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- Title
Anal Squamous Intraepithelial Lesions (SILs) in Human Immunodeficiency Virus–Positive Men Who Have Sex With Men: Incidence and Risk Factors of SIL and of Progression and Clearance of Low-Grade SILs.
- Authors
Jongen, V W; Richel, O; Marra, E; Heukelom, M L Siegenbeek van; Eeden, A van; Vries, H J C de; Cairo, I; Prins, J M; Loeff, M F Schim van der
- Abstract
Background Human immunodeficiency virus (HIV)–positive men who have sex with men (MSM) are at risk of anal squamous cell carcinoma. Data are limited on the natural history of the precursor to this carcinoma, anal squamous intraepithelial lesions (SILs). Methods HIV-positive MSM were screened for histopathological SILs by means of high-resolution anoscopy (HRA). For participants without SILs at baseline, we estimated the cumulative incidence and risk factors for SILs. For those with low-grade SILs (LSILs) at baseline, the risk of progression to high-grade SILs (HSILs) and the clearance rate were estimated at the lesion level. Results Of 807 men without SILs at baseline, 107 underwent follow-up HRA between 1 to 4.5 years later. At the second visit 18 men (16.8%) showed LSIL, and 25 (23.4%) HSIL. Age was associated with incident LSILs (adjusted odds ratio [aOR], 2.10 per 10-year increase in age; P =.01). Of 393 men with LSILs at baseline, 114 underwent follow-up HRA 0.5 to 2.5 years later. Of the 177 LSILs found at baseline, 87 (49.2%) had cleared at the second visit, and 29 (16.4%) had progressed to HSILs. Conclusion Incident LSILs and HSILs were common during follow-up among HIV-positive MSM without dysplasia at baseline. Among men with LSILs at baseline, nearly half of these lesions cleared, and a small portion progressed.
- Subjects
HIV; SYPHILIS; SQUAMOUS cell carcinoma; IMMUNODEFICIENCY; NATURAL history; ODDS ratio
- Publication
Journal of Infectious Diseases, 2020, Vol 222, Issue 1, p62
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1093/infdis/jiz614