ART is key to clearing oncogenic HPV genotypes (HR-HPV) in anal mucosa of HIV-positive MSM


Autoři: Carmen Hidalgo-Tenorio aff001;  Concepción Gil-Anguita aff001;  Miguel Angel López Ruz aff001;  Mohamed Omar aff002;  Javier López-Hidalgo aff003;  Juan Pasquau aff001
Působiště autorů: Department of Infectious Diseases; “Virgen de las Nieves” University Hospital, Granada, Spain aff001;  Unit of Infectious Diseases, Jaen “Hospital Complex”, Spain aff002;  Pathology Department; “Virgen de las Nieves” University Hospital, Granada, Spain aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224183

Souhrn

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.

Klíčová slova:

Carcinogenesis – Cytology – Histology – HIV diagnosis and management – Human papillomavirus – Human papillomavirus infection – Lesions – Viruses and cancer


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Článek vyšel v časopise

PLOS One


2019 Číslo 10