Antiretroviral therapy as a factor protective against anal dysplasia in HIV-infected males who have sex with males
Metadata
Show full item recordAuthor
Hidalgo Tenorio, Carmen; Rivero Rodríguez, Mar; Gil Anguita, Concepción; López del Hierro, Mercedes; Palma, Pablo; Ramírez Taboada, Jessica; Esquivias, Javier; López Ruz, Miguel Ángel; Javier, Rosario; Pasquau Liaño, JuanEditorial
Chinese University of Hong Kong
Date
2014-03Referencia bibliográfica
Hidalgo-Tenorio C, Rivero-Rodriguez M, Gil-Anguita C, Lopez De Hierro M, Palma P, et al. (2014) Antiretroviral Therapy as a Factor Protective against Anal Dysplasia in HIV-Infected Males Who Have Sex with Males. PLoS ONE 9(3): e92376. doi:10.1371/journal.pone.0092376
Abstract
Objectives: Chronic infection with oncogenic HPV genotype is associated with the development of anal dysplasia.
Antiretroviral therapy (ART) has been shown to decrease the incidence of cervical carcinoma in women with HIV. We sought
to: 1) describe the prevalence and grade of anal dysplasia and HPV infection in our study subjects; 2) analyze the grade of
correlation between anal cytology, PCR of high-risk HPV, and histology; 3) identify the factors associated with the
appearance of $AIN2 lesions.
Design: Cross-sectional, prospective study.
Methods: A cohort of HIV-positive males (n = 140, mean age = 37 years) who have sex with males (MSM) had
epidemiological, clinical and analytical data collected. Anal mucosa samples were taken for cytology, HPV PCR genotyping,
and anoscopy for histological analysis.
Results: Within the cohort, 77.1% were being treated with ART, 8.5% anoscopy findings were AIN2, and 11.4% carcinoma in
situ; 74.2% had high-risk (HR), 59.7% low-risk (LR) HPV genotypes and 46.8% had both. The combination of cytology with
PCR identifying HR-HPV better predicts the histology findings than either of these factors alone. Logistic regression
highlighted ART as a protective factor against $AIN2 lesions (OR: 0.214; 95%CI: 0.054–0.84). Anal/genital condylomas (OR:
4.26; 95%CI: 1.27–14.3), and HPV68 genotype (OR: 10.6; 95%CI: 1.23–91.47) were identified as risk factors.
Conclusions: In our cohort, ART has a protective effect against dysplastic anal lesions. Anal/genital warts and HPV68
genotype are predictors of $AIN2 lesions. Introducing PCR HPV genotype evaluation improves screening success over that
of cytology alone