rss
Sex Transm Infect 2008;84:94-96 doi:10.1136/sti.2007.027250
  • Clinical

Abnormal anal cytology in high-risk human papilloma virus infection in HIV-infected Australians

  1. J Anderson1,2,
  2. J Hoy2,3,
  3. R Hillman4,
  4. C Gittleson5,
  5. G Hartel5,
  6. G Medley6,
  7. R Basser5
  1. 1
    Carlton Clinic, Melbourne, Australia
  2. 2
    Infectious Diseases Unit, Alfred Hospital, Melbourne
  3. 3
    Department of Medicine, Monash University, Melbourne
  4. 4
    STI Research Centre, University of Sydney, Sydney, Australia
  5. 5
    CSL Limited, Melbourne, Australia
  6. 6
    Melbourne Pathology, Collingwood, Victoria, Australia
  1. Dr J S Anderson, Carlton Clinic, 88 Rathdowne St, Carlton, Melbourne, Vic 3053, Australia
  • Accepted 12 September 2007
  • Published Online First 19 September 2007

Abstract

Objective: To assess the prevalence of abnormal anal cytology and high-risk human papilloma virus (HPV)-type infection in HIV-infected people with a CD4 cell count >300 cells/μl.

Methods: The clinic-based patient population included 126 HIV-infected people: 124 men who have sex with men, and two women (median age 45 years; CD4 cell count >300 cells/μl). Anal cytology swabs were placed into liquid-based medium for HPV typing by Hybrid Capture-2 assay and cytological assessment, by a single cytopathologist.

Results: 106 (84%) participants were infected with high-risk HPV; 17 (14%) had no high-risk types of HPV detected; three (2%) had no HPV assay result because of an inadequate sample. Sixteen (13%) participants had cytological evidence of high-grade squamous intraepithelial (HGSIL) changes, 100% of whom had high-risk HPV types detected, and 13 (10%) had atypical squamous cells of undetermined significance with possible high-grade changes (ASCUS-H), 92% of whom had high-risk HPV types detected. Low-grade changes (LSIL) were detected in 24 (19%) participants, 96% of whom had high-risk HPV types, 32 (25%) had ASCUS with 88% high-risk HPV types, 30 (24%) had normal cytology with 73% high-risk HPV types, and 11 (9%) samples were inadequate for cytological assessment. The odds ratio of participants with high-risk HPV having abnormal anal cytology on anal swab was 5.03 (95% CI 1.45 to 17.39).

Discussion: High-risk HPV types are common in this HIV+ population with a CD4 cell count >300 cells/μl. The presence of high-risk HPV types was associated with abnormal anal cytology such as HGSIL and ASCUS-H.

Footnotes

  • Funding: The study was supported by CSL Ltd. RB, CG and GH are employees of CSL Ltd.

  • Competing interests: None declared.

  • The results of this study have been presented at the 22nd Papilloma Conference in Vancouver, Canada, in May 2005 (Anal intraepithelial neoplasia (AIN) and high-risk HPV types in HIV infected men and women with mild to moderate immunosuppression. P-242).

Responses to this article

  • Human papilloma virus, sexual behaviour and logical places of infection and malignancy
    • Prof.dr Nikola N. Ilankovic
    Sex Transm Infect published online October 22, 2009

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All versions of this article:
    1. sti.2007.027250v1
    2. 84/2/94 most recent

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.