Anal human papillomavirus genotype distribution in HIV-infected men who have sex with men by geographical origin, age, and cytological status in a Spanish cohort

Abstract

Knowledge of human papillomavirus (HPV) type distribution in populations at risk for anal cancer is needed. Here, we describe the anal HPV genotype distribution in a large Spanish cohort (Cohort of the Spanish HIV Research Network HPV [CoRIS-HPV]) of HIV-positive men who have sex with men (MSM) according to geographical origin, age, and cytological status. A cross-sectional analysis of baseline data from 1,439 HIV-infected MSM (2007 to 2012) was performed. Anal HPV genotyping was performed using the Linear Array HPV genotyping test. Descriptive analyses of subject characteristics, prevalences, and 95% confidence intervals (CI) were performed. The global prevalences of HPV, high-risk HPV (HR-HPV), and low-risk HPV (LR-HPV) types were 95.8%, 83.0%, and 72.7%, respectively. Among the HR-HPV types, HPV16 was the most common, followed by HPV59, -39, -51, -18, and -52. The prevalence of multiple HR-HPV infections was 58.5%. There were no differences in the crude analyses between Spanish and Latin-American MSM for most HPV types, and a peak in prevalence for most HPV types was seen in patients in their late thirties. Globally and by specific HPV groups, men with abnormal anal cytologies had a higher prevalence of infection than those with normal cytologies. This study has the largest number of HIV-positive MSM with HPV genotype data analyzed according to cytological status as far as we know. The information gained from this study can help with the design of anal cancer prevention strategies in HIV-positive patients.

Fig 1

Prevalences of HPV types in 1,439 HIV-infected MSM within CoRIS-HPV. The numbers above the bars indicate the number of patients in each category.

Fig 2

Prevalences of HPV types in HIV-infected MSM within CoRIS-HPV by geographical origin. *, P < 0.05.

Fig 3

Prevalences of HR-HPV (a), LR-HPV (b), and PHR-HPV and UR-HPV (c) types in 1,439 HIV-infected MSM within CoRIS-HPV by age. *, P < 0.05.

Fig 4

Prevalences of HPV type groups by age in 1,439 HIV-infected MSM within CoRIS-HPV. Statistically significant differences are indicated by dotted lines; HPV16, -18, -31, and -33 are the most frequent types found in AC cases, and HPV6, -11, -16, and -18 are the HPV types included in the approved quadrivalent vaccine.

Fig 5

Prevalence of multiple infections of HR-HPV types in 950 HIV-infected MSM with valid cytological results within CoRIS-HPV. *, P < 0.05.

Fig 6

Prevalence of anal HPV infections in HIV-infected MSM with abnormal cytological results stratified by age. *, P < 0.05.