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Kowo M, Nzoume Nsope Mengang JM, Simeni Njonnou SR, Kouotou EA, Atangana PJA, Ankouane Andoulo F. Giant anogenital tumor of Buschke-Löwenstein in a patient living with human immunodeficiency virus/acquired immunodeficiency syndrome: a case report. J Med Case Rep 2022; 16:116. [PMID: 35303943 PMCID: PMC8932054 DOI: 10.1186/s13256-022-03339-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 02/18/2022] [Indexed: 08/29/2023] Open
Abstract
Background Buschke–Löwenstein tumor is a giant condyloma acuminata infection that is characterized by degeneration, invasion, and recurrence. It is associated with human papilloma virus infection. It develops around the genital and perineal area, sometimes causing a large budding ulcerated lesion. Although human immunodeficiency virus infection is frequent in Africa, there are few descriptions of Buschke–Löwenstein tumor diagnosis and its management. Screening for other sexually transmitted infections must be systematic among these patients. Case presentation We report herein the case of a 21-year-old African origin male patient who developed a perineal swelling. Physical examination showed evidence of a huge exophytic tumor made up of budding pinkish vegetations, with serrated crests, a ‘’butterfly wing’’ structure, and a cauliflower-like appearance crowned with centrifugal circinate lesions. Multiple condylomatous lesions of the anal margin were also present. The patient tested positive for human immunodeficiency virus (cluster of differentiation 4 count of 119 cells/mm3) and hepatitis B infections. Real-time polymerase chain reaction revealed human papilloma virus-16 and other high-risk human papilloma virus deoxyribonucleic acid. The diagnosis of Buschke–Löwenstein tumor was made on mass biopsy, and the patient underwent multidisciplinary intervention (surgery, podophyllin application, and antiretroviral therapy). Medium-term evolution was, however, fatal due to opportunistic infection. Conclusion Buschke–Löwenstein tumor is a rare tumor associated with human immunodeficiency virus infection. It is more frequent in male human immunodeficiency virus-positive patients. There is a need to screen for other sexually transmitted infections. In most cases, the treatment is surgical, in association with local therapies. However, recurrences are common.
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Affiliation(s)
- Mathurin Kowo
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.,Yaounde University Teaching Hospital, Yaounde, Cameroon
| | - Jude-Marcel Nzoume Nsope Mengang
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Sylvain Raoul Simeni Njonnou
- Department of Internal Medicine and Specialties, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon. .,Dschang District Hospital, Dschang, Cameroon.
| | - Emmanuel Armand Kouotou
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.,Yaounde University Teaching Hospital, Yaounde, Cameroon
| | - Paul Jean Adrien Atangana
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Firmin Ankouane Andoulo
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.,Yaounde Central Hospital, Yaounde, Cameroon
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2
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Gupta R, Kaur A, Sandeep, Singh S, Gupta S. Anal cytological abnormalities and human papillomavirus infection in women living with HIV: A systematic review and meta-analysis. HIV Med 2022; 23:378-389. [PMID: 35150185 DOI: 10.1111/hiv.13227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/11/2021] [Accepted: 12/15/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To provide a summary estimate of the prevalence of anal cytological abnormalities and human papillomavirus (HPV) infection as well as their covariates in women living with HIV (WLHIV). METHODS Four databases - PubMed, Cochrane Library, ProQuest and Web of Science - were searched up to 31 May 2021 for studies reporting on the prevalence and/or covariates of abnormal anal cytology and/or anal HPV infection in WLHIV. The data were extracted independently by two authors using standardized extraction forms. Random effect models were used to estimate the summary effect sizes. RESULTS A total of 29 studies were included in the analysis. The overall prevalence of anal cytological abnormalities in WLHIV was 28.5% [95% confidence interval (CI): 22.8-35.5]. High-grade cytological lesions were seen in 12.1% (95% CI: 8.5-17.2) of the abnormal smears. HPV infection (any type) in the anal samples was detected in 60.7% (95% CI: 54.1-68.0) of the samples while high-risk HPV was found in 44.0% (95% CI: 37.6-51.5). A positive association was seen between anal cytological abnormality and factors such as receptive anal intercourse [meta-risk ratio (meta-RR) = 1.6, 95% CI: 1.3-1.8], having multiple sexual partners (1.6, 95% CI: 1.0-2.5), CD4 count < 200 cells/µL (4.6, 95% CI: 3.0-6.9), anal HPV (4.6, 95% CI: 2.4-8.8), abnormal cervical cytology (2.3, 95% CI: 2.0-2.8), and cervical HPV (meta-RR 4.6, 95% CI: 2.2-9.8). Anal HPV infection was significantly associated with cervical HPV positivity (2.5, 95% CI: 1.2-5.3). CONCLUSIONS Our results highlight the high prevalence of abnormal anal cytology and HPV infection in WLHIV. The positive association of anal cytological abnormality with parameters such as abnormal cervical cytology, cervical HPV infection and low CD4 count suggests that anal sex history and examination may be considered in WLHIV undergoing screening for sexually transmitted infection and possessing any of these risk factors.
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Affiliation(s)
- Ruchika Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | - Avineet Kaur
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | - Sandeep
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | - Sompal Singh
- Department of Pathology, Hindu Rao Hospital, Delhi, India
| | - Sanjay Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India
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3
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Morhason-Bello IO, Baisley K, Pavon MA, Adewole IF, Bakare R, de Sanjosé S, Francis SC, Watson-Jones D. Prevalence and genotype specific concordance of oro-genital and anal human papillomavirus infections among sexually active Nigerian women. Infect Agent Cancer 2021; 16:59. [PMID: 34496909 PMCID: PMC8424803 DOI: 10.1186/s13027-021-00398-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/24/2021] [Indexed: 12/24/2022] Open
Abstract
Background Human papillomavirus (HPV) associated cancers are increasingly reported globally, including in sub-Saharan Africa (SSA). However, with the exception of cervical HPV infection, data from SSA on the epidemiology of oral and genital HPV infections are limited. This study assessed the prevalence and concordance of oro-genital and anal HPV genotype specific infections among women in the general population.
Methods We conducted a cross-sectional study in sexually active women aged 18–45 years in Ibadan, Nigeria. After a face-to-face interview and clinical examination, oral, cervical, vulvar, and anal samples were collected from participants and tested by the Anyplex II 28 HPV assay. Descriptive and multivariable analyses were used to report prevalence and risk factors associated with HPV infections. Results The prevalence of any vulva, cervical, anal, and oral HPV infections was 68.0% (210/309), 59.7% (182/305), 56.8% (172/303), and 16.1% (14/286), respectively. There was an inverse relationship between age-group and HPV prevalence of HPV in all anatomic sites except for the oral HPV infections. HPV 35 was the most prevalent high-risk HPV genotype in the vulva, cervix and oral cavity. Associated risk factors for HPV infection in each of the anatomic sites were reported. Overall, 10.0% (31/310) women had concordance of any HPV type in the four anatomic sites. Conclusion There was a high prevalence of oro-genital and anal HPV infections among sexually active Nigerian women, with concordance of HPV types in the cervix, vulva, anus and oral cavity. We advocate large longitudinal studies that will involve sampling of multiple anatomic sites and inclusion of other women in the community for better understanding of HPV epidemiology in this region. Supplementary Information The online version contains supplementary material available at 10.1186/s13027-021-00398-9.
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Affiliation(s)
- Imran O Morhason-Bello
- Obstetrics and Gynaecology Department, Faculty of Clinical Sciences, College of Medicine/University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria. .,Institute of Advance Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Kathy Baisley
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Miquel Angel Pavon
- Infection and Cancer Laboratory, Cancer Epidemiology Research Program, ICO, Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), L'Hospitalet de Llobregat, Gran Via de l'Hospitalet, 199-203, 08908, Barcelona, Spain
| | - Isaac F Adewole
- Obstetrics and Gynaecology Department, Faculty of Clinical Sciences, College of Medicine/University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Rasheed Bakare
- Department of Microbiology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Silvia de Sanjosé
- Infection and Cancer Laboratory, Cancer Epidemiology Research Program, ICO, Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), L'Hospitalet de Llobregat, Gran Via de l'Hospitalet, 199-203, 08908, Barcelona, Spain.,Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, USA
| | - Suzanna C Francis
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Deborah Watson-Jones
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.,Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
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Blair KJ, Martínez-Vernaza S, Ordóñez-Blanco IT, Hernandez W, Quiroga C, Lowenstein E, Valderrama-Beltrán SL, Clark J, Lake JE, Juillard C, Lombana Amaya LJ. Screening With Anal Cytology in Colombia: Initial Experience and Need for High-Resolution Anoscopy. J Surg Res 2021; 267:374-383. [PMID: 34216798 DOI: 10.1016/j.jss.2021.05.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/03/2021] [Accepted: 05/27/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) living with human immunodeficiency virus (HIV) are at increased risk of anal cancer. Anal cytology can be used to screen for dysplasia, with high-resolution anoscopy (HRA) required for diagnostic confirmation. We describe the impact lack of HRA had on management of abnormal screening results in Bogotá, Colombia. MATERIAL AND METHODS This retrospective cohort study includes MSM with HIV who underwent anal cytology screening between January 2019February 2020, with colorectal surgery (CRS) follow-up through July 2020. Cytology results included atypical squamous cells of undetermined significance (ASC-US), low-grade squamous intraepithelial lesion (LSIL), and high-grade squamous intraepithelial lesion (HSIL). Categorical and continuous variables were compared via Fisher's exact test and Wilcoxon rank-sum, respectively. RESULTS Of 211 MSM screened, 68 had abnormal cytology: ASC-US (n = 23), LSIL (n = 41), HSIL (n = 4). Sixty (88.2%) were referred to CRS, and 51 (75.0%) attended ≥ 1 appointment. At initial assessment, 17 were referred for anal exam under anesthesia (EUA) for tissue resection, and 21 for rectosigmoidoscopy. Having perianal condyloma was associated with recommendation for EUA (P < 0.001), while cytology grade of dysplasia was not (P = 0.308). Eleven (16.2%) underwent EUA for condyloma resection. CONCLUSIONS Few studies have described anal cancer screening in settings without HRA. We found lack of HRA limited management of abnormal cytology in Colombia. Those with condyloma underwent resection, but HRA remains necessary to localize and treat microscopic disease. Next steps include implementation of HRA in order to further develop the anal cancer screening program for MSM with HIV in Bogotá.
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Affiliation(s)
- Kevin J Blair
- South American Program in HIV Prevention Research (SAPHIR), University of California Los Angeles (UCLA), Los Angeles, California; Program for the Advancement of Surgical Equity (PASE), Department of Surgery, UCLA, Los Angeles, California.
| | - Samuel Martínez-Vernaza
- Unidad de Infectología, Departamento de Medicina Interna, Hospital Universitario San Ignacio (HUSI), Bogotá, Colombia
| | - Ivonne Tatiana Ordóñez-Blanco
- Unidad de Infectología, Departamento de Medicina Interna, Hospital Universitario San Ignacio (HUSI), Bogotá, Colombia; Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - William Hernandez
- School of Nursing, UCLA, Los Angeles, California; DAP Health, Palm Springs, California
| | - Camilo Quiroga
- Unidad de Infectología, Departamento de Medicina Interna, Hospital Universitario San Ignacio (HUSI), Bogotá, Colombia; Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Ellen Lowenstein
- Unidad de Infectología, Departamento de Medicina Interna, Hospital Universitario San Ignacio (HUSI), Bogotá, Colombia
| | - Sandra Liliana Valderrama-Beltrán
- Unidad de Infectología, Departamento de Medicina Interna, Hospital Universitario San Ignacio (HUSI), Bogotá, Colombia; Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jesse Clark
- South American Program in HIV Prevention Research (SAPHIR), University of California Los Angeles (UCLA), Los Angeles, California; Division of Infectious Diseases, Department of Medicine, UCLA, Los Angeles, California
| | - Jordan E Lake
- South American Program in HIV Prevention Research (SAPHIR), University of California Los Angeles (UCLA), Los Angeles, California; Department of Internal Medicine, McGovern Medical School, The University of Texas Health Sciences Center at Houston, Houston, Texas
| | - Catherine Juillard
- Program for the Advancement of Surgical Equity (PASE), Department of Surgery, UCLA, Los Angeles, California
| | - Luis Jorge Lombana Amaya
- Unidad de Coloproctología, Departamento de Cirugía General, HUSI, Pontificia Universidad Javeriana, Bogotá, Colombia
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5
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Farahmand M, Monavari SH, Tavakoli A. Prevalence and genotype distribution of human papillomavirus infection in different anatomical sites among men who have sex with men: A systematic review and meta-analysis. Rev Med Virol 2021; 31:e2219. [PMID: 33527636 DOI: 10.1002/rmv.2219] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/07/2021] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Abstract
Men who have sex with men (MSM) are at increased risk of human papillomavirus (HPV) infection because of their high-risk sexual behaviours. In this study, a meta-analytic approach was used to systematically analyse the literature to elucidate the prevalence and genotype distribution of anal, penile, oral and urethral HPV infection among MSM in the world. To carry out this systematic review, five electronic databases including Web of Science, PubMed, Scopus, Embase, and Google Scholar were searched for relevant studies published from January 2012 to November 2019, and pertinent data were collected from the eligible articles. The pooled HPV prevalence was calculated for each anatomical region using a random-effect model weighted by the inverse variance method. The meta-analysis was performed using the "Metaprop" function in the R package Meta. The overall pooled prevalence of anal, penile, oral and urethral HPV infection among MSM were 78.4% (95% confidence interval [CI]: 75.6%-81.0%), 36.2% (95% CI: 29.1%-44.0%), 17.3% (95% CI: 13.6%-21.7%) and 15.4% (95% CI: 7.8%-27.9%), respectively. Stratified analyses showed that the prevalences of HPV were significantly higher in HIV-positive than HIV-negative MSM. The most frequent HPV high-risk type detected in the anus, penis and oral cavity was HPV-16 (19.9%, 4.9% and 3.1%, respectively). HPV infection is rising in MSM because of high-risk sexual behaviours, suggesting an increased future risk of developing HPV-related diseases and malignancies in this population.
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Affiliation(s)
- Mohammad Farahmand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Hamidreza Monavari
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Tavakoli
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
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6
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Tosato Boldrini NA, Bondi Volpini LP, Freitas LB, Spano LC, Musso C, Silva Santos MCLF, Barroso Dos Reis HL, Miranda AE. Sexually transmitted infections among women living with HIV in a Brazilian city. Braz J Infect Dis 2021; 25:101044. [PMID: 33417851 PMCID: PMC9392134 DOI: 10.1016/j.bjid.2020.101044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/18/2020] [Accepted: 11/30/2020] [Indexed: 11/27/2022] Open
Abstract
Background Clinical improvements following highly active antiretroviral therapy (HAART) may increase high-risk behaviors resulting in sexually transmitted infections (STI). Optimism related to the success of HAART in slowing disease progression, reducing viral load, and improving health status might be important factors for increasing sexual risk behaviors such as less use of condoms. Objective To determine the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, hepatitis B and C, high-risk HPV, and cervical cytological abnormalities among women living with HIV (WLHIV) who attended a Reference Center for STI/AIDS in Brazil. Methods A cross-sectional study was conducted among 151 WLHIV attending an STI Clinic in Vitória city, Brazil. A structured questionnaire, including demographic, behavioral, and clinical information, was used for data collection. Serological tests for HIV, syphilis, hepatitis C and B, CD4 counts, and viral load determination were performed. Cervical samples were collected for cytology and real-time PCR for HPV,Chlamydia, and Neisseria gonorrhoeae. Results In this study, 59% of women had at least one diagnosed STI at the time of the first clinic visit; 31% had clinical forms of anogenital HPV, 10% syphilis, 8%Neisseria gonorrhoeae, 5.0% trichomoniasis, 3% Chlamydia trachomatis, 1% hepatitis B, and 1% hepatitis C; 6.7% of the women presented with cervical cytological abnormalities. Furthermore, 46.3% of women had HR-HPV, and 17.6% had HPV 16/18. Only 5% of the women had a CD4 count <200 cells/mm3, 61.6% had undetectable HIV viral load, and 81.3% were currently on HAART. Conclusion A high prevalence of STI and HR-HPV infections were observed among HIV-infected women in this investigation. Prevention programs need to focus on counseling WLHIV and their regular partners with focused interventions such as couples counseling and education programs.
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Affiliation(s)
- Neide Aparecida Tosato Boldrini
- Federal University of Espírito Santo, Center of Health Sciences, Department of Gynecology and Obstetrics, Espírito Santo, ES, Brazil
| | - Lays Paula Bondi Volpini
- Federal University of Espírito Santo, Post-Graduation Program on Infectious Diseases, Espírito Santo, ES, Brazil
| | - Luciana Bueno Freitas
- Federal University of Espírito Santo, Post-Graduation Program on Infectious Diseases, Espírito Santo, ES, Brazil
| | - Liliana Cruz Spano
- Federal University of Espírito Santo, Post-Graduation Program on Infectious Diseases, Espírito Santo, ES, Brazil
| | - Carlos Musso
- University Hospital Federal University of Espírito Santo, Department of Pathology, Vitória, ES, Brazil
| | | | | | - Angelica Espinosa Miranda
- Federal University of Espírito Santo, Post-Graduation Program on Infectious Diseases, Espírito Santo, ES, Brazil
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Hidalgo-Tenorio C, Gil-Anguita C, López Ruz MA, Omar M, López-Hidalgo J, Pasquau J. ART is key to clearing oncogenic HPV genotypes (HR-HPV) in anal mucosa of HIV-positive MSM. PLoS One 2019; 14:e0224183. [PMID: 31648254 PMCID: PMC6813028 DOI: 10.1371/journal.pone.0224183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/06/2019] [Indexed: 12/23/2022] Open
Abstract
Background Anal squamous cell carcinoma (ASCC) is one of the most frequent non-AIDS-defining neoplasias in HIV patients, mainly in MSM, and it has been associated with chronic infection with high-risk human papilloma virus (HR-HPV). Our main objective was to determine HR-HPV clearance and acquisition rates and related factors and their relationship with the incidence of HSILs and ASCC in anal mucosa of HIV+ MSM. Patients and methods The study included consecutive HIV-infected MSM between May 2010 and December 2018. Data were gathered at baseline and annually on their sexual behavior, CD4 and CD8 levels, plasma HIV viral load, and results of anal cytology, HPV PCR, and high-resolution anoscopy. Results Out of the 405 patients studied, 34.9% of patients cleared oncogenic genotypes (IQR: 37–69) within 49 months, and 42.9% acquired new genotypes within 36 months (IQR:12–60). In multivariate analysis, clearance was only significantly influenced by the duration of antiretroviral therapy (ART) (OR: 1.016, 95% CI 1.003–1.030). The incidence of HSILs was 30.86/1,000 patient-years and that of ASCC was 81.22/100,000 patient-years; these incidences were not influenced by the acquisition (acquired: 14.9% vs. non-acquired: 10.4%; p = 0.238) or clearance (cleared 11.4% vs. non-cleared: 13.2%; p = 0.662) rates of these viruses. Conclusions The duration of ART appears to positively affect oncogenic genotype clearance in the anal mucosa of HIV+ MSM, although this clearance does not affect the incidence of HSILs or ASCC. The reduction in HSIL+ rate observed in our patients may be attributable to the bundle of measures adopted at our center.
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Affiliation(s)
- Carmen Hidalgo-Tenorio
- Department of Infectious Diseases; “Virgen de las Nieves” University Hospital, Granada, Spain
- * E-mail:
| | - Concepción Gil-Anguita
- Department of Infectious Diseases; “Virgen de las Nieves” University Hospital, Granada, Spain
| | - Miguel Angel López Ruz
- Department of Infectious Diseases; “Virgen de las Nieves” University Hospital, Granada, Spain
| | - Mohamed Omar
- Unit of Infectious Diseases, Jaen “Hospital Complex”, Spain
| | - Javier López-Hidalgo
- Pathology Department; “Virgen de las Nieves” University Hospital, Granada, Spain
| | - Juan Pasquau
- Department of Infectious Diseases; “Virgen de las Nieves” University Hospital, Granada, Spain
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8
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PIERBON M, COCCHIO S, RUSSO C, BONAMIN M, BALDO V. Sexually-transmitted infections: what is the true prevalence? A cross-sectional online survey of men who have sex with men in the Veneto Region of Italy. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E197-E202. [PMID: 31650054 PMCID: PMC6797894 DOI: 10.15167/2421-4248/jpmh2019.60.3.1181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 07/17/2019] [Indexed: 11/24/2022]
Abstract
Introduction Rates of sexually-transmitted infections (STIs) remain high among men who have sex with men (MSM), posing serious public health concerns. The MSM population is recognized as a vulnerable, high-risk group due to barriers to preventive healthcare services and homophobic stigma. Methods A cross-sectional online survey was conducted using a questionnaire based on European Man-for-Man Internet Survey 2010 (EMIS 2010) and European Centre for Disease Prevention and Control (ECDC) core indicators specific for behavioral risks. MSM were reached between June and August 2017, using Facebook and dating apps. Descriptive statistics and multivariate logistic regression were used to analyze the data. Results A total of 324 respondents were analyzed, 88 subjects (27.2% of the sample) reported having experienced at least one STI, the most common being gonorrhea and HPV. Ten respondents reported having HIV infection, and 7 subjects (70%) of them were co-infected with other STIs. The 49.7% (161 subjects) had seen a doctor specifically for STIs. As concerns HPV vaccination, only 4.0% of the total respondents had been vaccinated. Restricting the sample to the 161 respondents who consulted an STI clinic, the 88 individuals who reported having had at least one STI amount to 54.6%. A more consistent use of condoms and larger numbers of sexual partners were significantly associated with a lower and higher risk of STI, respectively. Conclusions Comprehensive STI prevention strategies are needed to improve sexual health among MSM. Such strategies should include implementing programs to improve awareness about routine screening, and promote a consistent use of condoms by MSM.
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Affiliation(s)
- M. PIERBON
- Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padua, Italy
- Degree Courses of Public and Community Health, University of Padua, Italy
| | - S. COCCHIO
- Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padua, Italy
- Correspondence: Silvia Cocchio, Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35131 Padova, Italy - Tel. +39 049 8275389 - Fax +39 049 8275389 - E-mail:
| | - C. RUSSO
- Degree Courses of Public and Community Health, University of Padua, Italy
| | - M.A. BONAMIN
- Degree Courses of Public and Community Health, University of Padua, Italy
| | - V. BALDO
- Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padua, Italy
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9
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Todorova A, Schwierzeck V, Turek D, Zink A, Schwerdtfeger C, Kaliebe K, Spinner CD, Traidl-Hoffmann C. Evaluation of anal carcinoma screening in male and female HIV patients at an interdisciplinary HIV therapy centre. J Eur Acad Dermatol Venereol 2019; 33:1595-1601. [PMID: 30883929 DOI: 10.1111/jdv.15575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/01/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Incidence of anal carcinoma is increased in people living with HIV (PLWH). Due to the improved life expectancy in PLWH, identifying appropriate prevention strategies for non-AIDS-defining cancer types such as anal carcinoma has become a priority in managing PLWH today. OBJECTIVE We aimed to evaluate anal cytology assessment as screening tool for anal dysplasia and/or carcinoma in PLWH, regardless of gender or sexual orientation. Additionally, we investigated the correlation between cancer risk factors and abnormal screening results in our patient cohort. METHODS People living with HIV from the Interdisciplinary HIV Centre of the University Hospital rechts der Isar in Munich, Germany (IZAR), were screened for anal carcinoma by single cytobrush examination and anal Papanicolaou (PAP) smear assessment from 2013 to 2015. Patients with abnormal PAP smear result were offered a follow-up examination after 12 months. Differences between two groups were tested for statistical significance using Student's t-test and Mann-Whitney U-test, as appropriate. RESULTS In total, 101 PLWH were included. 26.7% of subjects (n = 27) were PAP IIID, and 9.9% (n = 10) were PAP IVa. Seven female subjects had an abnormal finding at screening. Smoking was significantly associated with abnormal findings at screening (P = 0.005). In addition, our study found an association between sexually transmitted infections (STI) and anal dysplasia. Condylomata acuminata were increased in subjects with PAP IIID/PAP IVa (P = 0.045). Reactive syphilis serology was found to be significantly associated with abnormal screening results (P = 0.016), respectively. CONCLUSION Our results demonstrate that smoking and two common STIs, condylomata acuminata and syphilis, are risk factors associated with advanced anal intraepithelial neoplasia (AIN) stages in our PLWH cohort. While further analysis is needed to determine diagnostic guidelines concerning AIN in PLWH, these results suggest that interdisciplinary lifestyle prevention strategies are required to reduce the risk factors for AIN in PLWH in an outpatient setting.
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Affiliation(s)
- A Todorova
- Interdisciplinary HIV Center (IZAR), University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.,Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum Munich - German Research Center for Environmental Health (GmbH), Munich, Germany
| | - V Schwierzeck
- Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum Munich - German Research Center for Environmental Health (GmbH), Munich, Germany
| | - D Turek
- Interdisciplinary HIV Center (IZAR), University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.,Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum Munich - German Research Center for Environmental Health (GmbH), Munich, Germany
| | - A Zink
- Interdisciplinary HIV Center (IZAR), University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Dermatology and Allergy, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - C Schwerdtfeger
- Interdisciplinary HIV Center (IZAR), University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Medicine II, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - K Kaliebe
- Interdisciplinary HIV Center (IZAR), University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Dermatology and Allergy, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - C D Spinner
- Interdisciplinary HIV Center (IZAR), University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Medicine II, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - C Traidl-Hoffmann
- Interdisciplinary HIV Center (IZAR), University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.,Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum Munich - German Research Center for Environmental Health (GmbH), Munich, Germany
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