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. 2018 Dec 27;18(1):692.
doi: 10.1186/s12879-018-3618-3.

Human papillomavirus infection & anal cytological abnormalities in HIV-positive men in eastern India

Abhilasha Gautam  1 , Jaya Chakravarty  2 , Vijay Kumar Singh  1 , Amrita Ghosh  3 , Shashi Bhushan Chauhan  1 , Madhukar Rai  1 , Shyam Sundar  1
Affiliations

Human papillomavirus infection & anal cytological abnormalities in HIV-positive men in eastern India

Abhilasha Gautam et al. BMC Infect Dis. .

Abstract

Background: Oncogenic Human papillomavirus (HPV) infections are closely associated with anal cancer which is high among human immunodeficiency virus (HIV) infected males. There are no data regarding anal HPV infection and cytological abnormalities in HIV positive males receiving free therapy in the national program. Thus, this cross-sectional study was performed to assess the prevalence and risk factors of anal HPV infection and cytological abnormalities in HIV positive males.

Methods: We screened 126 HIV-positive male patients attending the antiretroviral treatment center (ART) between 2014 and 2015 with anal papanicolaou smear cytology and HPV-DNA testing. HPV-DNA was detected by using polymerase chain reaction (PCR) method with two consensus primer sets E6 and MY09/11 and further analyzed for the presence of various HPV genotype by Sanger sequencing. Risk factors associated with anal cytological abnormalities and HPV infection was analyzed by using univariate and multivariate logistic regression models.

Results: Out of 126, 52 were on antiretroviral therapy. 91% were married to female partners but during the study 48 (38%) gave positive history of anal intercourse with other men. Anal cytology was done in 95 patients, out of which 60 (63.15%) had cytological abnormalities. LSIL (low-grade squamous intraepithelial lesions) was present in 27 (45%), ASCUS (atypical squamous cells of undetermined significance) in 31 (52%) and ASC-H (atypical squamous cells cannot exclude a high-grade squamous intraepithelial lesion) in 2 (3.33%). In multivariate analysis, the risk factors for cytological abnormality were presence of history of anal intercourse (OR, 6.1; 95% CI, 2.0-18.7) and WHO stage III & IV (OR, 2.7; 95% CI, 1.1-7.5). HPV-DNA was detected in 33/119 (27.73%) patients. The most prevalent HPV type in the study was HPV-16 (10.08%), other HPV types detected were 18,31,35,17,66,72,52,68 and 107 (17.65%).

Conclusions: High prevalence of anal cytological abnormalities in our study suggests that regular anal Pap smear screening should be done in HIV positive males in the ART center.

Keywords: Anal cancer; Anal cytology; HIV; HPV; India; PCR.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Ethics committee of Institute of Medical Sciences, Banaras Hindu University (EC registration No- ECR/526/Inst./UP/2014 Dt-31.1.14). All HIV positive men above the age of 18, attending the ART center were eligible for the study. A written informed consent was obtained from all the participants. Baseline demographic data was collected from the cards of the patient maintained in the ART center.

Consent for publication

Not applicable.

Competing interests

The authors’ declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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References

    1. Chia-ching JW, Silverberg MJ, Abrams DI. Non-AIDS-defining malignancies in the HIV-infected population. Curr Infect Dis Rep. 2014;16:406. doi: 10.1007/s11908-014-0406-0. - DOI - PMC - PubMed
    1. Silverberg MJ, Lau B, Justice AC, Engels E, Gill MJ, et al. Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America. Clin Infect Dis. 2012;54:1026–1034. doi: 10.1093/cid/cir1012. - DOI - PMC - PubMed
    1. Palefsky JM, Holly EA, Ralston ML, Arthur SP, Jay N, et al. Anal squamous intraepithelial lesions in HIV-positive and HIV-negative homosexual and bisexual men: prevalence and risk factors. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;17:320–326. doi: 10.1097/00042560-199804010-00005. - DOI - PubMed
    1. Palefsky JM, Shiboski S, Moss A. Risk factors for anal human papillomavirus infection and anal cytologic abnormalities in HIV-positive and HIV-negative homosexual men. J Acquir Immune Defic Syndr. 1994;7:599–606. - PubMed
    1. Chin-Hong PV, Vittinghoff E, Cranston RD, Browne L, Buchbinder S, et al. Age-related prevalence of anal cancer precursors in homosexual men: the EXPLORE study. J Natl Cancer Inst. 2005;97:896–905. doi: 10.1093/jnci/dji163. - DOI - PubMed

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