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- Title
HIV, Immune Dysfunction, and the Natural History of Anal High-Risk Human Papillomavirus Infection in Gay and Bisexual Men.
- Authors
Poynten, I Mary; Jin, Fengyi; Garland, Suzanne M; Hillman, Richard J; Molano, Monica; Roberts, Jennifer M; Templeton, David J; Phillips, Samuel; Law, Carmella; Fairley, Christopher K; Farnsworth, Annabelle; Grulich, Andrew E
- Abstract
<bold>Background: </bold>Incidence of anal cancer is highest in gay and bisexual men (GBM). Better understanding of the natural history of anal high-risk human papillomavirus (hrHPV) infection is needed for anal cancer prevention.<bold>Methods: </bold>The Study of the Prevention of Anal Cancer was a 3-year study of Australian GBM, aged 35 years or older. We examined incidence, clearance, and risk factors for 13 hrHPV types at baseline and 3 annual visits.<bold>Results: </bold>In 525 men with ≥ 2 visits, 348 (66.3%) acquired ≥ 1 incident hrHPV infection. HPV16 incidence rates were similar, but non-16 hrHPV incidence was higher in HIV-positive (51.8/100 person years [PY]) than HIV-negative men (36.5/100 PY, P < .001). Annual clearance rates of HPV16 (13.21/100 PY, 95% confidence interval, 10.53-16.56) were lower than for other hrHPV types. hrHPV clearance rates were not associated with HIV overall but were significantly lower in those with a lower nadir CD4 (<200 cells/µL) for HPV16 (P = .015) and other hrHPV types (P = .007).<bold>Conclusions: </bold>Higher incidence of non-16 hrHPV types, coupled with lower clearance of non-16 hrHPV types in those with past impaired immune function, is consistent with the greater role of non-16 hrHPV in anal cancer in HIV-positive people.<bold>Australia New Zealand Clinical Trials Registry: </bold>ANZCTR365383.
- Subjects
AUSTRALIA; BISEXUAL men; PAPILLOMAVIRUS diseases; GAY men; ANAL cancer; HIV; HIV infection epidemiology; HIV infection complications; PAPILLOMAVIRUSES; RESEARCH; ANUS; RESEARCH methodology; EVALUATION research; ANAL tumors; HOMOSEXUALITY; COMPARATIVE studies; RESEARCH funding; ANAL diseases; DISEASE complications
- Publication
Journal of Infectious Diseases, 2021, Vol 224, Issue 2, p246
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiaa723