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Prevalence, incidence, and clearance of anal high-risk human papillomavirus (HPV) infection among HIV-infected men in the SUN Study.

Prevalence, incidence, and clearance of anal high-risk human papillomavirus (HPV) infection among HIV-infected men in the SUN Study.
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Patel P, Bush T, Kojic EM, Conley L, Unger ER, Darragh TM, Henry K, Hammer J, Escota G, Palefsky JM, Brooks JT,


Patel P, Bush T, Kojic EM, Conley L, Unger ER, Darragh TM, Henry K, Hammer J, Escota G, Palefsky JM, Brooks JT, (click to view)

Patel P, Bush T, Kojic EM, Conley L, Unger ER, Darragh TM, Henry K, Hammer J, Escota G, Palefsky JM, Brooks JT,

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The Journal of infectious diseases 2017 12 04() doi 10.1093/infdis/jix607

Abstract
Background
The natural history of anal HPV infection among HIV-infected men is unknown.

Methods
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.

Results
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.

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