The Journal of infectious diseases 2017 12 04() doi 10.1093/infdis/jix607
The natural history of anal HPV infection among HIV-infected men is unknown.
We collected anal swabs for cytology, HPV detection, and genotyping at annual visits from 2004-2012. We examined baseline prevalence, incidence and clearance of anal HPV infection at 48 months, and associated factors among HIV-infected men.
We examined 403 men who have sex with men (MSM) and 96 men who have sex with women (MSW) (median age 42 years for both, 87 vs. 91% were prescribed cART, median CD4 cell count was 454 vs. 379 cells/mm3, and 74 vs. 75% had undetectable viral load, respectively). For type 16, prevalence among MSM and MSW was 38% vs. 14% (p<0.001), and incidence was 24% vs. 6% (p=0.001), respectively. For type 18, prevalence was 24% vs. 8% (p<0.001), and incidence was 14% vs. 3% (p=0.009), respectively. Among MSM and MSW, clearance of prevalent HPV 16 and HPV 18 was 51% and 66% (p=0.682), and 69% and 60% (p=0.538), respectively. Condomless receptive anal sex was associated with persistent HPV 16 among all men (OR 2.37, p=0.014). Conclusions
MSM had higher prevalence and incidence of HPV than MSW, but similar clearance. Condomless anal sex may predict cancer risk among HIV-infected men.