Incidence, persistence, and clearance of anogenital human papillomavirus among men who have sex with men in Taiwan: a community cohort study. Front Immunol 2023; 14:1190007. [PMID: 37409111 PMCID: PMC10318129 DOI: 10.3389/fimmu.2023.1190007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/30/2023] [Indexed: 07/07/2023] Open
Abstract
Background Men who have sex with men (MSM) have an increased risk of human papillomavirus (HPV) infection. This study aimed to assess the incidence, persistence, and clearance of anogenital HPV infections among MSM and the correlates in a 3-year community cohort study. Methods From 2015 to 2019, MSM were recruited and followed up at 6, 12, 24, and 36 months in Taiwan. Questionnaires and anogenital swabs were collected at baseline and each follow-up visit. Thirty-seven HPV genotypes were tested and genotyped using the linear array HPV genotyping test. The incidence, persistence, and clearance rates of anogenital HPV infection and 95% confidence intervals (CIs) were estimated through Poisson regression. Correlates of the incidence and clearance rates were examined using a generalized estimating equations (GEE) model. Results A total of 201 MSM were retained in the cohort study with a median age of 27 years (interquartile range [IQR]: 24-32) at baseline. The incidence, persistence, and clearance rates of any anal HPV infection among MSM were 43.6 (95% CI: 33.7-55.6), 23.4 (17.7-30.2), and 58.3 (45.1-74.1) per 1,000 person months (pms), respectively. The incidence, persistence, and clearance rates of any penile HPV infection among MSM were 26.8 (20.1-34.9), 13.4 (8.0-20.9), and 51.5 (37.8-68.5) pms, respectively. MSM who did not consistently use a condom in receptive sex (adjusted odds ratio [AOR]: 2.06, 95% CIs: 1.14-3.72) were more likely to acquire any anal HPV infection. Age at recruitment (1.05, 1.01-1.09) was positively associated with any penile HPV incidence. MSM with over one sex partner in receptive anal sex (0.53, 0.30-0.94) were less likely to clear any anal HPV infection. MSM who were unemployed/students (0.55, 0.30-0.98) were less likely to clear any penile HPV infection. Conclusion High incidence and low clearance of anogenital HPV infection among MSM in the study serve as a reminder that this population needs to be targeted for HPV vaccination. It is essential for MSM to scale up HPV screening and adhere to safe sex.
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Affiliation(s)
- Xinyi Zhou
- School of Public Health (Shenzhen), Sun Yat‐sen University, Shenzhen, China
| | - Tian Tian
- School of Public Health (Shenzhen), Sun Yat‐sen University, Shenzhen, China
| | - Zhen Lu
- School of Public Health (Shenzhen), Sun Yat‐sen University, Shenzhen, China
| | - Yi-Fang Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuwei Li
- School of Public Health (Shenzhen), Sun Yat‐sen University, Shenzhen, China
| | - Yiguo Zhou
- School of Public Health, Peking University, Beijing, China
| | - Yi-Fan Lin
- School of Public Health (Shenzhen), Sun Yat‐sen University, Shenzhen, China
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat‐sen University, Shenzhen, China
- Kirby Institute, University of New South Wales, Sydney, Australia
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Nemcova J, Riegert J, Cerna K, Rob F, Smahelova J, Hercogova JT, Martinek P, Ondic O. Prevalence of oral and anal human papillomavirus infection in Czech predominantly Human immunodeficiency virus-positive men having sex with men - data from a previously unreported population. Int J STD AIDS 2022; 33:1054-1064. [PMID: 36073929 DOI: 10.1177/09564624221123869] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: HIV-positive men who have sex with men (MSM) are more likely to experience human papillomavirus (HPV) infection. The persistent HPV infection is the major factor in the development of anal and oropharyngeal neoplasms. Data on the prevalence of anal and oral HPV in MSM are almost absent from the countries of Central and Eastern Europe. We conducted a cross-sectional study focused on the prevalence of oral and anal HPV infections and the relationship between current anal and oral HPV intrapersonal infection in a Czech population of predominantly HIV-positive MSM. Methods: Oral gargle and anal swab samples from 205 predominantly HIV-positive MSM from the Czech Republic were analysed for HPV infection using PCR. Selected sociodemographic and clinical data were correlated with HPV detection using generalized linear models and multivariate analysis. Results: HPV infection was detected in 183 (96.8%) anal and 48 (23.6%) oral samples. The most common type of HR-HPV was HPV16 in both anal (25.4%) and oral (2.5%) samples. Multiple anal HPV infections and the presence of vaccine-targeted HR-HPV types were significantly correlated with abnormal anal cytology and HIV status. Conclusion: The prevalence of anal HPV infection in Czech predominantly HIV-positive MSM ranks among the highest reported, while oral HPV prevalence is consistent with MSM populations. Minimal overlap of oral and anal HPV types within a patient was observed.
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Affiliation(s)
- Jana Nemcova
- Biomedical Center of the Faculty of Medicine in Pilsen, Pilsen, Czech Republic.,Sikl's Department of Pathology, University Hospital in Pilsen, Pilsen, Czech Republic
| | - Jan Riegert
- Department of Zoology, Faculty of Science, 48271University of South Bohemia, České Budějovice, Czech Republic
| | - Katerina Cerna
- Biomedical Center of the Faculty of Medicine in Pilsen, Pilsen, Czech Republic.,Sikl's Department of Pathology, University Hospital in Pilsen, Pilsen, Czech Republic
| | - Filip Rob
- Department of Dermatovenereology, Second Faculty of Medicine, Bulovka University Hospital, 60568Charles University, Prague, Czech Republic
| | - Jana Smahelova
- National Reference Laboratory for Papillomaviruses and Polyomaviruses, 48231Institute Hematology and Blood Transfusion, Prague, Czech Republic.,Department of Genetics and Microbiology, Faculty of Science, 112302Charles University, Prague, Czech Republic
| | - Jana Tresnak Hercogova
- Department of Dermatovenereology, Second Faculty of Medicine, Bulovka University Hospital, 60568Charles University, Prague, Czech Republic
| | - Petr Martinek
- 524358Biopticka Laborator s.r.o., Pilsen, Czech Republic
| | - Ondrej Ondic
- Biomedical Center of the Faculty of Medicine in Pilsen, Pilsen, Czech Republic.,Sikl's Department of Pathology, University Hospital in Pilsen, Pilsen, Czech Republic
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Pauli S, Kops NL, Bessel M, Lina Villa L, Moreno Alves Souza F, Mendes Pereira GF, Neves Hugo F, Marcia Wendland E. Sexual practices and HPV infection in unvaccinated young adults. Sci Rep 2022; 12:12385. [PMID: 35859090 PMCID: PMC9300667 DOI: 10.1038/s41598-022-15088-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022] Open
Abstract
The present study aimed to evaluate the association of genital and oral HPV infection among different sexual practices in both sexes. In total, 6388 unvaccinated men and women aged 16–25 years from all state capitals of Brazil were enrolled in through primary care services between September 2016 and November 2017. Genital and oral HPV genotyping was performed using the Roche Linear Array. Poisson regression analysis with robust variance was conducted to examine factors associated with overall HPV infection. A higher prevalence of genital HPV was found in women who practiced oral sex (57.85%) and in men who practiced all types of sex (65.87%). However, having more sexual partners and being younger were more important than the type of sex practiced. HPV 6 (7.1%) and 16 (10.5%) were significantly more prevalent in women who practiced oral sex, while HPV 6 (23.96%) and 11 (21.49%) were more prevalent in men who practiced anal sex. The type of sex was not associated with oral HPV prevalence. Genital and oral HPV infection were not associated by different sexual practices in the studied population.
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Affiliation(s)
- Sílvia Pauli
- Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Porto Alegre, RS, 90035-004, Brazil
| | - Natália Luiza Kops
- Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Porto Alegre, RS, 90035-004, Brazil
| | - Marina Bessel
- Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Porto Alegre, RS, 90035-004, Brazil
| | - Luisa Lina Villa
- Department of Radiology and Oncology, Medical School, Universidade de São Paulo (USP), and Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil
| | - Flávia Moreno Alves Souza
- Department of Chronic Conditions and Sexually Transmitted Infections, Ministry of Health, Brasília, DF, Brazil
| | | | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Eliana Marcia Wendland
- Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Porto Alegre, RS, 90035-004, Brazil. .,Department of Public Health, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
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5
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Zhang Z, Ling X, Liu L, Xi M, Zhang G, Dai J. Natural History of Anal Papillomavirus Infection in HIV-Negative Men Who Have Sex With Men Based on a Markov Model: A 5-Year Prospective Cohort Study. Front Public Health 2022; 10:891991. [PMID: 35646789 PMCID: PMC9130828 DOI: 10.3389/fpubh.2022.891991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/20/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Men who have sex with men (MSM) are at increased risk for Human papillomavirus (HPV) infection compared to women and heterosexual men. We aimed to assess the incidence, clearance and duration of anal human papillomavirus (HPV) infection in HIV-negative MSM and the influencing factors in a 5-year prospective cohort study. Methods From April 2016 to April 2021, HIV-negative MSM were recruited and followed every 6 months in Urumqi, Xinjiang, China. Questionnaires and anal swabs were collected at baseline and every 6 months. We detected 37 anal HPV genotypes using the HPV Geno Array Diagnostic Kit Test. Incidence and clearance rates of anal HPV infection and the influencing factors were estimated using a two-state Markov model. Results A total of 585 MSM were included with a median age of 37 years [interquartile range (IQR): 31–43 years] and were followed for a median 2.8 years (IQR: 1.8–3.6 years). Incidence rates for any HPV and high-risk HPV (Hr-HPV) were 53.4 [95% confidence interval (CI): 49.1–58.0] and 39.0 (95% CI: 35.7–42.5)/1,000 person-months. Median duration of infection was 9.67 (95% CI: 8.67–10.86) and 8.51 (95% CI: 7.57–9.50) months, respectively. Clearance rates for any HPV and Hr-HPV were 50.9 (95% CI: 46.7–55.3) and 62.1 (95% CI: 56.8–66.7)/1,000 person-months, respectively. HPV16 and HPV6 had the highest incidence, lowest clearance rate and longest duration of infection among Hr-HPV and low-risk HPV (Lr-HPV) types, respectively. Receptive anal sex is a risk factor for any HPV [hazard ratio (HR) = 1.66, 95% CI: 1.16–2.38] and Hr-HPV infection (HR = 1.99, 95% CI:1.39–2.85). Recent anal sex without condom use was significantly associated with any HPV (HR = 1.80, 95% CI: 1.10–2.94) and Hr-HPV infection (HR = 2.60, 95% CI: 1.42–4.77). Age ≥35 years was significantly associated with Lr-HPV HPV infection only (HR = 1.40, 95% CI: 1.02–1.93). Both inserted and receptive anal sex (HR = 0.60, 95% CI: 0.40–0.89) and anal sex ≥2 times per week (HR = 0.61, 95% CI: 0.43–0.87) were associated with reduced Hr-HPV clearance. Six of the nine-valent vaccine types (HPV6, 11, 16, 18, 52 and 58) occurred most frequently, which indicates the need for high vaccination coverage in MSM. Conclusions In this cohort study, high incidence and low clearance of any HPV, Hr-HPV and individual HPV infections emphasize the importance of MSM vaccination. Modifiable behavioral factors such as condoms and drug use should be incorporated into HPV prevention strategies.
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6
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Nowak RG, Bentzen SM, Schumaker LM, Ambulos NP, Ndembi N, Dauda W, Mitchell A, Mathias TJ, Crowell TA, Baral SD, Blattner WA, Charurat ME, Palefsky JM, Cullen KJ. Evaluating the Jaccard Similarity Index as a Persistence Measure of Multiple Anal Human Papillomavirus Among Nigerian Men Who Have Sex With Men. Sex Transm Dis 2022; 49:297-303. [PMID: 34840323 PMCID: PMC8940626 DOI: 10.1097/olq.0000000000001587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multiple anal human papillomavirus (HPVs) may increase the risk of anal cancer among men who have sex with men (MSM) living with human immunodeficiency virus (HIV). The Jaccard Similarity Index (JSI) was explored as a measure of multiple HPV persistence. METHODS The TRUST/RV368 cohort enrolled MSM living with and without HIV in Abuja and Lagos, Nigeria. Participants with anal swabs at baseline, 3- and 12-month visits were tested for high- and low-risk HPVs using a next-generation sequencing assay. Persistence of the same HPV genotypes over time was calculated using the JSI and categorized into high, medium, and low similarity tertiles. Factors associated with higher versus lower similarity were estimated with multivariable ordinal logistic regression and reported as adjusted odds ratios (aORs) and 95% confidence intervals (CIs). RESULTS Of the 225 participants, median age was 25 years (interquartile range, 22-29 years), 62% were living with HIV, median HPVs was 3 (interquartile range, 2-5), and HPV6 (28%), HPV16 (26%), HPV11 (23%), and HPV45 (20%) were most prevalent. Fifty-three percent of participants had highly similar HPVs at 3 months, and the similarity was associated with HIV (aOR, 3.11; 95% CI, 1.6-5.9) and recent receptive sex (aOR, 1.9; 95% CI, 1.0-3.5). By 12 months, 20% had highly similar HPVs, and it was associated with 12 years or longer since anal coital debut (aOR, 6.8; 95% CI, 3.1-5.2), self-reported genital warts (aOR, 3.1; 95% CI, 1.5-6.6), and 200 or less CD4 cells/mm3 (aOR, 13.3; 95% CI, 2.7-65.2) for those living with HIV. CONCLUSIONS Studies evaluating the JSI as a predictor of high-grade intraepithelial lesions would further confirm its applicability as a quantitative measure of multiple HPV persistence.
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Affiliation(s)
| | - Søren M Bentzen
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD
| | - Lisa M Schumaker
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD
| | - Nicholas P Ambulos
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD
| | | | - Wuese Dauda
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | | | - Trevor J Mathias
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD
| | | | | | | | | | - Joel M Palefsky
- Department of Medicine, University of California, San Francisco, CA
| | - Kevin J Cullen
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD
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Gonçalves MG, Ferreira MT, Lopéz RVM, Ferreira S, Sirak B, Baggio ML, Lazcano-Ponce E, Nyitray AG, Giuliano AR, Villa LL, Sichero L. Prevalence and persistence of HPV-16 molecular variants in the anal canal of men: The HIM Study. J Clin Virol 2022; 149:105128. [DOI: 10.1016/j.jcv.2022.105128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
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8
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Ekanayake Weeramange C, Shu D, Tang KD, Batra J, Ladwa R, Kenny L, Vasani S, Frazer IH, Dolcetti R, Ellis JJ, Sturm RA, Leo P, Punyadeera C. Analysis of human leukocyte antigen associations in human papillomavirus-positive and -negative head and neck cancer: Comparison with cervical cancer. Cancer 2022; 128:1937-1947. [PMID: 35176174 PMCID: PMC9306518 DOI: 10.1002/cncr.34148] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 11/08/2022]
Abstract
Background Although the majority of human papillomavirus (HPV) infections are cleared by the immune system, a small percentage of them progress to develop HPV‐driven cancers. Cervical cancer studies highlight that HPV persistence and cancer risk are associated with genetic factors, especially at the human leukocyte antigen (HLA) genes. This study was conducted to investigate such associations in head and neck cancer (HNC). Methods In all, 192 patients with HNC and 384 controls were genotyped with the Infinium Global Screening Array (Illumina, Inc). HLA variants were imputed with SNP2HLA, and an association analysis was performed by logistic regression. Results HPV‐positive HNCs were significantly associated with single‐nucleotide polymorphisms (SNPs) at DRB1_32660090 (P = 1.728 × 10–6) and DRB1_32660116 (P = 1.728 × 10–6) and with the amino acid variant DRB1_11_32660115 (P = 1.728 × 10–6). None of these associations were observed in the HPV‐negative cohort, and this suggested their specificity to convey risk for HPV‐associated HNCs. In general, associations observed for HPV‐negative HNC were relatively weak, and variants in the HLA‐DPA1 region were the strongest among them (P = 4.531 × 10–4). Several lead signals reported by previous HNC genome‐wide association studies, including SNPs rs3135001 (P = .012), rs1049055 (P = .012), and rs34518860 (P = .029) and allele HLA‐DQB1*06 (P = .009), were replicated in the current study. However, these associations were limited to the HPV‐positive HNC group. Several cervical cancer–associated HLA variants, including SNPs rs9272143 (P = .002) and rs9271858 (P = .002) and alleles HLA‐B‐1501 (P = .009) and HLA‐B‐15 (P = .015), were also exclusively associated with HPV‐positive HNC. Conclusions HPV‐positive HNC risk is associated with distinct HLA variants, and some of them are shared by both cervical cancer and HPV‐positive HNC. Human papillomavirus (HPV)–positive head and neck cancer (HNC) risk is associated with distinct human leukocyte antigen variants, and some of them are shared by both cervical cancer and HPV‐positive HNC. Lay Summary Cervical cancer studies highlight that human papillomavirus (HPV)–driven cancer risk is linked with human leukocyte antigen (HLA) polymorphism. Hence, the current study was designed to investigate the HLA associations in HPV‐positive and HPV‐negative head and neck cancer (HNC) and compare these associations with cervical cancer. Several lead signals reported by previous HNC and cervical genome‐wide association studies were replicated in the current study. However, these associations were limited to the HPV‐positive HNC group, and this suggests that HPV‐positive HNC risk is associated with distinct HLA variants, and some of them are shared by both cervical cancer and HPV‐positive HNC.
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Affiliation(s)
- Chameera Ekanayake Weeramange
- Centre for Biomedical Technologies, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Saliva and Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery and Menzies Health Institute Queensland, Southport, Queensland, Australia.,Translational Research Institute, Woolloongabba, Queensland, Australia.,Department of Medical Laboratory Sciences, Faculty of Health Sciences, Open University of Sri Lanka, Nugegoda, Sri Lanka
| | - Danhua Shu
- School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Translational Research Institute, Woolloongabba, Queensland, Australia.,Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kai Dun Tang
- Centre for Biomedical Technologies, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Jyotsna Batra
- School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Rahul Ladwa
- Department of Cancer Care Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Lizbeth Kenny
- Faculty of Medicine, University of Queensland, Herston, Queensland, Australia.,Department of Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Sarju Vasani
- Faculty of Medicine, University of Queensland, Herston, Queensland, Australia.,Department of Otolaryngology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Ian H Frazer
- Translational Research Institute, Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Riccardo Dolcetti
- Faculty of Medicine, University of Queensland, Herston, Queensland, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.,Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jonathan J Ellis
- School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Translational Research Institute, Woolloongabba, Queensland, Australia.,Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Richard A Sturm
- Diamantina Institute, University of Queensland, Woolloongabba, Queensland, Australia
| | - Paul Leo
- School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Translational Research Institute, Woolloongabba, Queensland, Australia.,Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Chamindie Punyadeera
- Centre for Biomedical Technologies, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Saliva and Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery and Menzies Health Institute Queensland, Southport, Queensland, Australia.,Translational Research Institute, Woolloongabba, Queensland, Australia
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9
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Donà MG, Giuliani M, Rollo F, Vescio MF, Benevolo M, Giglio A, Giuliani E, Morrone A, Latini A. Incidence and clearance of anal high-risk Human Papillomavirus infection and their risk factors in men who have sex with men living with HIV. Sci Rep 2022; 12:184. [PMID: 34996988 PMCID: PMC8741812 DOI: 10.1038/s41598-021-03913-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/07/2021] [Indexed: 11/09/2022] Open
Abstract
HIV-infected men who have sex with men (MSM) display the highest prevalence of anal infection by high-risk Human Papillomaviruses (hrHPVs) and incidence of anal carcinoma. Anal specimens were genotyped by the Linear Array. Incidence and clearance of anal infection by hrHPVs, hrHPVs other than HPV16, low-risk HPVs, and four individual types (6,11,16,18) were estimated using a two-state Markov model. Determinants for incidence and clearance were assessed by logistic regression. Overall, 204 individuals were included (median age 42 years, IQR = 34-49). For hrHPVs, incidence and clearance rates were 36.1 × 1000 person-months (p-m) (95% CI 23.3-56.5) and 15.6 × 1000 p-m (95% CI 10.7-23.3), respectively. HPV16 showed a higher incidence than HPV18 (10.2 vs. 7.2 × 1000 p-m). Its clearance was more than twofold lower than that of HPV18 (30.1 vs. 78.2 × 1000 p-m). MSM receiving cART displayed a 68% to 88% decrease in risk of acquiring hrHPVs, hrHPVs other than HPV16, HPV16, and HPV18 (adjusted Hazard Ratio [aHR] 0.13, 95% CI 0.02-0.67; aHR 0.22, 95% CI 0.06-0.78; aHR 0.32, 95% CI 0.12-0.90; aHR 0.12, 95% CI 0.04-0.31, respectively) than patients not treated. A nadir CD4 + count < 200 cells/mm3 significantly reduced the clearance of hrHPVs other than HPV16 (aHR 0.39, 95% CI 0.17-0.90). cART use reduces the risk of acquiring anal infection by hrHPVs.
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Affiliation(s)
- Maria Gabriella Donà
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Francesca Rollo
- Pathology Department, Regina Elena National Cancer Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Maria Fenicia Vescio
- Infectious, Parasitic and Immunomediated Diseases Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Maria Benevolo
- Pathology Department, Regina Elena National Cancer Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Amalia Giglio
- Microbiology and Clinical Pathology Department, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Eugenia Giuliani
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
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10
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Tuan LA, Prem K, Pham QD, Toh ZQ, Tran HP, Nguyen PD, Mai CTN, Ly LTK, Cao V, Le-Ha TD, Tuan NA, Jit M, Bright K, Brisson M, Nguyen TV, Garland S, Anh DD, Trang NV, Mulholland K. Anal human papillomavirus prevalence and risk factors among men who have sex with men in Vietnam. Int J Infect Dis 2021; 112:136-143. [PMID: 34517047 PMCID: PMC8627386 DOI: 10.1016/j.ijid.2021.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/24/2021] [Accepted: 09/07/2021] [Indexed: 12/28/2022] Open
Abstract
HPV infection in men having sex with men (MSM) was studied in two cities of Vietnam Prevalence of any HPV and HPV16/18 among MSM was 32.3% and 11.0%, respectively High-risk HPV infections in MSM were associated with risky sexual behaviours A targeted HPV vaccination strategy would be beneficial for MSM in Vietnam
Objectives Men who have sex with men (MSM) are at risk of human papillomavirus (HPV)-related cancers, while published data are scarce. This study determined HPV prevalence and risk factors in MSM in Vietnam to inform HPV prevention strategies in this key population. Methods A cross-sectional study of 799 MSM aged 16-50 years was conducted in Vietnam in 2017-2018. Information was collected on risk behaviours, and knowledge of HPV and anal cancer; rectal swabs were taken to detect anal HPV infection. An in-house polymerase chain reaction and Genoflow HPV array test kit were used for HPV detection and genotyping. Results The median age of the study participants was 25 years (range 18-52). Overall prevalence of any HPV and HPV16/18 infection was 32.3% and 11.0%, respectively. A higher prevalence of high-risk HPV infection to all 14 types tested was found in Ho Chi Minh City (30.9%) than in Hanoi (18.4%). High-risk HPV infection was associated with inconsistent condom use and history of engaging in sex under the influence of drugs (adjusted odds ratio (aOR), 2.27; 95% CI, 1.48-10.67), as well as having multiple sexual partners (aOR, 1.01; 95% CI, 1.00–1.02). Conclusions High-risk anal HPV infections in Vietnamese MSM were significantly associated with risky sexual behaviours. A targeted HPV vaccination strategy would have substantial benefit for MSM in Vietnam.
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Affiliation(s)
- Le Anh Tuan
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
| | - Kiesha Prem
- London School of Hygiene and Tropical Medicine, London, UK.
| | - Quang Duy Pham
- Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | - Zheng Quan Toh
- Infection and Immunity, Murdoch Children's Research Institute, VIC, Australia; Department of Paediatrics, The University of Melbourne, VIC, Australia.
| | - Hau Phuc Tran
- Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | - Phuc Duy Nguyen
- Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | | | - Le Thi Khanh Ly
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
| | - Van Cao
- Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | - Tam-Duong Le-Ha
- Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | - Nguyen Anh Tuan
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
| | - Mark Jit
- London School of Hygiene and Tropical Medicine, London, UK; School of Public Health, University of Hong Kong, Hong Kong, SAR, China; Public Health England, Modelling and Economics Unit, London, UK.
| | - Kathryn Bright
- Infection and Immunity, Murdoch Children's Research Institute, VIC, Australia.
| | - Marc Brisson
- Centre de recherche du CHU de Québec, Université Laval, Québec, QC, Canada; Department of Social and Preventive Medicine, Université Laval, Québec, Canada.
| | - Thuong Vu Nguyen
- Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | - Suzanne Garland
- Infection and Immunity, Murdoch Children's Research Institute, VIC, Australia; Centre for Women's Infectious Diseases, The Royal Women's Hospital, Melbourne, Department of Obstetrics and Gynaecology, University of Melbourne, Australia.
| | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
| | | | - Kim Mulholland
- London School of Hygiene and Tropical Medicine, London, UK; Infection and Immunity, Murdoch Children's Research Institute, VIC, Australia; Department of Paediatrics, The University of Melbourne, VIC, Australia.
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11
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Nyitray AG, Schick V, Swartz MD, Giuliano AR, Fernandez ME, Deshmukh AA, Ridolfi TJ, Ajala C, Brzezinski B, Sandoval M, Nedjai B, Smith JS, Chiao EY. Rationale and design of the Prevent Anal Cancer Self-Swab Study: a protocol for a randomised clinical trial of home-based self-collection of cells for anal cancer screening. BMJ Open 2021; 11:e051118. [PMID: 34187833 PMCID: PMC8245463 DOI: 10.1136/bmjopen-2021-051118] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Squamous cell carcinoma of the anus is a common cancer among sexual minority men, especially HIV-positive sexual minority men; however, there is no evidenced-based national screening protocol for detection of anal precancers. Our objective is to determine compliance with annual anal canal self-sampling or clinician-sampling for human papillomavirus (HPV) DNA. METHODS AND ANALYSIS This is a prospective, randomised, two-arm clinical study to evaluate compliance with annual home-based versus clinic-based HPV DNA screening of anal canal exfoliated cells. The setting is primary care community-based clinics. Recruitment is ongoing for 400 HIV-positive and HIV-negative sexual minority men and transgender persons, aged >25 years, English or Spanish speaking, no current use of anticoagulants other than nonsteroidal anti-inflammatory drugs and no prior diagnosis of anal cancer. Participants are randomised to either receive a swab in the mail for home-based collection of an anal canal specimen at 0 and 12 months (arm 1) or attend a clinic for clinician collection of an anal canal specimen at 0 and 12 months (arm 2). Persons will receive clinic-based Digital Anal Rectal Examinations and high-resolution anoscopy-directed biopsy to assess precancerous lesions, stratified by study arm. Anal exfoliated cells collected in the study are assessed for high-risk HPV persistence and host/viral methylation. The primary analysis will use the intention-to-treat principle to compare the proportion of those who comply with 0-month and 12-month sampling in the home-based and clinic-based arms. The a priori hypothesis is that a majority of persons will comply with annual screening with increased compliance among persons in the home-based arm versus clinic-based arm. ETHICS AND DISSEMINATION The study has been approved by the Medical College of Wisconsin Human Protections Committee. Results will be disseminated to communities where recruitment occurred and through peer-reviewed literature and conferences. TRIAL REGISTRATION NUMBER NCT03489707.
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Affiliation(s)
- Alan G Nyitray
- Clinical Cancer Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioural Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Vanessa Schick
- Department of Management, Policy, and Community Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| | - Michael D Swartz
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, H Lee Moffitt Cancer Center and Research Insitute, Tampa, Florida, USA
| | - Maria E Fernandez
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| | - Ashish A Deshmukh
- Department of Management, Policy, and Community Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| | - Timothy J Ridolfi
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Christopher Ajala
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioural Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Bridgett Brzezinski
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioural Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Micaela Sandoval
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| | - Belinda Nedjai
- Wolfson Institute of Preventive Medicine, Centre for Cancer Prevention, Queen Mary University of London, London, UK
| | - Jennifer S Smith
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Elizabeth Y Chiao
- Department Epidemiology, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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12
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Laurie C, El-Zein M, Tota JE, Khosrow-Khavar F, Tellier PP, Coutlée F, de Pokomandy A, Franco EL. Efficacy of a carrageenan gel in preventing anal human papillomavirus (HPV) infection: interim analysis of the Lubricant Investigation in Men to Inhibit Transmission of HPV Infection (LIMIT-HPV) randomised controlled trial. Sex Transm Infect 2021; 98:239-246. [PMID: 34140405 DOI: 10.1136/sextrans-2021-055009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/20/2021] [Accepted: 04/25/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Carrageenan, a non-toxic gelling agent derived from red algae, has potent anti-human papillomavirus (HPV) activity in in vitro and animal studies. We assessed, in an interim analysis, the efficacy of a carrageenan-based gel in reducing the risk of new detections of anal HPV among gay, bisexual and other men who have sex with men (gbMSM). METHODS The LIMIT-HPV study (Lubricant Investigation in Men to Inhibit Transmission of HPV Infection) is a phase IIb, double-blind, placebo-controlled randomised controlled trial conducted in Montreal, Canada. gbMSM were randomly assigned (1:1) to receive a carrageenan-based or placebo gel. Participants were instructed to apply the gel to the anus, condom and/or partners' penis before and-as required-during receptive anal intercourse. Questionnaire data and anal samples were collected at 0, 1, 2, 3, 6, 9 and 12 months. We estimated new detections of anal HPV infection(s) detected via Linear Array using Cox proportional hazards models. RESULTS Participants recruited from February 2016 to December 2019 were randomly assigned to the carrageenan (n=127) or placebo (n=128) arm. The efficacy and safety analyses included 201 and 210 participants. The median follow-up time was 7.6 months (range: 0-28.5) in the carrageenan group and 9.3 months (range: 0-40.7) in the placebo group. The HR for new detections was 1.21 (95% CI 0.86 to 1.70): 69.4% and 65.1% new detections of HPV in the carrageenan and placebo arms, respectively. More adverse events were reported in the carrageenan (59.8%) compared with the placebo (39.8%) arm. CONCLUSIONS The interim analysis did not demonstrate a protective effect of carrageenan on the risk of new detections of anal HPV infection among gbMSM. Carrageenan gel use was associated with a higher proportion of adverse events. Given these findings and the (assumed) low probability that a beneficial effect would be found by the study's end, the trial was terminated as recommended by the Data Safety and Monitoring Board. TRIAL REGISTRATION NUMBER NCT02354144.
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Affiliation(s)
- Cassandra Laurie
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Mariam El-Zein
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Joseph E Tota
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | | | | | - François Coutlée
- Laboratoire de virologie moléculaire, Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), et Département de Microbiologie, infectiologie et Immunologie, Université de Montréal, Montreal, Quebec, Canada
| | | | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
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13
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Cotte L, Veyer D, Charreau I, Péré H, Cua E, Carette D, Chas J, Capitant C, Chidiac C, Fléjou JF, Fouéré S, Heard I, Meyer L, Puech J, Tremblay C, Delaugerre C, Molina JM. Prevalence and Incidence of Human Papillomavirus Infection in Men Having Sex With Men Enrolled in a Pre-exposure Prophylaxis Study: A Sub-study of the Agence Nationale de Recherches sur le SIDA et les Hépatites Virales "Intervention Préventive de l'Exposition aux Risques avec et pour les hommes Gays" Trial. Clin Infect Dis 2021; 72:41-49. [PMID: 31907521 DOI: 10.1093/cid/ciaa002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/06/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is more frequent in men having sex with men (MSM) who are living with human immunodeficiency virus (HIV) than in MSM without HIV. There are currently no data regarding HPV infections in preexposure prophylaxis (PrEP)-using MSM. METHODS MSM living without HIV who were enrolled in the Agence Nationale de Recherches sur le SIDA et les Hépatites Virales "Intervention Préventive de l'Exposition aux Risques avec et pour les hommes Gays" PrEP study were prospectively enrolled. Anal, penile, and oral samples were collected at baseline and every 6 months for HPV detection and genotyping. Anal swabs for cytology were obtained at baseline and at 24 months. RESULTS We enrolled 162 participants. The prevalences of any HPV genotypes at baseline were 92%, 32%, and 12% at the anal, penile, and oral sites, respectively. High-risk (HR) HPV genotypes were observed in 84%, 25%, and 10% of anal, penile, and oral baseline samples, respectively. Nonavalent HPV vaccine genotypes were observed in 77%, 22%, and 6% of anal, penile, and oral baseline samples, respectively. Multiple infections were observed in 76%, 17%, and 3% of cases at the anal, penile, and oral sites, respectively. The most frequent HR genotypes were HPV 53, 51, and 16 in anal samples; HPV 33, 39, and 73 in penile samples; and HPV 66 in oral samples. The incidence of any HPV genotype at the anal site was 86.2/1000 person-months and the incidence of HR-HPV genotypes was 72.3/1000 person-months. The baseline cytology was normal in 32% of cases and was classified as atypical squamous cells of undetermined significance, low-grade squamous intra-epithelial lesion, high-grade squamous intra-epithelial lesion (HSIL), and atypical squamous cells that cannot exclude HSIL in 23%, 40%, 5%, and 1% of cases, respectively. CONCLUSIONS PrEP users have a similar risk of HPV infection as MSM living with HIV and the risk is much higher than that previously reported in MSM living without HIV.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1052, Lyon, France
| | - David Veyer
- Department of Virology, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Isabelle Charreau
- Institut National de la Santé et de la Recherche Médicale, Service Commun 10, Unité de Service 19, Villejuif, France
| | - Hélène Péré
- Department of Virology, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Institut National de la Santé et de la Recherche Médicale, Unité 970, Paris Centre de Recherche Cardiovasculaire, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Eric Cua
- Department of Infectious Diseases, Hôpital L'Archet, Nice, France
| | - Diane Carette
- Institut National de la Santé et de la Recherche Médicale, Service Commun 10, Unité de Service 19, Villejuif, France
| | - Julie Chas
- Department of Infectious Diseases, Assistance Publique - Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Catherine Capitant
- Institut National de la Santé et de la Recherche Médicale, Service Commun 10, Unité de Service 19, Villejuif, France
| | - Christian Chidiac
- Department of Infectious Diseases, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.,Université Claude Bernard - Lyon 1, Lyon, France
| | - Jean-François Fléjou
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France.,Sorbonne Université, Paris, France
| | - Sébastien Fouéré
- Department of Dermatology, Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Isabelle Heard
- French Human Papillomavirus Reference Laboratory, Institut Pasteur, Paris, France.,Department of Endocrinology and Reproductive Medicine, Institut Endocrinologie, Maladies Métaboliques et Médecine Interne, Assistance Publique - Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Laurence Meyer
- Institut National de la Santé et de la Recherche Médicale, Service Commun 10, Unité de Service 19, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, Centre de Recherche en Epidémiologie et Santé Publique, Unité 1018, Université Paris Sud, Paris Saclay, Le Kremlin-Bicêtre, France.,Department of Public Health, Assistance Publique - Hôpitaux de Paris, Groupe Hospitalier Universitaire Paris Sud, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Julien Puech
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 839, Institut du Fer à Moulin, Sorbonne Université, Paris, France
| | - Cécile Tremblay
- Département de Microbiologie, Infectiologie, et Immunologie, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Constance Delaugerre
- Department of Virology, Centre National de Référence du Virus de l'Immunodéficience Humaine , Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France.,Institut National de la Santé et de la Recherche Médicale, Unité 944, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7212, Institut Universitaire d'Hématologie, Université Paris Diderot, Paris, France
| | - Jean-Michel Molina
- Institut National de la Santé et de la Recherche Médicale, Unité 944, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7212, Institut Universitaire d'Hématologie, Université Paris Diderot, Paris, France.,Department of Infectious Diseases, Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
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14
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Incidence, Persistence, and Factors Associated With HPV Infection Among Male Adolescents With and Without Perinatally Acquired HIV Infection. J Acquir Immune Defic Syndr 2021; 85:553-560. [PMID: 32925357 DOI: 10.1097/qai.0000000000002499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Infection with high-risk human papillomavirus (HR-HPV) has been shown to be more prevalent and persistent in female adolescents with HIV. However, data among male adolescents with perinatally acquired HIV (PHIV) are limited. SETTING We investigated the incidence and persistence of HR-HPV in anogenital compartments and associated factors among PHIV in comparison to HIV-uninfected (HU) male adolescents in Thailand. METHODS PHIV and HU males aged 12-24 years were enrolled. At baseline and 3 subsequent annual visits, specimens from the scrotum, penis, and anal area were obtained for HPV and other testing. RESULTS From June 2013 to October 2017, 49 PHIV and 47 HU male adolescents with a median age of 18 (interquartile range 17-20) years were enrolled. PHIV had higher incidence of any HR-HPV infection than HU adolescents {33.05 [95% confidence interval (CI): 20.82 to 52.46] vs. 15.73 [95% CI: 8.18 to 30.22] per 100 person-years, P = 0.04}. The persistence of any HR-HPV genotypes (detected at ≥2 annual visits) was not different by group (PHIV 27% vs. HU 23%, P = 0.75). Having ≥3 sex partners in past 6 months (adjusted prevalence ratio 2.39, 95% CI: 1.14 to 5.05; P = 0.02) and co-infection with other sexually transmitted infections (syphilis, chlamydia, and/or gonorrhea) were associated with persistent HR-HPV infection (adjusted prevalence ratio 6.21, 95% CI: 2.87 to 13.41; P < 0.001). CONCLUSIONS Thai PHIV male adolescents had a higher incidence of HR-HPV infection than those without HIV. Having multiple sex partners and co-infection with sexually transmitted infections was associated with persistent HR-HPV infection. These data demonstrate the need to prioritize PHIV male adolescents in routine and catch-up HPV vaccination programs.
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15
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Choi Y, Loutfy M, Remis RS, Liu J, Rebbapragada A, Huibner S, Brunetta J, Smith G, Reko T, Halpenny R, Kaul R, Grennan T. HPV genotyping and risk factors for anal high-risk HPV infection in men who have sex with men from Toronto, Canada. Sci Rep 2021; 11:4779. [PMID: 33637798 PMCID: PMC7910431 DOI: 10.1038/s41598-021-84079-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 02/10/2021] [Indexed: 11/22/2022] Open
Abstract
Men who have sex with men (MSM) are disproportionately affected by anal cancer, predominantly caused by high-risk (HR) human papillomavirus (HPV) infection. Currently, the nonavalent HPV vaccine provides coverage against nine HPV genotypes, including seven HR-HPV genotypes. Here, we characterize anal HR-HPV genotype distribution and associated risk factors in MSM from Toronto, Canada recruited between September 2010 and June 2012. Wilcoxon-Mann-Whitney test was used for continuous variables, Chi-square test was performed for categorical variables, and a multivariable model using logistic regression was created to assess for correlates of anal HR-HPV infection. A total of 442 MSM were recruited, with a median age of 45 (IQR 38-50) and an overall HPV prevalence of 82%. The prevalence of any HR-HPV infection was 65.3% and 50.7% in the HIV-positive and HIV-negative MSM, respectively. No participant tested positive for all genotypes covered by the nonavalent vaccine. HIV status (aOR 1.806; 95% CI 1.159-2.816), smoking (aOR 2.176; 95% CI 1.285-3.685) and the number of lifetime sexual partners (aOR 2.466; 95% CI 1.092-5.567) were independent risk factors for anal HR-HPV infection. Our findings will be useful to inform HPV vaccine rollout and HPV prevention strategies in Canadian MSM.
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Affiliation(s)
- Yoojin Choi
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada.
| | - Mona Loutfy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Maple Leaf Medical Clinic, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Robert S Remis
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Juan Liu
- Public Health Laboratory-Toronto, Public Health Ontario, Toronto, Ontario, Canada
| | | | - Sanja Huibner
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Graham Smith
- Maple Leaf Medical Clinic, Toronto, Ontario, Canada
| | | | | | - Rupert Kaul
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Troy Grennan
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- St. Paul's Hospital, Vancouver, British Columbia, Canada
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16
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Wei F, Guo M, Huang S, Li M, Cui X, Su Y, Wu X, Ma X, Zheng Y, Huang Y, Wang L, Pan L, Wu T, Zhang J, Xia N. Sex Differences in the Incidence and Clearance of Anogenital Human Papillomavirus Infection in Liuzhou, China: An Observational Cohort Study. Clin Infect Dis 2021; 70:82-89. [PMID: 30852604 DOI: 10.1093/cid/ciz168] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 03/05/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) causes anogenital warts and cancers in men and women. However, little is known about sex differences regarding the natural history of anogenital HPV infection. METHODS Starting in May 2014, an observational cohort study including 2309 men and 2378 women aged 18-55 years was conducted in Liuzhou, China. Samples from anogenital sites were tested for HPV genotypes by multicolor real-time polymerase chain reaction and melting curve analysis biannually for ~1 year. RESULTS The incidence of oncogenic HPV infection was similar in men and women (10.3 and 11.5/1000 person-months; P = .275), whereas the incidence of HPV-6/11 infection was higher in men than in women (2.0 vs 1.1; P = .018). The incidence of both oncogenic HPV and HPV-6/11 infections was significantly higher in women in the 18- to 25-year age group than in the older age groups (P = .006 and .011, respectively), whereas it did not vary by age among men (P = .552 and .425, respectively). Additionally, men were more likely than women to clear oncogenic infections (101.5 vs 58.6/1000 person-months; P < .001), but no significant difference was found in the clearance of HPV-6/11 by sex (111.7 vs 84.8; P = .266). The median time to clearance of oncogenic type and type 6/11 infections was not age dependent for either sex (all P > .05). CONCLUSIONS The natural history of oncogenic and nononcogenic HPV infection differs by sex, which implies that sex-specific vaccination strategies should be considered for oncogenic and nononcogenic HPV. CLINICAL TRIALS REGISTRATION NCT02188004.
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Affiliation(s)
- Feixue Wei
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Meng Guo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Shoujie Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Mingqiang Li
- Liuzhou Center for Disease Control and Prevention, China
| | - Xuelian Cui
- Liuzhou Center for Disease Control and Prevention, China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Xin Wu
- Liuzhou Center for Disease Control and Prevention, China
| | - Xinjing Ma
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Ya Zheng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Yue Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Lin Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Lili Pan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Ting Wu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Jun Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University
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17
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Poynten IM, Jin F, Garland SM, Hillman RJ, Molano M, Roberts JM, Templeton DJ, Phillips S, Law C, Fairley CK, Farnsworth A, Grulich AE. HIV, Immune Dysfunction, and the Natural History of Anal High-Risk Human Papillomavirus Infection in Gay and Bisexual Men. J Infect Dis 2020; 224:246-257. [PMID: 33220687 DOI: 10.1093/infdis/jiaa723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/19/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Incidence of anal cancer is highest in gay and bisexual men (GBM). Better understanding of the natural history of anal high-risk human papillomavirus (hrHPV) infection is needed for anal cancer prevention. METHODS The Study of the Prevention of Anal Cancer was a 3-year study of Australian GBM, aged 35 years or older. We examined incidence, clearance, and risk factors for 13 hrHPV types at baseline and 3 annual visits. RESULTS In 525 men with ≥ 2 visits, 348 (66.3%) acquired ≥ 1 incident hrHPV infection. HPV16 incidence rates were similar, but non-16 hrHPV incidence was higher in HIV-positive (51.8/100 person years [PY]) than HIV-negative men (36.5/100 PY, P < .001). Annual clearance rates of HPV16 (13.21/100 PY, 95% confidence interval, 10.53-16.56) were lower than for other hrHPV types. hrHPV clearance rates were not associated with HIV overall but were significantly lower in those with a lower nadir CD4 (<200 cells/µL) for HPV16 (P = .015) and other hrHPV types (P = .007). CONCLUSIONS Higher incidence of non-16 hrHPV types, coupled with lower clearance of non-16 hrHPV types in those with past impaired immune function, is consistent with the greater role of non-16 hrHPV in anal cancer in HIV-positive people. AUSTRALIA NEW ZEALAND CLINICAL TRIALS REGISTRY ANZCTR365383.
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Affiliation(s)
- I Mary Poynten
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Fengyi Jin
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Suzanne M Garland
- Centre for Women's Infectious Disease Research, Royal Women's Hospital Melbourne, Parkville, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | | | - Monica Molano
- Centre for Women's Infectious Disease Research, Royal Women's Hospital Melbourne, Parkville, Victoria, Australia
| | | | - David J Templeton
- Royal Prince Alfred Sexual Health Service, Sydney Local Health District, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Samuel Phillips
- Centre for Women's Infectious Disease Research, Royal Women's Hospital Melbourne, Parkville, Victoria, Australia
| | - Carmella Law
- St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Christopher K Fairley
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | | | - Andrew E Grulich
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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18
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The Classification of the Persistent Infection Risk for Human Papillomavirus among HIV-Negative Men Who Have Sex with Men: Trajectory Model Analysis. BIOMED RESEARCH INTERNATIONAL 2020. [DOI: 10.1155/2020/8174983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. To classify the infection risk of human papillomavirus (HPV) among human immunodeficiency virus- (HIV-) negative men who have sex with men (MSM) using group-based trajectory modeling (GBTM). Methods. This study collected data on demographic and sexual behavior characteristics by questionnaires at semiannual visits from March 1st, 2016 to December 31th, 2017. Researchers collected anal exfoliated cells to finish HPV testing and blood samples to finish HIV testing at baseline and follow-up visits. Accumulative infection numbers of different types of HPV as the primary outcome and the follow-up visits as the independent predicator to build a GBTM model. Results. There were 500 potentially eligible HIV-negative participants at baseline, 361 (72.2%) of whom were included in this study after screening. Three trajectory groups were identified as the best-fitted GBTM model. Trajectory 1, defined as decreased group (DG) accounted for 44.6% (161/361) of the sample, showed a declining pattern with visits. Trajectory 2, defined as flat group (FG) accounted for 49.6% (179/361) of the sample, showed a flat pattern with visits. Trajectory 3, regarded as the increased group (IG) accounted for 5.8% (21/361) of the sample, showed an uptrend. Compared to the DG, risk factors for the FG included receptive anal intercourse (AOR, 2.24; 95% CI, 1.36-3.71), occasional condom use in anal sex during the past six months (AOR, 1.90; 95% CI, 1.16-3.14), experience of transactional sex with males in the past year (AOR, 3.60; 95% CI, 1.12-11.54), and substance use (AOR, 1.81; 95% CI, 1.08-3.04). Risk factors for the IG included receptive anal intercourse (AOR, 2.81; 95% CI, 1.04-7.70), occasional condom use in anal sex during the past six months (AOR, 3.93; 95% CI, 1.40-11.01), and history of other STIs (AOR, 5.72; 95% CI, 1.40-23.46). Conclusion. The MSM data in this study showed three distinct developmental trajectories (DG, FG, and IG) of HPV infection among HIV-negative MSM, with receptive anal intercourse and occasional condom use in anal sex during the past six months being the risk factors associated with FG and IG.
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19
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Incidence, clearance, persistence and factors related with high-risk anal HPV persistence in South-East Asian MSM and transgender women. AIDS 2020; 34:1933-1941. [PMID: 32773478 DOI: 10.1097/qad.0000000000002654] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Persistent anal high-risk human papillomavirus (HR-HPV) infection is a major risk factor for anal cancer among MSM and transgender women (TGW). We aimed to estimate incidence, clearance, and persistence of anal HR-HPV in HIV-positive and HIV-negative MSM and TGW, and to assess factors for HR-HPV persistence. DESIGN Prospective cohort study. METHODS MSM and TGW aged at least 18 years, were enrolled from Indonesia, Malaysia, and Thailand, then followed up 6-monthly for 12 months. Anal swabs were collected at every visit for HR-HPV genotypes to define anal HR-HPV incidence, clearance, and persistence. Logistic regression was used to evaluate factors associated with HR-HPV persistence. RESULTS Three hundred and twenty-five MSM and TGW were included in this study, of whom 72.3% were HIV-positive. The incidence of anal HR-HPV persistence was higher in HIV-positive than HIV-negative MSM participants (28.4/1000 vs. 13.9/1000 person-months). HIV-positive participants had HR-HPV lower clearance rate than HIV-negative participants (OR 0.3; 95% CI 0.1-0.7). The overall persistence of HR-HPV was 39.9% in HIV-positive and 22.8% HIV-negative participants. HPV-16 was the most persistent HR-HPV in both HIV-positive and HIV-negative participants. HIV infection (aOR 2.87; 95% CI 1.47-5.61), living in Kuala Lumpur (aOR 4.99; 95% CI 2.22-11.19) and Bali (aOR 3.39; 95% CI 1.07-10.75), being employed/freelance (aOR 3.99; 95% CI 1.48-10.77), and not being circumcised (aOR 2.29; 95% CI 1.07-4.88) were independently associated with anal HR-HPV persistence. CONCLUSION HIV-positive MSM and TGW had higher risk of persistent anal HR-HPV infection. Prevention program should be made available and prioritized for HIV-positive MSM and TGW where resources are limited.
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20
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Marra E, Kovaleva A, Bruisten SM, Vermeulen W, Boyd A, Schim van der Loeff MF. Incidence and Clearance of Anal High-risk Human Papillomavirus Infections and Their Determinants Over 5 Years Among Human Immunodeficiency Virus-negative Men Who Have Sex With Men. Clin Infect Dis 2020; 68:1556-1565. [PMID: 30169621 DOI: 10.1093/cid/ciy738] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/29/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We aimed to assess the incidence and clearance of anal high-risk human papillomavirus (hrHPV) infections and determinants thereof among human immunodeficiency virus (HIV)-negative men who have sex with men (MSM) over a period of up to 5 years. METHODS From 2010 to 2015, HIV-negative MSM were followed every 6 months. Anal self-swabs were collected at inclusion and every 6 months thereafter, and were HPV genotyped using the SPF10-PCR DEIA/LiPA25-system-v1. Incidence rates (IRs) and clearance rates (CRs) of incident anal hrHPV infections were assessed by hrHPV type (types 16, 18, 31, 33, 45, 52, and 58). Determinants of transitions between uninfected and infected states were assessed by hrHPV type using a time-homogenous multi-state Markov model. RESULTS This study included 713 HIV-negative MSM, with a median age of 37 years (interquartile range [IQR] 31-43) and a median number of study visits of 6 (IQR 2-7). The IRs of anal infections had a median of 5.2 per 100 person-years (range: 2.2-7.9) across types, with HPV16 having the highest IR. The CRs of incident anal hrHPV infections had a median of 53.7 per 100 person-years (range: 33.4-65.3) across types, with HPV16 having the lowest CR. Having had over 100 lifetime sex partners was significantly associated with incident anal hrHPV infections in multivariable analyses. CONCLUSIONS The high incidence and low clearance rates of anal HPV16 infection, compared to other hrHPV types, is consistent with HPV16 being implicated in the large majority of anal cancer cases.
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Affiliation(s)
- Elske Marra
- Department of Infectious Diseases, Public Health Service Amsterdam, the Netherlands
| | - Alexandra Kovaleva
- Department of Infectious Diseases, Public Health Service Amsterdam, the Netherlands
| | - Sylvia M Bruisten
- Department of Infectious Diseases, Public Health Service Amsterdam, the Netherlands.,Amsterdam Infection and Immunity Institute, Academic Medical Center, University of Amsterdam, the Netherlands
| | - Wilma Vermeulen
- Department of Infectious Diseases, Public Health Service Amsterdam, the Netherlands
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service Amsterdam, the Netherlands.,Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service Amsterdam, the Netherlands.,Amsterdam Infection and Immunity Institute, Academic Medical Center, University of Amsterdam, the Netherlands
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21
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Prevalence and genotypes of anal human papillomavirus infection among HIV-positive vs. HIV-negative men in Taizhou, China. Epidemiol Infect 2020; 147:e117. [PMID: 30868975 PMCID: PMC6518779 DOI: 10.1017/s0950268818003205] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study aims to investigate the prevalence and genotype distribution of anal human papillomavirus (HPV) infection among men with different sexual orientations with or without human immunodeficiency virus (HIV) in China. A cross-sectional study was conducted during 2016-2017 in Taizhou City, Zhejiang Province. Convenient sampling was used to recruit male participants from HIV voluntary counselling and testing clinics and Center for Disease Control and Prevention. A face-to-face questionnaire interview was administered and an anal-canal swab was collected for HPV genotyping. A total of 160 HIV-positive and 113 HIV-negative men participated in the study. The prevalence of any type HPV was 30.6% for heterosexual men, 74.1% for homosexual and 63.6% for bisexual men among HIV-positive participants, while the prevalence was 8.3%, 29.2% and 23.8% respectively among HIV-negatives. The most prevalent genotypes were HPV-58 (16.9%), HPV-6 (15.6%) and HPV-11 (15.0%) among HIV-positive men, and were HPV-16 (4.4%), HPV-52 (4.4%) and HPV-6 (3.5%) among HIV-negative men. Having ever had haemorrhoids and having ever seen blood on tissue after defaecation was associated with HPV infection. One-fourth of the HPV infections in this study population can be covered by the quadrivalent vaccine in market. The highly prevalent anal HPV infection among men especially HIV-infected men calls for close observation and further investigation for anal cancer prevention.
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22
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Donà MG, Giuliani M. Natural History of Human Papillomavirus Anal Infection. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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23
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Lazcano-Ponce E, Sudenga SL, Torres BN, Stoler M, León-Maldonado L, Allen-Leigh B, Posso H, Quiterio M, Hernández-Nevarez MDP, Salmerón J, Giuliano AR. Incidence of external genital lesions related to human papillomavirus among Mexican men. A cohort study. SALUD PUBLICA DE MEXICO 2019; 60:633-644. [PMID: 30699268 DOI: 10.21149/8461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 09/18/2018] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To determine external genital lesion (EGL) incidence -condyloma and penile intraepithelial neoplasia (PeIN)- and genital HPV-genotype progression to these EGLs. MATERIALS AND METHODS Participants (healthy males 18- 74y from Cuernavaca, Mexico, recruited 2005-2009, n=954) underwent a questionnaire, anogenital examination, and sample collection every six months;including excision biopsy on suspicious EGL with histological confirmation.Linear array assay PCR characterized 37 high/low-risk HPV-DNA types. EGL incidence and cumulative incidence were calculated, the latter with Kaplan-Meier. RESULTS EGL incidence was 1.84 (95%CI=1.42-2.39) per 100-person-years (py); 2.9% (95%CI=1.9-4.2) 12-month cumulative EGL.Highest EGL inci- dence was found in men 18-30 years:1.99 (95%CI=1.22-3.25) per 100py. Seven subjects had PeIN I-III (four with HPV16). HPV11 most commonly progresses to condyloma (6-month cumulative incidence=44.4%, 95%CI=14.3-137.8). Subject with high-risk sexual behavior had higher EGL incidence. CONCLUSIONS In Mexico, anogenital HPV infection in men is high and can cause condyloma. Estimation of EGL magnitude and associated healthcare costs is necessary to assess the need for male anti-HPV vaccination.
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Affiliation(s)
- Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Staci L Sudenga
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute.Tampa, Florida
| | - B Nelson Torres
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute.Tampa, Florida
| | - Mark Stoler
- University of Virginia Health System. Charlottesville, VA, USA
| | - Leith León-Maldonado
- Cátedra Conacyt, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Betania Allen-Leigh
- Dirección de Salud Reproductiva, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Héctor Posso
- Universidad de la Sabana. Chia-Cundinamarca, Colombia
| | - Manuel Quiterio
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | | | - Jorge Salmerón
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico.,Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca, Morelos, México
| | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute.Tampa, Florida
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Posso H, León-Maldonado L, Allen-Leigh B, Salmerón J, Quiterio M, Giuliano AR, Sudenga SL, Nyitray AG, Torres BN, Abrahamsen M, Lazcano-Ponce E. Prevalence and incidence of anal human papillomavirus infection in Mexican men: Need for universal prevention policies. SALUD PUBLICA DE MEXICO 2019; 60:645-652. [PMID: 30699269 DOI: 10.21149/8454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 08/30/2018] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Describe the natural history of anal HPV among men. MATERIALS AND METHODS Prospective study among men 18-70 years (n=665), from Cuernavaca, Mexico who completed questionnaires and provided specimens (HPV genotyped) at enrollment and 1+ follow-up visit. HPV prevalence and incidence were estimated. Prevalence ratios were calculated with Poisson regression using robust variance estimation. Person-time for incident HPV infection was estimated using number of events modeled as Poisson variable for total person-months. RESULTS Anal infection prevalence: any HPV type=15%, high-risk=8.4%, HPV16=1.4%, tetravalent vaccine types (4vHPV)=4.4%, nonavalent vaccine types (9vHPV)=6.3%. Factors associated with prevalence: 50+ lifetime female sex partners (adjusted prevalence ratio, a PR=3.25, 95% CI:1.12- 9.47), 10+ lifetime male sex partners (aPR=3.06, 95%CI:1.4- 6.68), and 1+ recent male anal sex partners (aPR=2.28, 95%CI:1.15-4.5). Anal incidence rate: high-risk HPV=7.8/1000 person-months (95%CI:6.0-10.1), HPV16=1.8/1000 personmonths (95%CI:1.1-2.9),4vHPV=3.4/1000 person-months (95%CI:2.3-4.9) and 9vHPV=5.5/1000 person-months (95%CI:4.1-7.5). CONCLUSIONS Implementation of universal HPV vaccination programs, including men, is a public health priority.
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Affiliation(s)
- Hector Posso
- Universidad de la Sabana. Chia-Cundinamarca, Colombia
| | - Leith León-Maldonado
- Cátedra Conacyt, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Betania Allen-Leigh
- Dirección de Salud Reproductiva, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Jorge Salmerón
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México. Ciudad de México, México.,Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Manuel Quiterio
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca, Morelos, México
| | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute.Tampa, Florida
| | - Staci L Sudenga
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute.Tampa, Florida
| | - Alan G Nyitray
- Department of Epidemiology, The University of Texas School of Public Health. Houston, Texas, USA
| | - B Nelson Torres
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute.Tampa, Florida
| | - Martha Abrahamsen
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute.Tampa, Florida
| | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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25
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Wittawatmongkol O, Gatechompol S, Kerr SJ, Chalermchockcharoenkit A, Teeratakulpisarn N, Lermankul W, Thamkhantho M, Phanuphak N, Sohn AH, Chokephaibulkit K. Human papillomavirus infection among male adolescents and young adults with perinatally-acquired HIV and without HIV in Thailand. Int J STD AIDS 2019; 30:960-968. [PMID: 31284841 DOI: 10.1177/0956462419853384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
HIV infection may increase the risk of persistent human papillomavirus (HPV) infection and complications. Male adolescents and young adults (AYAs) with perinatally-acquired HIV (PHIV) and without HIV in Thailand were matched by age and lifetime number of sexual partners. HPV infection at oral, anal, penile, and scrotal sites was detected by polymerase chain reaction. A total of 49 PHIV and 47 HIV-uninfected male AYAs (median age 18 [17–20] years) were enrolled (June 2013–September 2014). Overall, 18 were men who have sex with men (MSM) (12% of PHIV, 26% of HIV-uninfected AYAs; P = 0.12). Among the PHIV, the median (interquartile range) CD4 cell count was 573 (434–747) cells/mm3and 69% had HIV RNA <40 copies/ml. The prevalence of any HPV infection was 61% in PHIV and 49% in HIV-uninfected AYAs ( P = 0.23) and that of high-risk HPV was 33% in PHIV and 28% in HIV-uninfected AYAs ( P = 0.59). Among those with HPV, 55% had any high-risk HPV type and 28% had HPV-16 and/or HPV-18. In multivariate models, smoking (OR 6.10, 95% CI, 1.19–31.35, P = 0.01) and prior history of STI symptoms (OR 5.01, 95% CI, 1.63–15.40, P = 0.004) were associated with high-risk HPV infection. HPV vaccination in early adolescence presents a valuable but missed prevention opportunity.
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Affiliation(s)
| | | | - Stephen J Kerr
- 2 HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | | | - Watcharee Lermankul
- 1 Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - Annette H Sohn
- 4 TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand
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Patel P, Bush T, Kojic EM, Conley L, Unger ER, Darragh TM, Henry K, Hammer J, Escota G, Palefsky JM, Brooks JT. Prevalence, Incidence, and Clearance of Anal High-Risk Human Papillomavirus Infection Among HIV-Infected Men in the SUN Study. J Infect Dis 2019; 217:953-963. [PMID: 29211874 DOI: 10.1093/infdis/jix607] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/22/2017] [Indexed: 01/10/2023] Open
Abstract
Background The natural history of anal human papilloma virus (HPV) infection among human immunodeficiency virus (HIV)-infected men is unknown. Methods Annually, from 2004 to 2012, we examined baseline prevalence, incidence, and clearance of anal HPV infection at 48 months, and associated factors among HIV-infected men. Results We examined 403 men who have sex with men (MSM) and 96 men who have sex with women (MSW) (median age 42 years for both, 78% versus 81% prescribed cART, median CD4+ T-lymphocyte cell count 454 versus 379 cells/mm3, and 74% versus 75% had undetectable viral load, respectively). Type 16 prevalence among MSM and MSW was 38% versus 14% (P < .001), and incidence 24% versus 7% (P = .001). Type 18 prevalence was 24% versus 8% (P < .001), and incidence 13% versus 4% (P = .027). Among MSM and MSW, clearance of prevalent HPV 16 and HPV 18 was 31% and 60% (P = .392), and 47% and 25% (P = .297), respectively. Among MSM, receptive anal sex (with or without a condom) was associated with persistent HPV 16 (OR 2.24, P < .001). Conclusions MSM had higher prevalence and incidence of HPV than MSW, but similar clearance. Receptive anal sex may predict cancer risk among HIV-infected MSM.
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Affiliation(s)
- Pragna Patel
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tim Bush
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Lois Conley
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Keith Henry
- Hennepin County Medical Center, Minneapolis, Minnesota
| | - John Hammer
- Denver Infectious Disease Consultants, Colorado
| | - Gerome Escota
- Washington University School of Medicine, St. Louis, Missouri
| | | | - John T Brooks
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Binda GA, Gagliardi G, Dal Conte I, Verra M, Cassoni P, Cavazzoni E, Stocco E, Delmonte S, De Nardi P, Sticchi L, Mistrangelo M. Practice parameters for the diagnosis and treatment of anal intraepithelial neoplasia (AIN) on behalf of the Italian Society of Colorectal Surgery (SICCR). Tech Coloproctol 2019; 23:513-528. [PMID: 31243606 DOI: 10.1007/s10151-019-02019-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/17/2019] [Indexed: 12/15/2022]
Abstract
Squamous cell carcinoma (SCC) of the anus is a human papilloma virus (HPV) related malignancy that is preceded by anal intraepithelial neoplasia (AIN) making this cancer, at least theoretically, a preventable disease. In the past 10 years the diagnosis, management and nomenclature of AIN has dramatically changed. Increased life expectancy in human immunodeficiency virus (HIV) positive patients due to highly active antiretroviral therapy (HAART) has caused an increase in the incidence of SCC of the anus. While many experts recommend screening and treatment of anal high-grade squamous intraepithelial lesion (HSIL), there is no consensus on the optimal management these lesions. Therefore, there is a need to review the current evidence on diagnosis and treatment of AIN and formulate recommendations to guide management. Surgeons who are members of the Italian Society of Colorectal Surgery (SICCR) with a recognized interest in AIN were invited to contribute on various topics after a comprehensive literature search. Levels of evidence were classified using the Oxford Centre for Evidence-based Medicine of 2009 and the strength of recommendation was graded according to the United States (US) preventive services task force. These recommendations are among the few entirely dedicated only to the precursors of SCC of the anus and provide an evidence-based summary of the current knowledge about the management of AIN that will serve as a reference for clinicians involved in the treatment of patients at risk for anal cancer.
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Affiliation(s)
- G A Binda
- Coloproctological Surgery, Biomedical Institute, Via Prà 1/b, 16157, Genoa, Italy.
| | - G Gagliardi
- Department of Surgery, University of Illinois at Chicago, Chicago, USA
| | - I Dal Conte
- Sexually Transmitted Infection Clinic, ASL Città di Torino, Turin, Italy
| | - M Verra
- Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - P Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - E Cavazzoni
- Department of Surgery, University of Perugia School of Medicine, Perugia, Italy
| | - E Stocco
- Department of Surgery, ASS-5 Friuli Venezia Giulia, 33078, San Vito al Tagliamento, Italy
| | - S Delmonte
- Medical Science Department, Dermatologic Clinic, University of Turin, Turin, Italy
| | - P De Nardi
- Department of Gastrointestinal Surgery, San Raffaele Scientific Institute, Milan, Italy
| | - L Sticchi
- Hygiene Unit, Department of Health Sciences (DISSAL), IRCCS Policlinico San Martino Hospital, University of Genoa, Genoa, Italy
| | - M Mistrangelo
- Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
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Kahn JA, Belzer M, Chi X, Lee J, Gaur AH, Mayer K, Martinez J, Futterman DC, Stier EA, Paul ME, Chiao EY, Reirden D, Goldstone SE, Ortiz Martinez AP, Cachay ER, Barroso LF, Da Costa M, Wilson CM, Palefsky JM. Pre-vaccination prevalence of anogenital and oral human papillomavirus in young HIV-infected men who have sex with men. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2019; 7:52-61. [PMID: 30658128 PMCID: PMC6356116 DOI: 10.1016/j.pvr.2019.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/06/2018] [Accepted: 01/10/2019] [Indexed: 11/23/2022]
Abstract
The aims of this study were to: 1) determine prevalence of anogenital and oral HPV, 2) determine concordance between HPV at anal, perianal, scrotal/penile, and oral sites; and 3) describe factors associated with anogenital HPV types targeted by the 9-valent vaccine. Data were collected from 2012 to 2015 among men who have sex with men 18-26 years of age enrolled in a vaccine trial (N = 145). Penile/scrotal, perianal, anal, and oral samples were tested for 61 HPV types. Logistic regression was used to identify factors associated with types in the 9-valent vaccine. Participants' mean age was 23.0 years, 55.2% were African-American, and 26.2% were Hispanic; 93% had anal, 40% penile, and 6% oral HPV. Among those with anogenital infection, 18% had HPV16. Concordance was low between anogenital and oral sites. Factors independently associated with a 9-valent vaccine-type HPV were: race (African-American vs. White, OR=2.67, 95% CI=1.11-6.42), current smoking (yes vs. no, OR=2.37, 95% CI=1.03-5.48), and number of recent receptive anal sex partners (2+ vs. 0, OR=3.47, 95% CI=1.16-10.4). Most MSM were not infected with HPV16 or HPV18, suggesting that they may still benefit from HPV vaccination, but anogenital HPV was very common, highlighting the importance of vaccinating men before sexual initiation. CLINICAL TRIAL NUMBER: NCT01209325.
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Affiliation(s)
- Jessica A Kahn
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Marvin Belzer
- Department of Pediatrics, University of Southern California, Los Angeles, CA, USA.
| | - Xiaofei Chi
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Jeannette Lee
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Aditya H Gaur
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Kenneth Mayer
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Jaime Martinez
- John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
| | | | | | - Mary E Paul
- Baylor College of Medicine, Houston, TX, USA.
| | | | - Daniel Reirden
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
| | | | - Ana P Ortiz Martinez
- Cancer Control and Population Sciences Program, University of Puerto Rico, San Juan, PR, USA.
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA.
| | - Luis F Barroso
- Department of Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA.
| | - Maria Da Costa
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Craig M Wilson
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Joel M Palefsky
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
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Goldstein ND, LeVasseur MT, Tran NK, Purtle J, Welles SL, Eppes SC. Modeling HPV vaccination scale-up among urban young men who have sex with men in the context of HIV. Vaccine 2019; 37:3883-3891. [PMID: 31155416 DOI: 10.1016/j.vaccine.2019.05.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Young men who have sex with men (YMSM) are at high risk to contract human papillomavirus (HPV). While an effective vaccination exists, its use among YMSM is markedly lower compared to non-MSM and women. This study compares scaling up HPV vaccination in conjunction with other prevention strategies. METHODS An agent-based model of urban YMSM (≤26 years of age) reflective of the demography of Philadelphia, PA, simulated for up to ten years of follow-up to examine anal and oral transmission of the HPV genotypes covered in the nonavalent (9v) vaccine: 6, 11, 16, 18, 31, 33, 45, 52, 58. Starting HPV prevalences ranged from a high of 18% (type 6) to a low of 6% (type 31); overall 65% of individuals carried any HPV genotype. Simulated levels of vaccination were ranged from 0% to 13% (present-day level), 25%, 50%, 80% (Healthy People 2020 target), and 100% in conjunction with condom use and HIV seroadaptive practices. The primary outcome was the relative reduction in HPV infection. RESULTS Compared to present-day vaccination levels (13%), scaling-up vaccination led to expected declines in 10-year post-simulation HPV prevalence. Anal HPV (any 9v types) declined by 9%, 27%, 46%, and 58% at vaccination levels of 25%, 50%, 80%, and 100%, respectively. Similarly, oral HPV (any 9v types) declined by 11%, 33%, 57%, and 71% across the same levels of vaccine uptake. Comparing the prevention strategies, condoms blocked the greatest number of anal transmissions when vaccination was at or below present-day levels. For oral transmission, vaccination was superior to condom use at all levels of coverage. CONCLUSIONS Public health HPV preventions strategies should continue to emphasize the complementary roles of condoms and vaccination, especially for preventing oral infection. Improving vaccination coverage will ultimately have the greatest impact on reducing HPV infection among YMSM.
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Affiliation(s)
- Neal D Goldstein
- Department of Pediatrics, Christiana Care Health System, 4745 Ogletown-Stanton Road, MAP 1, Suite 116, Newark, DE 19713, United States; Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, United States.
| | - Michael T LeVasseur
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, United States
| | - Nguyen K Tran
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, United States
| | - Jonathan Purtle
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, United States
| | - Seth L Welles
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, United States
| | - Stephen C Eppes
- Department of Pediatrics, Christiana Care Health System, 4745 Ogletown-Stanton Road, MAP 1, Suite 116, Newark, DE 19713, United States
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Nyitray AG, Peng F, Day RS, Carvalho Da Silva RJ, Baggio ML, Salmerón J, Quiterio M, Abrahamsen M, Lazcano-Ponce E, Villa LL, Giuliano AR. The association between body mass index and anal canal human papillomavirus prevalence and persistence: the HIM study. Hum Vaccin Immunother 2019; 15:1911-1919. [PMID: 30897017 DOI: 10.1080/21645515.2019.1593083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: While receptive anal sex is an established risk factor for anal human papillomavirus (HPV) infection and squamous cell carcinoma of the anus (SCCA), people with anal HPV infection and SCCA commonly report no lifetime receptive anal sex suggesting other factors may also increase risk for anal HPV infection and persistence. Given potential associations between obesity and conditions that may cause perianal or anal canal lesions, we hypothesized that body mass index (BMI) was associated with HPV infection. Methods: Genotyping for 36 HPV types was conducted on anal canal specimens from men, ages 18-70, from Brazil, Mexico, and the USA. Eligibility included no history of genital warts or HIV. Evaluable specimens were collected from 328 men having sex with men (MSM) and 1348 men having sex with women (MSW) who reported no lifetime receptive anal sex. Prevalence of anal HPV infection and six-month persistence by BMI were estimated in addition to adjusted prevalence ratios for the association between BMI and HPV infection. Results: Among MSW, obese men had a higher prevalence of HPV-16 in the anal canal (3.1%), compared to normal weight men (1.3%) although 95% CI overlapped. Among MSM, prevalence of HPV decreased with increasing BMI. A similar pattern was observed for persistence. After adjustment for confounders, obese MSW had 2.4 times higher odds of HPV-16 compared to normal weight men. Conclusions: BMI may be positively associated with anal HPV (especially HPV-16) among MSW and negatively associated with anal HPV among MSM which supports continued universal HPV vaccination programs.
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Affiliation(s)
- Alan G Nyitray
- a Clinical Cancer Center and Center for AIDS Intervention Research, Medical College of Wisconsin , Milwaukee , WI , USA
| | - Fen Peng
- b Department of Clinical Research, Medtronic, Inc , Northridge , CA , USA
| | - Rena S Day
- c Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Sciences Center School of Public Health at Houston , Houston , TX , USA
| | | | - Maria Luiza Baggio
- e Centro de Investigação Translacional em Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil
| | - Jorge Salmerón
- f Research Center on Policies, Population, and Health, Faculty of Medicine, National Autonomous University of Mexico , Mexico City , Mexico.,g Center for Population Health Research, National Institute of Public Health , Cuernavaca , Morelos , Mexico
| | - Manuel Quiterio
- g Center for Population Health Research, National Institute of Public Health , Cuernavaca , Morelos , Mexico
| | - Martha Abrahamsen
- h Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute , Tampa , FL , USA
| | - Eduardo Lazcano-Ponce
- g Center for Population Health Research, National Institute of Public Health , Cuernavaca , Morelos , Mexico
| | - Luisa L Villa
- i Faculdade de Medicina, Universidade de São Paulo Department of Radiology and Oncology, Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo , Brazil
| | - Anna R Giuliano
- h Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute , Tampa , FL , USA
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31
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Nyitray AG, Fujimoto K, Zhao J, Giuliano AR, Schneider JA, Hwang LY. Prevalence of and Risk Factors for Anal Human Papillomavirus Infection in a Sample of Young, Predominantly Black Men Who Have Sex With Men, Houston, Texas. J Infect Dis 2019; 217:777-784. [PMID: 29216355 DOI: 10.1093/infdis/jix617] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 11/29/2017] [Indexed: 12/15/2022] Open
Abstract
Background Young men who have sex with men (MSM) are at increased risk for human papillomavirus (HPV)-associated disease as a result of HPV infection. Our objective was to characterize the prevalence of high-risk anal HPV infection and factors associated with prevalence in a group of young, primarily black MSM in Houston, Texas. Methods MSM aged 18-29 years were recruited using a respondent-driven sampling method to study HIV and sexually transmitted disease transmission and risk. All engaged in peer-recruitment chains and self-collected anal exfoliated cells. Prevalence ratios assessed factors associated with high-risk HPV and HPV types in the 9-valent vaccine. Results Black race was reported by 87% of men. Slightly over one half (53%) were human immunodeficiency virus (HIV) positive. Approximately 75% of men had at least 1 high-risk HPV type, and 39% of HIV-positive men harbored HPV-16. Analysis that controlled for potential confounders revealed that only HIV infection was associated with high-risk HPV infection. Conclusion Black MSM would benefit from increased HPV vaccination efforts, owing to high rates of HPV infection, increased HPV disease, and low vaccination series completion rates in this population.
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Affiliation(s)
- Alan G Nyitray
- Center for Infectious Diseases, Department of Epidemiology, Human Genetics, and Environmental Sciences, Tampa, Florida
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Tampa, Florida
| | - Jing Zhao
- Center for Infectious Diseases, Department of Epidemiology, Human Genetics, and Environmental Sciences, Tampa, Florida
| | - Anna R Giuliano
- Center for Infection Research in Cancer (CIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | - Lu-Yu Hwang
- Center for Infectious Diseases, Department of Epidemiology, Human Genetics, and Environmental Sciences, Tampa, Florida
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32
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Mainali B, Schabath MB, Sudenga SL, Ye Y, Wiener HW, Villa LL, Giuliano AR, Shrestha S. Variants in immune-related genes and genital HPV 16 persistence in men. ACTA ACUST UNITED AC 2018; 7:11-14. [PMID: 30092369 PMCID: PMC6290760 DOI: 10.1016/j.pvr.2018.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVES While most human papillomavirus (HPV) infection clears on its own, persistent HPV infection can cause genital warts and anal, penile and oropharyngeal cancers in men. We conducted genetic analysis in a sub-cohort of the HPV infection in men (HIM) study to test the hypothesis that differences in host genes influence HPV persistence in men. METHODS Baseline and longitudinal genital HPV status at the genitals was measured every 6-months using the Linear Array assay amplified HPV L1 gene fragment using the PGMY09/11 L1 consensus primer system. DNA was extracted from peripheral blood and single nucleotide polymorphisms (SNPs) in the customized genome-wide genotyping array, the "TxArray," were examined using logistic regression in a case-control study design to assess the association with HPV16 persistence/clearance. RESULTS Of the total of 737,742 autosomal SNPs in the array, 605,885 passed basic quality control and were examined between 40 men (cases) with > 18 months persistent genital HPV 16 infection vs. 151 controls who were HPV 16-positive, but whose infections cleared in < 18 months. The logistic regression analysis from this case-control study showed variants in several gene regions associated with genital HPV 16 persistence, with the strongest association detected with SNPs on chromosomes 20 (p < 5.72 × 10-6) and 15 (p < 5.89 × 10-6), after adjusting for age, smoking status, number of sex partners and four principal components (ancestral background). CONCLUSIONS Our results provide a preliminary basis for understanding the biological mechanism of oncogenic HPV 16 pathogenesis at the genitals in men. Some of the genes flanking the top hit SNPs are consistent with previous findings in both HPV related and non-related cancers but further genetic studies in larger cohorts are warranted to confirm these and identify novel major susceptibility genes involved in the pathogenesis of genital HPV persistence in men.
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Affiliation(s)
- Bigyan Mainali
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35242, USA
| | - Matthew B Schabath
- Center for Infection Research in Cancer, Moffitt Caner Center, Tampa, FL, USA
| | - Staci L Sudenga
- Center for Infection Research in Cancer, Moffitt Caner Center, Tampa, FL, USA; Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yuanfan Ye
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35242, USA
| | - Howard W Wiener
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35242, USA
| | - Luisa L Villa
- School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Caner Center, Tampa, FL, USA
| | - Sadeep Shrestha
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35242, USA.
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Ucciferri C, Tamburro M, Falasca K, Sammarco ML, Ripabelli G, Vecchiet J. Prevalence of anal, oral, penile and urethral Human Papillomavirus in HIV infected and HIV uninfected men who have sex with men. J Med Virol 2017; 90:358-366. [PMID: 28906006 DOI: 10.1002/jmv.24943] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/07/2017] [Accepted: 08/17/2017] [Indexed: 12/31/2022]
Abstract
Aims of the study were to evaluate Human Papillomavirus (HPV) and type-specific prevalence in four anatomical sites in HIV infected men who have sex with men (MSM) compared with HIV uninfected MSM. Participants were recruited among the attendees of Infectious Diseases Clinics in Central Italy. A trained medical practitioner collected by interview sociodemographic data and information on medical history, sexual behavior, and drug use. Swabs from anal canal, oral cavity, urethral mucosa, and coronal sulcus were tested for HPV DNA and genotyping. Ninety MSM were enrolled, 45 subjects within each group. Overall, 48.9% MSM were HPV positive and prevalence was higher in HIV infected men (60.0% vs 37.8%, P = 0.035). HPV at multiple anatomic sites occurred in 59.1% MSM, with 34.1% and 22.7% at two and three sites, respectively. Prevalence of anal, coronal sulcus, oral, and urethral HPV was 96.3%, 37%, 21.6%, and 18.5% in HIV infected MSM, and 70.6%, 70.6%, 29.4%, and 23.5% among HIV uninfected. A similar proportion of HIV infected and uninfected MSM (59.2% and 58.8%) carried at least one high-risk genotype. Prevalence of types covered by nonavalent vaccine was 77.8% in HIV infected compared with 82.3% in HIV uninfected MSM. HPV 58 and 16 were mostly detected in HIV positive (43.7% and 31.2%) and negative MSM (50.0% and 40.0%). HPV detection rate underlined the high vulnerability of MSM to acquire multisite infections, characterized by various genotype combinations. Since nonavalent vaccine could have prevented 80% of HPV infections, study findings support the implementation of vaccination programs among MSM.
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Affiliation(s)
- Claudio Ucciferri
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Manuela Tamburro
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Katia Falasca
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Michela Lucia Sammarco
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Giancarlo Ripabelli
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Jacopo Vecchiet
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
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Marra E, King A, van Logchem E, van der Weele P, Mooij SH, Heijman T, Meijer CJLM, Verhagen DWM, van der Sande MAB, Schim van der Loeff MF. Anal HPV 16 and 18 viral load: A comparison between HIV-negative and -positive MSM and association with persistence. J Med Virol 2017; 90:76-83. [PMID: 28700080 DOI: 10.1002/jmv.24898] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/07/2017] [Indexed: 11/12/2022]
Abstract
Does anal HPV viral load explain the difference in anal HPV persistence between HIV-negative and -positive men who have sex with men (MSM)? MSM ≥18 years were recruited in Amsterdam, the Netherlands, in 2010-2011. Anal self-swabs were collected every 6 months and genotyped (SPF10 -PCR-DEIA-LIPA25 -system). HPV16 and HPV18 load was determined with a type specific quantitative (q)PCR, and compared between HIV-negative and -positive men using ranksum test. Persistence was defined as ≥3 positive samples for the same HPV-type. Determinants of persistent HPV16/18 infection and its association with HPV16/18 load were assessed with logistic regression. Of 777 recruited MSM, 54 and 22 HIV negative men were HPV16 and HPV18 positive at baseline, and 64 and 39 HIV-positive MSM. The geometric mean titer (GMT) of HPV16 was 19.6 (95%CI 10.1-38.0) and of HPV18 8.6 (95%CI 2.7-27.5) DNA copies/human cell. HPV16 and HPV18 load did not differ significantly between HIV-negative and -positive MSM (P = 0.7; P = 0.8, respectively). In multivariable analyses HPV16 load was an independent determinant of HPV16 persistence (OR 1.8, 95%CI 1.3-2.4). No difference in anal HPV viral load was found between HIV-positive and HIV-negative MSM. HPV 16/18 viral load is an independent determinant of type-specific persistence.
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Affiliation(s)
- Elske Marra
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - Audrey King
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Elske van Logchem
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Pascal van der Weele
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Sofie H Mooij
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Titia Heijman
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - Chris J L M Meijer
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Dominique W M Verhagen
- Department of Internal Medicine, Jan van Goyen Medical Center, Amsterdam, the Netherlands
| | - Marianne A B van der Sande
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands.,Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Butame SA, Lawler S, Hicks JT, Wilkerson JM, Hwang LY, Baraniuk S, Ross MW, Chiao EY, Nyitray AG. A qualitative investigation among men who have sex with men on the acceptability of performing a self- or partner anal exam to screen for anal cancer. Cancer Causes Control 2017; 28:1157-1166. [PMID: 28779467 DOI: 10.1007/s10552-017-0935-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 07/27/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Persistent infection with oncogenic human papillomavirus (HPV) is the primary cause of anal cancer, a disease that disproportionately affects men who have sex with men (MSM); however, there is no uniform screening protocol to detect anal cancer. This qualitative study explores whether a self-anal exam (SAE) or partner anal exam (PAE), that includes self-palpation or palpation of a partner's anal canal, is an acceptable and self-efficacious screening test, which will cue appropriate follow-up care in MSM. METHODS Twenty-four MSM living in Houston took part in four focus group sessions eliciting their responses to a study teaching them to perform an SAE or PAE (SAE/PAE). Participants were asked about the acceptability and feasibility of executing an SAE/PAE routinely. Thematic analysis of session transcripts was used to identify common patterns in participant responses. RESULTS Overall, participants expressed self-efficacy for performing an SAE/PAE and voiced a preference for being taught the procedure by a clinician. Participants agreed that they would consult with a clinician if they ever discovered an abnormality while performing an SAE/PAE. A lack of knowledge about anal cancer among MSM may present a barrier to adopting SAE/PAE. In discussing their experience of the exams, some participants suggested that it could become a routine practice for them. CONCLUSIONS Our findings suggest that SAE and PAE, as a screen for anal cancer, are acceptable and feasible to MSM. Future research should explore attitudes and beliefs of MSM, with the aim of improving anal cancer education and understanding of pathologic findings.
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Affiliation(s)
- Seyram A Butame
- Department of Management, Policy, and Community Health (MPACH), School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St., RAS - E903K, Houston, TX, 77030-3900, USA.
| | - Sylvia Lawler
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Joseph T Hicks
- Division of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, School of Public Health, Houston, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J Michael Wilkerson
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lu-Yu Hwang
- Division of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, School of Public Health, Houston, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Sarah Baraniuk
- Department of Biostatistics, Coordinating Center for Clinical Trials, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Michael W Ross
- Program in Human Sexuality, University of Minnesota, Minneapolis, MN, USA
| | - Elizabeth Yu Chiao
- Department of Internal Medicine, Baylor College of Medicine Houston, Houston, TX, USA
| | - Alan G Nyitray
- Division of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, School of Public Health, Houston, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Sudenga SL, Nyitray AG, Torres BN, Silva R, Villa L, Lazcano-Ponce E, Abrahamsen M, Baggio ML, Salmeron J, Quiterio M, Giuliano AR. Comparison of anal HPV natural history among men by country of residence: Brazil, Mexico, and the United States. J Infect 2017; 75:35-47. [PMID: 28363585 PMCID: PMC6640845 DOI: 10.1016/j.jinf.2017.03.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/16/2017] [Accepted: 03/22/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Globally, anal cancer incidence is rare, but is increasing in some world regions. Our objective was to assess differences in anal HPV natural history in three countries. METHODS Men aged 18-70 years were recruited from the US (n = 634), Mexico (n = 665), and Brazil (n = 731). Anal specimens were collected every six-months. HPV genotyping was assessed by Linear Array. Anal HPV prevalence was compared using the Fisher's exact test. HPV infection incidence rates (IR) and 95% confidence intervals (CI) were calculated. RESULTS Any anal HPV prevalence was highest among men from Brazil (24%) compared to Mexico (15%) and the US (15%). When stratified by sexual history, the prevalence of any HPV among MSM/MSMW was 43%, 37%, and 45% and 9%, 12%, and 10% for MSW from Brazil, Mexico, and US, respectively. Any HPV incidence was significantly higher among men from Brazil compared to US men (IRR = 2.4, 95% CI = 1.7-3.4) and comparable between men from Mexico and the US (IRR = 1.2, 95% CI = 0.8-1.8). CONCLUSION Men in Brazil and Mexico often have similar, if not higher incidence of anal HPV compared to men from the U.S., and may benefit from gender neutral HPV vaccine policies.
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Affiliation(s)
- Staci L Sudenga
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA; Division of Epidemiology, Vanderbilt University, Nashville, TN, USA
| | - Alan G Nyitray
- Center for Infectious Disease, The University of Texas School of Public Health at Houston, TX, USA
| | - B Nelson Torres
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Roberto Silva
- Centro de Referência e Treinamento em DST/AIDS, São Paulo, Brazil
| | - Luisa Villa
- School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Eduardo Lazcano-Ponce
- Center for Translational Investigation in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Martha Abrahamsen
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Maria Luiza Baggio
- Center for Translational Investigation in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA.
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Rodriguez O, Kovarik CL. Immunostaining for High-Risk Human Papillomavirus in Condyloma Lesions in Immunocompromised Patients. Am J Clin Dermatol 2017; 18:413-417. [PMID: 28224503 DOI: 10.1007/s40257-017-0262-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is the underlying infectious cause of condyloma acuminata (CA) and high-risk types of HPV can cause cancer. Condyloma may undergo malignant degeneration, particularly in immunosuppressed patients. The presence of high-risk HPV in CA is a risk factor for developing malignancy; however, determining which patients with condyloma are clinically at risk can be difficult. High-risk HPV can now be localized within CA using routine immunohistochemical stains. METHODS We examined HPV (cocktail, 16, 18) immunohistochemical staining of CA and the relevant clinical history from immunocompromised patients and compared them with age- and sex- matched immunocompetent patients with biopsied CA. RESULTS HPV was detected in 9 of the 12 specimens from immunocompromised patients (75%), and 6 of the 12 specimens from the age- and sex-matched comparison patients (50%). HPV-16 was detected in 7 of the 12 specimens from immunocompromised patients (58%), and 4 of the 12 specimens from comparison patients (33%). HPV-18 was not detected in any of the 21 specimens from immunocompromised or comparison patients for which the stain was available. CONCLUSION High-risk HPV is found within CA lesions, more often in immunocompromised patients, and confirming the presence of these HPV types with stains in high-risk patient populations may help guide the clinician in treatment and surveillance in certain cases.
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Affiliation(s)
- Olaf Rodriguez
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Carrie L Kovarik
- Department of Dermatology, University of Pennsylvania, 3600 Spruce Street, 2 Maloney Building, Philadelphia, PA, 19104, USA.
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Abstract
In the current era of therapy for human immunodeficiency virus (HIV), life expectancy for persons living with HIV (PLWH) approaches that of the general population. This newly prolonged survival among PLWH is associated with an increased prevalence of comorbidities due to the inflammation, immune activation and immune senescence associated with HIV infection. Higher prevalence of tobacco and alcohol use, co-infection with viral hepatitis and traditional cardiovascular risk factors such as hypertension and hyperlipidemia contribute as well. In this review, we hope to describe the current comorbidities occurring among PLWH and bring increased awareness for conditions that may otherwise not be considered given the younger age at time of presentation.
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Affiliation(s)
- Emma Kaplan-Lewis
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1090, New York, NY 10029, USA.
| | - Judith A Aberg
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1090, New York, NY 10029, USA
| | - Mikyung Lee
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1090, New York, NY 10029, USA
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Tincati C, Rainone V, Comi L, Pandolfo A, Barco A, Bellistrì GM, Rovati M, Monforte AD, Trabattoni D, Marchetti G. Cell-Mediated Immunity in HIV-Infected Males With Human Papillomavirus-Related Anal Dysplastic Lesions. Clin Infect Dis 2016; 63:1396-1398. [PMID: 27578822 DOI: 10.1093/cid/ciw590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Camilla Tincati
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo
| | | | - Laura Comi
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo
| | - Alessandro Pandolfo
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo
| | - Ambra Barco
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo
| | - Giusi M Bellistrì
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo
| | - Marco Rovati
- Second Surgery Unit, Department of Biomedical, Surgical and Dental Sciences, ASST Santi Paolo e Carlo, University of Milan, Italy
| | | | | | - Giulia Marchetti
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo
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Donà MG, Gheit T, Vescio MF, Latini A, Moretto D, Benevolo M, Cristaudo A, Tommasino M, Giuliani M. Incidence, clearance and duration of cutaneous beta and gamma human papillomavirus anal infection. J Infect 2016; 73:380-3. [PMID: 27427205 DOI: 10.1016/j.jinf.2016.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 07/06/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Maria Gabriella Donà
- STI/HIV Unit, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, France
| | - Maria Fenicia Vescio
- Infectious, Parasitic and Immunomediated Diseases Department, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Domenico Moretto
- Clinical Pathology and Microbiology Department, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Maria Benevolo
- Pathology Department, Regina Elena National Cancer Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Antonio Cristaudo
- STI/HIV Unit, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, France
| | - Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy.
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Anal human papillomavirus in HIV-uninfected men who have sex with men: incidence and clearance rates, duration of infection, and risk factors. Clin Microbiol Infect 2016; 22:1004.e1-1004.e7. [PMID: 27585942 DOI: 10.1016/j.cmi.2016.08.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/12/2016] [Accepted: 08/19/2016] [Indexed: 11/21/2022]
Abstract
Little is known regarding the natural history of anal human papillomavirus (HPV) infection. We aimed to evaluate incidence and clearance rates, their risk factors, and duration of anal HPV infection in HIV-uninfected men who have sex with men (MSM). A longitudinal study was conducted. Anal samples were analysed using the Linear Array HPV Genotyping test. Incidence and clearance rates, and corresponding risk factors, were estimated using a two-state Markov model. Overall, 155 MSM (median age 33.4 years) attending the largest sexually transmitted infection (STI) centre in Rome, Italy, were followed for a median of 12.2 months (Q1-Q3: 7.0-18.1). Incidence and clearance rates for any HPV were 85.6 (95% CI: 58.4-125.4) and 35.6 (95% CI: 24.7-51.5) × 1000 person-months, respectively; the median duration of infection was 9.4 months (Q1-Q3: 7.5-12.1). Receptive anal sex emerged as the only risk factor for the acquisition of any HPV (Hazard Ratio, HR = 2.65, 95% CI: 1.16-6.06). The incidence rates for carcinogenic and non-carcinogenic types were 42.3 (95% CI: 29.2-61.4) and 29.2 (95% CI: 19.5-43.7) × 1000 person-months, respectively (p = 0.13); their clearance rates were 62.9 (95% CI: 45.1-87.7) and 65.7 (95% CI: 47.4-91.0) × 1000 person-months, respectively (p = 0.83). HPV16 showed the lowest clearance rate among carcinogenic types (59.7 × 1000 person-months), and a duration of infection of 16.8 months. In conclusion, a higher incidence rate was observed for carcinogenic compared to non-carcinogenic HPV types, although the difference was not significant. HPV16 emerged as the type with the longest duration of infection and the lowest clearance rate among carcinogenic types.
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Pamnani SJ, Nyitray AG, Abrahamsen M, Rollison DE, Villa LL, Lazcano-Ponce E, Huang Y, Borenstein A, Giuliano AR. Sequential Acquisition of Anal Human Papillomavirus (HPV) Infection Following Genital Infection Among Men Who Have Sex With Women: The HPV Infection in Men (HIM) Study. J Infect Dis 2016; 214:1180-7. [PMID: 27489298 DOI: 10.1093/infdis/jiw334] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 07/21/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the risk of sequential acquisition of anal human papillomavirus (HPV) infection following a type-specific genital HPV infection for the 9-valent vaccine HPV types and investigate factors associated with sequential infection among men who have sex with women (MSW). METHODS Genital and anal specimens were available for 1348 MSW participants, and HPV genotypes were detected using the Roche Linear Array assay. Sequential risk of anal HPV infection was assessed using hazard ratios (HRs) among men with prior genital infection, compared with men with no prior genital infection, in individual HPV type and grouped HPV analyses. RESULTS In individual analyses, men with prior HPV 16 genital infections had a significantly higher risk of subsequent anal HPV 16 infections (HR, 4.63; 95% confidence interval [CI], 1.41-15.23). In grouped analyses, a significantly higher risk of sequential type-specific anal HPV infections was observed for any of the 9 types (adjusted HR, 2.80; 95% CI, 1.32-5.99), high-risk types (adjusted HR, 2.65; 95% CI, 1.26, 5.55), and low-risk types (adjusted HR, 5.89; 95% CI, 1.29, 27.01). CONCLUSIONS MSW with prior genital HPV infections had a higher risk of a subsequent type-specific anal infection. The higher risk was not explained by sexual intercourse with female partners. Autoinoculation is a possible mechanism for the observed association.
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Affiliation(s)
- Shitaldas J Pamnani
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute Department of Epidemiology and Biostatistics, University of South Florida, Tampa
| | - Alan G Nyitray
- Center for Infectious Diseases, University of Texas School of Public Health, Houston
| | - Martha Abrahamsen
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute
| | - Dana E Rollison
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute Department of Epidemiology and Biostatistics, University of South Florida, Tampa
| | | | | | - Yangxin Huang
- Department of Epidemiology and Biostatistics, University of South Florida, Tampa
| | - Amy Borenstein
- Department of Epidemiology and Biostatistics, University of South Florida, Tampa
| | - Anna R Giuliano
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute Department of Epidemiology and Biostatistics, University of South Florida, Tampa
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