Anal | Anal And Oral Human Papillomavirus (HPV) Infection In HIV Infected Subjects In ...

Methods: Patients with no previously documented HPV-related anogenital lesion/disease were recruited to participate in a longitudinal study. Polymerase chain reaction (PCR) was performed to detect HPV from oral and anal swabs and to detect Human Herpes Virus 8 (HHV-8) DNA in saliva on 2 separate specimen series, one collected at baseline and the other collected 6 months later.

A multivariate logistic analysis was performed using anal HPV infection as the dependent variable versus a set of covariates: age, HIV plasma viral load, CD4+ count, hepatitis B virus (HBV) serology, hepatitis C virus (HCV) serology, syphilis serology and HHV-8 viral shedding. A stepwise elimination of covariates with a p-value >0.1 was performed.

Results: The overall prevalence of HPV did not vary significantly between the baseline and the follow-up, either in the oral (20.1 and 21.3%, respectively) or the anal specimens (88.6 and 86.3%).

The prevalence of high-risk (HR) genotypes among the HPV-positive specimens was similar in the oral and anal infections (mean values 24.3% and 20.9%). Among 68 patients with either a HR, low-risk (LR) or undetermined genotype at baseline, 75% had persistent HPV and the persistence rates were 71.4% in HR infections and 76.7% in LR infections.

There was a lack of genotype concordance between oral and anal HPV samples. The prevalence of HR HPV in anus appeared to be higher in the younger patients, peaking (>25%) in the 43-50 years age group.

A decrease of the high level of anal prevalence of all genotypes of HPV in the patients >50 years was evident. HHV-8 oral shedding was positively related to HPV anal infection (p=0.0046).

A significant correlation was found between the persistence of HHV-8 shedding and HIV viral load by logistic bivariate analysis (Odds Ratio of HHV-8 persistence for 1-log increase of HIV viral load=1.725+/-0.397, p=0.018).

Conclusions: A high prevalence of HPV infection was found in our cohort of HIV-infected MSM, with a negative correlation between anal HPV infection and CD4 cell count.

Author: Saverio ParisiMario CrucianiRenzo ScaggianteCaterina BoldrinSamantha AndreisFederico Dal BelloSilvana PagniAndrea BarelliAndrea SattinCarlo MengoliGiorgio Palu
Credits/Source: BMC Infectious Diseases 2011, 11:150

Published on: 2011-05-25

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