Paper # 1019
High-risk HPV Prevalence by HIV-1 Status in Spanish Men Who Had Sex with Men in an Outpatient Sexually Transmitted Diseases Clinic and in a Prospective Cohort of HIV+ MSM and Women belonging to the Spanish Multicenter Cohort
M Ortiz1, M Torres1, C González1, B Hernández-Novoa2, P Viciana3, J Ballesteros4, J R Blanco5, A Peña6, J Del Romero4, and Julia Del Amo*1
1Inst de Salud Carlos III, Madrid, Spain; 2Hosp Ramón y Cajal, Madrid, Spain; 3Hosp Virgen del Rocío, Sevilla, Spain; 4Ctr Sandoval, Madrid, Spain; 5Hosp San Pedro, La Rioja, Spain; and 6Hosp San Cecilio, Granada, Spain
Background: We aim to assess: (1) anal prevalence
of HR-HPV and genotypes distribution by HIV status; and (2) Prevalence of HR-HPV,
genotypes distribution, and Squamous Intraepithelial Lesions in HIV+
subjects.
Methods: (1) Cross-sectional study of a convenience
sample of MSM recruited at a sexually transmitted diseases clinic in Madrid (2005 to 2006). HR-HPV infection was determined through HC2 HR HPV DNA test. HPV
Genotypes were determined by Linear Array Genotyping HPV. (2) Multicenter
cohort (CoRIS) of HIV+ subjects naïve to antiretrovirals (2004 to 2009)
in Spain. HPV infection was determined with Amplicor HPV DNA Test and HPV
genotype as aforementioned. Anal and cervical smears, Papanicolau (Pap) or
liquid cytology, were classified according to Bethesda System 2001; Low (LSIL) or High Grade Squamous Intraepithelial Lesions (HSIL) and
Atypical Squamous Cells of Undetermined Significance (ASCUS). Data were analyzed
with multiple logistic regression.
Results: HR-HPV prevalence and genotype distribution
by HIV status: Of 361 MSM, 142 (39.3%) were HIV+. The largest
group of men, 228 (63.1%) were Spanish. HR-HPV prevalence was higher in HIV
positive MSM compared to HIV negative (73.9% vs 42.0, P <0.01).
In HIV positive men only, HR-HPV prevalence was higher in Latin-Americans than
in Spaniards (OR = 4.8. 95%CI 1.4 to 17.0). Multiple HR-HPV infections were
more frequent in HIV+ men than in HIV‑ (57% vs
23.7%, P <0.001). The most frequent HR-HPV genotypes
detected were HPV-16, HPV-68, HPV-18, HPV-58 in HIV+ men and HPV 16,
HPV-18, HPV-51, HPV-39 in HIV‑ men. HR-HPV prevalence,
genotype distribution, and cytological analysis in HIV+ subjects: Of
419 patients, 80% were MSM and 17.2% heterosexual women. HR-HPV prevalence was 87.6%
in MSM, 65% and 55% in female anal and cervical samples. Prevalence of multiple
infections was 67.5% in MSM, 45.7 % and 38.9% in anal and cervical female samples.
Most frequent types in MSM were 16 (40%), 45, 39, 59 (20.7%),
18 (18.4%). Anal cytologies from 233 MSM were available. Of 91 Pap smears, the prevalences of LSIL and of HSIL were 9% and
3.3%, and 53% and 8.5% in 142 liquid cytologies.
Conclusions: Prevalence of HR-HPV infection and
multiple HPV infections are very high in MSM, especially in HIV+
men. A high prevalence of anal intraepithelial lesions is observed in HIV+
men. These data call support the need to screen for HPV-related cancers in
HIV-positive subjects.
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