Format

Send to

Choose Destination
Papillomavirus Res. 2016 Dec;2:97-105. doi: 10.1016/j.pvr.2016.05.003. Epub 2016 May 24.

Prevalence and risk factors associated with high-grade anal squamous intraepithelial lesions (HSIL)-AIN2 and HSIL-AIN3 in homosexual men.

Author information

1
HIV Epidemiology and Prevention Program, The Kirby Institute for infection and immunity in society, University of New South Wales, Sydney, Australia; Department of Microbiology and Infectious Diseases, Royal Women's Hospital and Murdoch Childrens Research Institute, Melbourne, Australia.
2
HIV Epidemiology and Prevention Program, The Kirby Institute for infection and immunity in society, University of New South Wales, Sydney, Australia.
3
Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales 2137, Australia; Centre for Infectious Diseases and Microbiology, Westmead Clinical School, University of Sydney, New South Wales 2006, Australia; St Vincent's Hospital, Sydney, New South Wales, Australia.
4
HIV Epidemiology and Prevention Program, The Kirby Institute for infection and immunity in society, University of New South Wales, Sydney, Australia; RPA Sexual Health, Sydney Local Health District, Sydney, Australia.
5
St Vincent's Hospital, Sydney, New South Wales, Australia.
6
Douglass Hanly Moir Pathology, Sydney, New South Wales, Australia.
7
Department of Microbiology and Infectious Diseases, Royal Women's Hospital and Murdoch Childrens Research Institute, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.
8
Melbourne Sexual Health Centre, Carlton, Victoria, Australia and Central Clinical School Monash University, Victoria, Australia.
9
HIV Epidemiology and Prevention Program, The Kirby Institute for infection and immunity in society, University of New South Wales, Sydney, Australia. Electronic address: agrulich@kirby.unsw.edu.au.

Abstract

BACKGROUND:

Anal intraepithelial neoplasia grade 2 (AIN2) and AIN grade 3 (AIN3) are commonly grouped together as high grade squamous intraepithelial lesions (HSIL). We assessed risk factors for HSIL-AIN2 and HSIL-AIN3 in a cohort of homosexual men.

METHODS:

At the baseline visit in the Study for the Prevention of Anal Cancer (SPANC), all men completed a questionnaire and underwent anal swabbing for cytology and HPV genotyping, followed by high resolution anoscopy.

RESULTS:

Composite-HSIL prevalence was 47% and 32% among 220 HIV-positive and 396 HIV-negative men, respectively. HSIL-AIN3 (37.7% versus 24.7%; p<0.001), but not HSIL-AIN2 (9.5% versus 7.6%; p=0.395) was more common in HIV-positive men. Recent receptive anal partners (p-trend=0.045), and increasing number of high-risk (HR)-HPV types (p-trend<0.001) were associated with HSIL-AIN2. Lifetime receptive partners (p-trend<0.001), HIV status (OR 1.74; 95% CI: 1.05-2.87) and HPV16 (OR 3.00; 95% CI: 1.56-5.75) were associated with HSIL-AIN3. HPV16 was the most common HR-HPV type detected in men with HSIL-AIN3, both HIV-negative (61.1%) and HIV-positive (54.9%). HPV16 was less commonly detected in men with HSIL-AIN2.

CONCLUSIONS:

Grouping HSIL-AIN2 and HSIL-AIN3 as HSIL may mask considerable heterogeneity in anal cancer risk. Given the strong link between HPV16 and anal cancer, men with HSIL-AIN3 and HPV16 are likely to be at greatest risk of cancer.

KEYWORDS:

Cancer screening; HSIL; Human papillomavirus; Risk factors; Surrogate endpoints

PMID:
29074193
PMCID:
PMC5886874
DOI:
10.1016/j.pvr.2016.05.003
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center