Objective: To assess the prevalence of abnormal anal cytology and high-risk 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 (MSM), 2 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 due to an inadequate sample. Sixteen (13%) participants had cytological evidence of high-grade squamous intraepithelial (HGSIL) changes, of whom 100% had high-risk HPV types detected and 13 (10%) had atypical squamous cells of undetermined significance with possible high grade changes (ASCUS-H), of whom 92% had high-risk HPV types detected. Low-grade changes (LSIL) were detected in 24 (19%) participants, of whom 96% 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 having abnormal anal cytology in those participants with high-risk HPV on anal swab was 5.03 (C.I. 1.45-17.39).
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.
- Anal intraepithelial neoplasia