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Presence of multiple genotypes in subjects with HPV-16 infection is highly associated with anal squamous intraepithelial lesions in HIV-1 infected males.

Presence of multiple genotypes in subjects with HPV-16 infection is highly associated with anal squamous intraepithelial lesions in HIV-1 infected males.
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Rovelli C, Poli A, Galli L, Cernuschi M, Tamburini AM, Racca S, Tambussi G, Rolla S, Albarello L, Rosati R, Lazzarin A, Castagna A, Nozza S,


Rovelli C, Poli A, Galli L, Cernuschi M, Tamburini AM, Racca S, Tambussi G, Rolla S, Albarello L, Rosati R, Lazzarin A, Castagna A, Nozza S, (click to view)

Rovelli C, Poli A, Galli L, Cernuschi M, Tamburini AM, Racca S, Tambussi G, Rolla S, Albarello L, Rosati R, Lazzarin A, Castagna A, Nozza S,

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PloS one 2017 10 3112(10) e0186367 doi 10.1371/journal.pone.0186367

Abstract
OBJECTIVES
The aim of the study was to determine the prevalence of abnormal cytological findings, high risk (HR)-HPV genotypes and to identify factors associated with an abnormal cytological findings in a cohort of HIV-infected males.

PATIENTS AND METHODS
Retrospective observational study on HIV-infected male patients who performed screening in the absence of clinical symptoms. Cytological abnormalities were classified as atypical squamous cells of undetermined significance (ASC-US), low-grade(LSIL) or high high-grade squamous intraepithelial lesion (HSIL). Logistic regression models were used to identify predictors of having LSIL/HSIL.

RESULTS
Among 875 pts, abnormal cytology findings were observed in 254 (29%, 95% CI: 26.1%-32.1%) subjects: 142 (16%) had LSIL and 49 (6%) HSIL. Overall, 581 (66%, 95%CI: 63.2%-69.5%) subjects had ≥1 HR-HPV type and 269 (31%) had ≥2 HR HPV types. Multivariate logistic regression showed that subjects with multiple HR-HPV genotypes (OR = 1.351, 95%CI: 1.005-2.111) and with HPV-16 type (OR = 2.032, 95%CI: 1.313-3.146) were more likely to have LSIL/HSIL in addition to a lower CD4+/CD8+ ratio, a previous diagnosis of syphilis and a positive viral load. In another multivariate model, the presence of multiple HPV types in subjects with HPV-16 type was associated with the highest adjusted OR of having a LSIL/HSIL (OR = 2.598, 95%CI: 1.460-4.624).

CONCLUSIONS
In HIV-infected men, the prevalence of abnormal cytological findings was of 29% and of HR-HPV was 66%. The concomitant presence of HPV-16 and multiple HR genotypes was associated with an increased risk of abnormal cytological findings. These data highlight the importance of screening multiple HPV genotypes in HIV-infected patients.

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