Introduction India has a third large population of people living with Human Immunodeficiency Virus (HIV) in the world. Incidence of Human papilloma virus (HPV) infection anal cancer is high among People Living with HIV/AIDS (PLHIV). However, there are very few studies among HIV positive men in India. Thus this cross-sectional study was performed to assess the prevalence and risk factors of anal HPV infection and anal HPV types in HIV positive males attending the Antiretroviral therapy (ART) centre.
Method We screened HIV positive men with Anal Papanicolaou smear cytology and HPV testing. HPV DNA was detected by Consensus Polymerase Chain Reaction (PCR) using dissimilar E6 consensus and MY09/11 consensus primers followed by sequencing for confirmation the type of HPV.
Results 126 HIV-positive men were included in the study. Mean age was 35.37±8.2 years. Median CD4+T cell counts were 253/µL. Mean weight and mean Haemoglobin was 49.53±8.45 Kg and 11.2±1.73 g/dl respectively.74 patients were treatment naive and 52 were on Anti-Retroviral Therapy (ART) 48 (38%) gave positive for history of anal intercourse with other men although 91% were married. Anal cytology was done in 95 patients, out of which 61 (64.2%) had cytological abnormalities, of which 28 (29.4%) cases had LSIL, 33 (34.7%), had ASCUS. In multivariate analysis, an only risk factor for cytological abnormality was a history of anal intercourse Odds Ratio (OR) 0.122 (95% 0.036–0.410). HPV DNA was detected in 25.21% patients. The most prevalent HPV type in the study group was HPV-16 (10%) followed by HPV-18,31,35,17,66,72,52,68 and 107 (15.21%) genotypes were detected in anal pap samples.
Conclusion In our study, the prevalence of HPV infection was 25.21% and anal cytological abnormality was 64.2%, which is high. Anal Pap smear screening should be done especially in HIV positive males with the history of bisexuality. HPV DNA screening by using consensus PCR method followed by sequencing more beneficial and cost-effective for HPV genotyping HIV infected men on antiretroviral therapy.