The Role of Human Papillomavirus Genotypes on Anal Squamous Intraepithelial Lesions Among Gay, Bisexual and Other Men Who Have Sex With Men Living With HIV: Beyond HPV-16
Persistent high-risk human papillomavirus (hHPV) infection, especially HPV-16, plays a central role in the development of high-grade squamous intraepithelial lesions (HSIL). This study aimed to evaluate the performance of co-testing (cytology and hHPV detection) in a real-world cohort of men who hav...
| Autores: | , , , , , , , |
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| Formato: | artículo |
| Fecha de publicación: | 2025 |
| País: | España |
| Recursos: | Conselleria de Salut i Consum del Govern de les Illes Balears |
| Repositorio: | Docusalut |
| Idioma: | inglés |
| OAI Identifier: | oai:docusalut.com:20.500.13003/25887 |
| Acesso em linha: | https://hdl.handle.net/20.500.13003/25887 |
| Access Level: | acceso abierto |
| Palavra-chave: | Anal Canal Anus Neoplasms Female HIV Infections Genotype Homosexuality, Male Human Papillomavirus Viruses Human papillomavirus 16 Papillomaviridae Papillomavirus Infections Prospective Studies Risk Factors Spain Squamous Intraepithelial Lesions Transgender Persons Young Adult Middle Aged Canal Anal Neoplasias del Ano Femenino Infecciones por VIH Genotipo Homosexualidad Masculina Virus del Papiloma Humano Papillomavirus Humano 16 Infecciones por Papillomavirus Estudios Prospectivos Factores de Riesgo España Lesiones Intraepiteliales Escamosas Personas Transgénero Adulto Joven Persona de Mediana Edad HPV HSIL PLHIV anal cancer anal dysplasia co‐testing |
| Resumo: | Persistent high-risk human papillomavirus (hHPV) infection, especially HPV-16, plays a central role in the development of high-grade squamous intraepithelial lesions (HSIL). This study aimed to evaluate the performance of co-testing (cytology and hHPV detection) in a real-world cohort of men who have sex with men (MSM) and transgender women (TW) living with HIV. We conducted a prospective study (2017-2023) at a tertiary care center in Spain. MSM and TW living with HIV underwent screening with anal cytology and PCR-based hHPV testing. High-resolution anoscopy (HRA) with biopsy was performed in cases with abnormal cytology and/or hHPV positivity. Clinical, epidemiological, and HIV-related data were collected to identify risk factors for abnormal cytology and biopsy. 734 cytologies were performed in 380 participants. Abnormal cytology was found in 34%, most commonly ASCUS. hHPV was detected in 63.1% of samples; HPV-16 was the most prevalent genotype (19.4%), present in 60% of HSIL cytologies and 65% of AIN2-3 biopsies. Risk factors for abnormal cytology included nadir CD4 < 200 cells/μL (aOR 2.61), prior condylomas (aOR 2.66), and infection with any oncogenic HPV genotype (aOR 4.12). Among 91 HRAs, 29.6% showed AIN2-3% and 2.1% in situ carcinoma. HPV-16, HPV-52, and HPV-66 were most frequently associated with abnormal findings in the cytology. In conclusion, anal HPV infection was prevalent in MSM and TW living with HIV. The genotypes most frequently associated with abnormal cytology and histopathological findings were HPV-16, HPV-52, and HPV-66. These findings highlight the potential value of implementing co-testing strategies in anal dysplasia screening for this high-risk population. |
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