TY - JOUR
T1 - Risk factors for anal HPV infection and anal precancer in HIV-infected men who have sex with men
AU - Schwartz, Lauren M.
AU - Castle, Philip E.
AU - Follansbee, Stephen
AU - Borgonovo, Sylvia
AU - Fetterman, Barbara
AU - Tokugawa, Diane
AU - Lorey, Thomas S.
AU - Sahasrabuddhe, Vikrant V.
AU - Luhn, Patricia
AU - Gage, Julia C.
AU - Darragh, Teresa M.
AU - Wentzensen, Nicolas
N1 - Funding Information:
Financial support. This work was supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute.
PY - 2013/12/1
Y1 - 2013/12/1
N2 - Background. Carcinogenic human papillomaviruses (HPVs) cause a large proportion of anal cancers. Human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) are at increased risk of HPV infection and anal cancer compared with HIV-negative men. We evaluated risk factors for HPV infection and anal precancer in a population of HIV-infected MSM. Methods. Our study included 305 MSM at an HIV/AIDS clinic in the Kaiser Permanente Northern California Health Maintenance Organization. Logistic regression was used to estimate associations of risk factors comparing men without anal HPV infection; men with anal HPV infection, but no precancer; and men with anal precancer. Results. Low CD4 count (<350 cells/mm3) and previous chlamydia infection were associated with an increased risk of carcinogenic HPV infection (odds ratio [OR], 3.65; 95% confidence interval [CI], 1.28-10.40 and OR, 4.24; 95% CI, 1.16-15.51, respectively). History of smoking (OR, 2.71 95% CI, 1.43-5.14), duration, recency, and dose of smoking increased the risk of anal precancer among carcinogenic HPV-positive men but had no association with HPV infection. Conclusions. We found distinct risk factors for anal HPV infection and anal precancer. Risk factors for HPV infection and anal precancer are similar to established risk factors for cervical cancer progression.
AB - Background. Carcinogenic human papillomaviruses (HPVs) cause a large proportion of anal cancers. Human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) are at increased risk of HPV infection and anal cancer compared with HIV-negative men. We evaluated risk factors for HPV infection and anal precancer in a population of HIV-infected MSM. Methods. Our study included 305 MSM at an HIV/AIDS clinic in the Kaiser Permanente Northern California Health Maintenance Organization. Logistic regression was used to estimate associations of risk factors comparing men without anal HPV infection; men with anal HPV infection, but no precancer; and men with anal precancer. Results. Low CD4 count (<350 cells/mm3) and previous chlamydia infection were associated with an increased risk of carcinogenic HPV infection (odds ratio [OR], 3.65; 95% confidence interval [CI], 1.28-10.40 and OR, 4.24; 95% CI, 1.16-15.51, respectively). History of smoking (OR, 2.71 95% CI, 1.43-5.14), duration, recency, and dose of smoking increased the risk of anal precancer among carcinogenic HPV-positive men but had no association with HPV infection. Conclusions. We found distinct risk factors for anal HPV infection and anal precancer. Risk factors for HPV infection and anal precancer are similar to established risk factors for cervical cancer progression.
KW - Anal cancer
KW - Anal intraepithelial neoplasia (ain)
KW - Human immunodeficiency virus (hIV)
KW - Human papillomavirus (HPV)
KW - Men who have sex with men (MSM)
UR - http://www.scopus.com/inward/record.url?scp=84888594539&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84888594539&partnerID=8YFLogxK
U2 - 10.1093/infdis/jit374
DO - 10.1093/infdis/jit374
M3 - Article
C2 - 23908478
AN - SCOPUS:84888594539
SN - 0022-1899
VL - 208
SP - 1768
EP - 1775
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 11
ER -
