. 2020 Dec:10:100200.

doi: 10.1016/j.pvr.2020.100200. Epub 2020 May 31.

Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria

Rebecca G Nowak¹, Lisa M Schumaker², Nicholas P Ambulos², Nicaise Ndembi³, Wuese Dauda³, Chinedu H Nnaji³, Andrew Mitchell⁴, Trevor J Mathias², Paul Jibrin⁵, Teresa M Darragh⁶, Oluwole Olaomi⁵, Trevor A Crowell⁷, Stefan D Baral⁸, Manhattan E Charurat⁴, Søren M Bentzen², Joel M Palefsky⁹, Kevin J Cullen²; TRUST/RV368 Study Group

Collaborators, Affiliations

Collaborators

TRUST/RV368 Study Group:
Manhattan Charurat¹⁰, Julie Ake¹¹, Aka Abayomi¹², Sylvia Adebajo¹³, Stefan Baral¹⁴, Trevor Crowell⁷, Charlotte Gaydos¹⁴, Sosthenes Ketende¹⁴, Afoke Kokogho¹⁵, Jennifer Malia¹⁶, Olumide Makanjuola¹⁷, Nelson Michael¹⁸, Nicaise Ndemb³, Rebecca Nowak¹⁰, Oluwasolape Olawore¹⁴, Zahra Parker⁷, Sheila Peel¹⁶, Habib Ramadhani¹⁰, Merlin Robb¹⁹, Cristina Rodriguez-Hart²⁰, Eric Sanders-Buell⁷, Elizabeth Shoyemi²¹, Sodsai Tovanabutra⁷, Sandhya Vasan⁷

Affiliations

¹ Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: rnowak@ihv.umaryland.edu.
² University of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.
³ Institute of Human Virology Nigeria, Abuja, Nigeria.
⁴ Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
⁵ National Hospital, Abuja, Nigeria.
⁶ Department of Pathology, University of California, San Francisco, CA, USA.
⁷ U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
⁸ Johns Hopkins School of Public Health, Baltimore, MD, USA.
⁹ Department of Medicine, University of California, San Francisco, CA, USA.
¹⁰ University of Maryland, Baltimore, USA.
¹¹ U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
¹² International Centre for Advocacy for the Right to Health, Abuja, Nigeria.
¹³ Maryland Global Initiatives Corporation, Abuja, Nigeria.
¹⁴ Johns Hopkins University, Baltimore, USA.
¹⁵ U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; HJF Medical Research International, Abuja, Nigeria.
¹⁶ Department of Laboratory Diagnostics and Monitoring, Walter Reed Army Institute of Research, Silver Spring, USA.
¹⁷ The Initiative for Equal Rights, Lagos, Nigeria.
¹⁸ Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, USA.
¹⁹ Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
²⁰ New York City Department of Health and Mental Hygiene, Long Island City, USA.
²¹ Population Council Nigeria, Lagos, Nigeria.

PMID: 32492573
PMCID: PMC7287273
DOI: 10.1016/j.pvr.2020.100200

Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria

Rebecca G Nowak et al. Papillomavirus Res. 2020 Dec.

. 2020 Dec:10:100200.

doi: 10.1016/j.pvr.2020.100200. Epub 2020 May 31.

Authors

Collaborators

TRUST/RV368 Study Group:
Manhattan Charurat¹⁰, Julie Ake¹¹, Aka Abayomi¹², Sylvia Adebajo¹³, Stefan Baral¹⁴, Trevor Crowell⁷, Charlotte Gaydos¹⁴, Sosthenes Ketende¹⁴, Afoke Kokogho¹⁵, Jennifer Malia¹⁶, Olumide Makanjuola¹⁷, Nelson Michael¹⁸, Nicaise Ndemb³, Rebecca Nowak¹⁰, Oluwasolape Olawore¹⁴, Zahra Parker⁷, Sheila Peel¹⁶, Habib Ramadhani¹⁰, Merlin Robb¹⁹, Cristina Rodriguez-Hart²⁰, Eric Sanders-Buell⁷, Elizabeth Shoyemi²¹, Sodsai Tovanabutra⁷, Sandhya Vasan⁷

Affiliations

¹ Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: rnowak@ihv.umaryland.edu.
² University of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.
³ Institute of Human Virology Nigeria, Abuja, Nigeria.
⁴ Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
⁵ National Hospital, Abuja, Nigeria.
⁶ Department of Pathology, University of California, San Francisco, CA, USA.
⁷ U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
⁸ Johns Hopkins School of Public Health, Baltimore, MD, USA.
⁹ Department of Medicine, University of California, San Francisco, CA, USA.
¹⁰ University of Maryland, Baltimore, USA.
¹¹ U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
¹² International Centre for Advocacy for the Right to Health, Abuja, Nigeria.
¹³ Maryland Global Initiatives Corporation, Abuja, Nigeria.
¹⁴ Johns Hopkins University, Baltimore, USA.
¹⁵ U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; HJF Medical Research International, Abuja, Nigeria.
¹⁶ Department of Laboratory Diagnostics and Monitoring, Walter Reed Army Institute of Research, Silver Spring, USA.
¹⁷ The Initiative for Equal Rights, Lagos, Nigeria.
¹⁸ Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, USA.
¹⁹ Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
²⁰ New York City Department of Health and Mental Hygiene, Long Island City, USA.
²¹ Population Council Nigeria, Lagos, Nigeria.

PMID: 32492573
PMCID: PMC7287273
DOI: 10.1016/j.pvr.2020.100200

Abstract

Background: Anal precancers and cancers can be detected during screening with high-resolution anoscopy (HRA). The sensitivity of HRA depends on the burden and duration of human papillomavirus (HPV) among those screened as well as anoscopist proficiency, which is highly correlated with prior screening experience. Our objective was to compare the identification and type of HPV and the likelihood of HRA-detected precancer for men who have sex with men (MSM) undergoing their first HRA-screening in Nigeria.

Methods: MSM were recruited from an HIV test-and-treat cohort, TRUST/RV368, into a new anal cancer screening program. Anal swabs obtained during screening underwent Ion Torrent next-generation sequencing using barcoded HPV PCR broad-spectrum primers 5+/6+ to detect up to 161 HPVs. All high-risk (HR) HPVs and the most abundant low-risk (LR)-HPVs were evaluated as type-specific infections with some categorized as belonging to a multiple infection. HRA screening results included benign, low-grade squamous intraepithelial lesions (LSIL), or HSIL as detected by cytology or histology. Multivariable logistic regression was used to assess the association of HPV and other cofactors with any SIL.

Results: Among 342 MSM, 60% were HIV-infected, 89% were under 35 years of age, and 51% had 8 or more years since anal coital debut. Of those with SIL, 89% had LSIL and only 11% had HSIL. Prevalence of any HPV and high-risk (HR)-HPV was 92% and 74%, respectively. The most prevalent genotypes in rank order were HPV6 (31%), HPV16 (23%), HPV42 (20%), HPV11 (18%), HPV45 (18%), and HPV51 (17%). For multiple HR-HPVs, 31% had a single HR-HPV, 32% had 2-3, and 10% had 4 or more. Low-risk HPVs, type 6 and/or 11, were common (42%) and were significantly associated with SIL (adjusted odds ratio [aOR]:1.8, 95% confidence interval [CI]: 1.1-3.1) together with perianal warts (aOR:6.7, 95% CI: 3.3-13.5). In contrast, HR-HPV and multiple HR-HPVs were not significantly associated with SIL (all p > 0.05).

Conclusions: Detection of HSIL was low. Although HR-HPV was abundant, HSIL development also depends on the duration of HR-HPV infections and the anoscopist's level of experience. As our cohort ages and the anoscopist becomes more skilled, detection of HSIL will likely improve.

Keywords: Anal cancer screening; HPV in MSM; Next-generation sequencing; Sub-Saharan Africa.

PubMed Disclaimer

Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: JMP has stock and ownership interests in Ubiome, Virion Therapeutics, VIR Biotechnology; has received honoraria from Janssen Pharmaceuticals, Vaccitech, Antiva Biosciences; has a consulting or advisory role for Antiva Biosciences, VIR Biotechnology, Vaccitech and Novan; receives research funding from Merck, Antiva Biosciences, VIR Biotechnology, CEL-SCI; and receives travel, accommodations and expenses from Merck, Vaccitech and Janssen. None of this relates to this specific work. All other authors have no declarations of interest.

Figures

**Fig. 1**
HPV prevalence ratios and 95% confidence intervals by HIV status.

See this image and copyright information in PMC

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Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria

Collaborators

Affiliations

Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

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