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Abstract
HIV-INFECTED INTRAVENOUS DRUG USERS ARE AT HIGH RISK OF ANAL SQUAMOUS INTRAEPITHELIAL LESIONS RELATED TO HPV INFECTION
PIKETTY C, DARRAGH T, DA COSTA M, BRUNEVAL P, HEARD I, KAZATCHKINE M, PALEFSKY J
Objective: A high prevalence of anal squamous intraepithelial lesions (SIL) and HPV infection have been observed in HIV-infected homosexual males. To date, the prevalence of anal SIL and HPV infection have not been evaluated in HIV-infected intravenous drug users (IVDU) in the absence of receptive anal intercourse.
Methods: 117 HIV-infected patients were enrolled in a cross-sectional study, including 67 homosexual males and 50 IVDU males. Each patient provided anal samples for anal cytology, histology and HPV DNA testing. All IVDU reported never having had sex with men. HPV DNA was detected and typed by L1 consensus PCR. Anal cytologic samples were processed by the Thin Prep™ method.
Results: Mean CD4 cell counts (± SE) and mean plasma HIV-RNA were 286.8 ± 0.7 x 106 cells/L and 3.20 ± 0.12 log copies/mL, respectively. Twenty-eight percent of the patients had an AIDS defining event prior to the inclusion in the study and 88% of the patients received antiretroviral therapy. Anal cytology was abnormal in 48/67 (72%) homosexuals and 18/50 (36%) IVDU. Among the group of homosexuals, high grade SIL was observed in 16 patients (24%) and low grade SIL in 30 patients (45%) and ASCUS in 3 patients (4%). Among the group of IVDU, high grade SIL was observed in 9 patient (18%) and low grade SIL in 8 patients (16%). HPV DNA was detected in 82 % and 46 % of homosexuals and IVDU, respectively. Logistic regression analysis showed that lower CD4 cell count and a prior AIDS related event were risk factors for anal SIL in the IVDU group only, whereas, receptive anal intercourse was risk factor for anal SIL in the homosexual group.
Conclusion: Our results demonstrate a high prevalence of anal SIL, including high grade SIL, and anal HPV infection in HIV-infected IVDU in the absence of receptive anal intercourse. These data suggest that all HIV-positive men regardless of history of anal intercourse, should be considered for anal cytology screening.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
67
Suggested Citation
"PIKETTYC, et al.
HIV-INFECTED INTRAVENOUS DRUG USERS ARE AT HIGH RISK OF ANAL SQUAMOUS INTRAEPITHELIAL LESIONS RELATED TO HPV INFECTION.
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
67"
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