Cargando…

Role of Low-Risk HPV PCR Monoinfection in Screening for HSIL and Anal Cancer in Men Who Have Sex with Men Living with HIV

To determine the value of low-risk human papillomavirus (HPV) PCR to screen for “high-grade anal squamous intraepithelial lesion and anal cancer” (HSIL-plus), rate of patients with low-grade anal squamous intraepithelial lesion (LSIL) progressing to HSIL-plus, and progression-related factors. Prospe...

Descripción completa

Detalles Bibliográficos
Autores principales: García-Martínez, Carmen María, Calle-Gómez, Inmaculada, López-Hidalgo, Javier, Gómez-Ronquillo, Patricia, Omar-Mohamed Balgahata, Mohamed, Hidalgo-Tenorio, Carmen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056681/
https://www.ncbi.nlm.nih.gov/pubmed/36982714
http://dx.doi.org/10.3390/ijms24065642
_version_ 1785016183263592448
author García-Martínez, Carmen María
Calle-Gómez, Inmaculada
López-Hidalgo, Javier
Gómez-Ronquillo, Patricia
Omar-Mohamed Balgahata, Mohamed
Hidalgo-Tenorio, Carmen
author_facet García-Martínez, Carmen María
Calle-Gómez, Inmaculada
López-Hidalgo, Javier
Gómez-Ronquillo, Patricia
Omar-Mohamed Balgahata, Mohamed
Hidalgo-Tenorio, Carmen
author_sort García-Martínez, Carmen María
collection PubMed
description To determine the value of low-risk human papillomavirus (HPV) PCR to screen for “high-grade anal squamous intraepithelial lesion and anal cancer” (HSIL-plus), rate of patients with low-grade anal squamous intraepithelial lesion (LSIL) progressing to HSIL-plus, and progression-related factors. Prospective, longitudinal study of consecutive MSM-LHIV attended between May 2010 and December 2021 and followed for 43 months (IQR: 12–76). HIV-related variables were gathered at baseline, performing anal cytology for HPV detection/genotyping, thin-layer cytological study, and high-resolution anoscopy (HRA). Follow-up was annual when HRA was normal or LSIL, and post-treatment in cases of HSIL-plus, re-evaluating sexual behavior, viral-immunological status, and HPV infection of anal mucosa. The 493 participants had mean age of 36 years: CD4 nadir < 200 cells/uL in 23.1%, virological failure in 4.1%, and tetravalent HPV vaccine > 5 years earlier in 15%. HSIL-plus was ruled out in patients with monoinfection by low-risk HPV genotype and normal cytology (100% sensitivity, 91.9% specificity, PPV 2.9%, and NPV 100%). Progression from LISL to HSIL-plus occurred in 4.27% of patients within 12 months (IQR: 12–12): risk factors were acquisition of high-risk (HR: 4.15; 95% CI: 1.14–15.03) and low-risk (HR: 3.68 95% CI: 1.04–12.94) HPV genotypes, specifically genotype 6 (HR: 4.47, 95% CI: 1.34–14.91), and history of AIDS (HR: 5.81 95% CI: 1.78–18.92). Monoinfection by LR-HPV genotypes in patients with normal cytology is not associated with anal cancer or precursor lesions. Progression from LSIL to HSIL-plus, observed in <5% of patients, was related to acquisition of HR and LR HPV genotypes, especially 6, and a history of AIDS.
format Online
Article
Text
id pubmed-10056681
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100566812023-03-30 Role of Low-Risk HPV PCR Monoinfection in Screening for HSIL and Anal Cancer in Men Who Have Sex with Men Living with HIV García-Martínez, Carmen María Calle-Gómez, Inmaculada López-Hidalgo, Javier Gómez-Ronquillo, Patricia Omar-Mohamed Balgahata, Mohamed Hidalgo-Tenorio, Carmen Int J Mol Sci Article To determine the value of low-risk human papillomavirus (HPV) PCR to screen for “high-grade anal squamous intraepithelial lesion and anal cancer” (HSIL-plus), rate of patients with low-grade anal squamous intraepithelial lesion (LSIL) progressing to HSIL-plus, and progression-related factors. Prospective, longitudinal study of consecutive MSM-LHIV attended between May 2010 and December 2021 and followed for 43 months (IQR: 12–76). HIV-related variables were gathered at baseline, performing anal cytology for HPV detection/genotyping, thin-layer cytological study, and high-resolution anoscopy (HRA). Follow-up was annual when HRA was normal or LSIL, and post-treatment in cases of HSIL-plus, re-evaluating sexual behavior, viral-immunological status, and HPV infection of anal mucosa. The 493 participants had mean age of 36 years: CD4 nadir < 200 cells/uL in 23.1%, virological failure in 4.1%, and tetravalent HPV vaccine > 5 years earlier in 15%. HSIL-plus was ruled out in patients with monoinfection by low-risk HPV genotype and normal cytology (100% sensitivity, 91.9% specificity, PPV 2.9%, and NPV 100%). Progression from LISL to HSIL-plus occurred in 4.27% of patients within 12 months (IQR: 12–12): risk factors were acquisition of high-risk (HR: 4.15; 95% CI: 1.14–15.03) and low-risk (HR: 3.68 95% CI: 1.04–12.94) HPV genotypes, specifically genotype 6 (HR: 4.47, 95% CI: 1.34–14.91), and history of AIDS (HR: 5.81 95% CI: 1.78–18.92). Monoinfection by LR-HPV genotypes in patients with normal cytology is not associated with anal cancer or precursor lesions. Progression from LSIL to HSIL-plus, observed in <5% of patients, was related to acquisition of HR and LR HPV genotypes, especially 6, and a history of AIDS. MDPI 2023-03-15 /pmc/articles/PMC10056681/ /pubmed/36982714 http://dx.doi.org/10.3390/ijms24065642 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
García-Martínez, Carmen María
Calle-Gómez, Inmaculada
López-Hidalgo, Javier
Gómez-Ronquillo, Patricia
Omar-Mohamed Balgahata, Mohamed
Hidalgo-Tenorio, Carmen
Role of Low-Risk HPV PCR Monoinfection in Screening for HSIL and Anal Cancer in Men Who Have Sex with Men Living with HIV
title Role of Low-Risk HPV PCR Monoinfection in Screening for HSIL and Anal Cancer in Men Who Have Sex with Men Living with HIV
title_full Role of Low-Risk HPV PCR Monoinfection in Screening for HSIL and Anal Cancer in Men Who Have Sex with Men Living with HIV
title_fullStr Role of Low-Risk HPV PCR Monoinfection in Screening for HSIL and Anal Cancer in Men Who Have Sex with Men Living with HIV
title_full_unstemmed Role of Low-Risk HPV PCR Monoinfection in Screening for HSIL and Anal Cancer in Men Who Have Sex with Men Living with HIV
title_short Role of Low-Risk HPV PCR Monoinfection in Screening for HSIL and Anal Cancer in Men Who Have Sex with Men Living with HIV
title_sort role of low-risk hpv pcr monoinfection in screening for hsil and anal cancer in men who have sex with men living with hiv
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056681/
https://www.ncbi.nlm.nih.gov/pubmed/36982714
http://dx.doi.org/10.3390/ijms24065642
work_keys_str_mv AT garciamartinezcarmenmaria roleoflowriskhpvpcrmonoinfectioninscreeningforhsilandanalcancerinmenwhohavesexwithmenlivingwithhiv
AT callegomezinmaculada roleoflowriskhpvpcrmonoinfectioninscreeningforhsilandanalcancerinmenwhohavesexwithmenlivingwithhiv
AT lopezhidalgojavier roleoflowriskhpvpcrmonoinfectioninscreeningforhsilandanalcancerinmenwhohavesexwithmenlivingwithhiv
AT gomezronquillopatricia roleoflowriskhpvpcrmonoinfectioninscreeningforhsilandanalcancerinmenwhohavesexwithmenlivingwithhiv
AT omarmohamedbalgahatamohamed roleoflowriskhpvpcrmonoinfectioninscreeningforhsilandanalcancerinmenwhohavesexwithmenlivingwithhiv
AT hidalgotenoriocarmen roleoflowriskhpvpcrmonoinfectioninscreeningforhsilandanalcancerinmenwhohavesexwithmenlivingwithhiv