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AIDS. 2019 Jan 27;33(1):145-152. doi: 10.1097/QAD.0000000000002059.

Increased risk of anal squamous cell carcinoma in HIV-positive men with prior hepatitis B virus infection.

Author information

1
Department of Cancer Immunology and Virology.
2
Department of Medical Oncology, Center for Population Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.

Abstract

OBJECTIVE(S):

HIV-positive individuals have elevated rates of anal squamous cell carcinoma (SCC), and sexually transmitted infections with its causative agent, high-risk human papillomavirus, and other oncoviruses including hepatitis B virus (HBV). HBV infection can cause liver cancer, and has been associated with increased risk of some extra-hepatic cancers including biliary tract cancer, pancreatic cancer, and non-Hodgkin lymphoma. Whether HBV is associated with anal SCC risk is unknown.

DESIGN:

Prospective study of anal SCC risk in HIV-positive and HIV-negative MSM in the Multicenter AIDS Cohort Study from 1984 to 2014.

METHODS:

Poisson regression models were used to examine the association between past or current HBV infection (positive tests for HBV core antibodies, surface antigen, and/or DNA) and anal SCC risk.

RESULTS:

We observed 53 cases of anal SCC among 5298 participants with 79 334 person-years follow-up. Among HIV-positive men, past or current HBV infection was associated with anal SCC risk in models adjusted for age, CD4 cell counts, HAART use, and other risk factors [incidence rate ratio (IRR), 95% confidence interval 3.15, 1.27-7.82]. Additional risk factors included immunological parameters 1 and 6 years prior to diagnosis (IRR, 95% confidence interval 2.45, 1.31-4.58 and 2.44, 1.3-4.59 for CD4 cell counts <500 cells/μl; 2.43, 1.34-4.42 and 2.77, 1.5-5.11 for CD4 : CD8 ratios <0.5, respectively). Among HIV-negative men, IRR for prior HBV and anal SCC risk was similar, but NS due to small number of cases.

CONCLUSION:

HIV-positive MSM with prior HBV infection have increased anal SCC risk. This population may benefit from screening.

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