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O05.1 High Grade Anal Intraepithelial Neoplasia: One Virus, One Lesion
  1. O Richel1,
  2. K D Quint2,3,
  3. J Lindenman2,
  4. C M Van Noesel1,
  5. M N C De Koning2,
  6. H A M Van den Munckhof2,
  7. H J C De Vries1,4,
  8. J M Prins1,
  9. W G V Quint2
  1. 1Academic Medical Center, Amsterdam, The Netherlands
  2. 2DDL Diagnostic Laboratory, Rijswijk, The Netherlands
  3. 3Leiden University Medical Center, Department of Dermatology, Leiden, The Netherlands
  4. 4STI outpatient clinic, Public Health Service Amsterdam, Amsterdam, The Netherlands

Abstract

Background Prevention and treatment of anal intraepithelial neoplasia (AIN) in HIV+ men who have sex with men (MSM) is subject of discussion. Knowledge on causative HPV types is crucial in understanding AIN and in vaccination studies. However, data on AIN-specific HPV are limited and whole tissue sections (WTS) often show multiple HPV infections.

In this study, we analysed whether WTS and subsequent laser capture micro-dissection (LCM) with HPV PCR genotyping accurately detects type-specific HPV DNA in individual areas of high grade (HG)AIN.

Methods 31 WTS with HGAIN of 21 HIV+ MSM were analysed by the SPF10 PCR/LiPA25 (version 1) HPV genotyping system. In case of multiple HPV types, PCR was repeated in selected areas of AIN, isolated by LCM.

Results WTS PCR showed a single HPV type in 17 (55%). In the remaining 14 WTS sections with multiple HPV types, PCR was repeated in LCM-isolated dysplastic areas (median: 4 per WTS). In 12 of 14 these samples, the number of HPV types could be reduced to single HPV types within discrete areas of a lesion, resulting in a total of 29 (17+12), in which (components of) HGAIN show a singe HPV type. HPV 16 was found in 14/29 (48%), HPV 18 in 3 and HPV 58 in 3. The remaining HPV types that could be linked to a lesional area were HPV 26, 31, 35, 39, 52, 53, 54, 59, 67, 68/73, 74, 91 and one indeterminate HPV type.

Conclusion WTS PCR and subsequent LCM PCR is accurate in detecting lesion specific HPV types in AIN and it seems that 94% of the AIN-lesions (on macroscopic or microscopic level) are caused by a single HPV type. Apart from HPV 16, the predominant type, a wide range of other HPV types are responsible for HGAIN, which has consequences for vaccination development.

  • anal intraepithelial neoplasia
  • HIV
  • HPV

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