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Anal human papillomavirus DNA screening by Hybrid Capture II TM in human immunodeficiency virus-positive patients with or without anal intercourse


European Journal of Dermatology. Volume 13, Number 4, 367-71, July 2003, Investigative report

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Author(s) : C. DROBACHEFF, P. DUPONT, C. MOUGIN, Y. BOUREZANE, B. CHALLIER, M. FANTOLI, D. BETTINGER, R. LAURENT

Summary : High risk human papillomaviruses (HPVs) have emerged as risk factors for anal carcinoma, of which incidence is higher in HIV-positive patients than in the general population. The aim of our study was to investigate the prevalence and risk factors for anal HPV infections in HIV-positive patients with or without history of anal intercourse. Fifty HIV1-infected patients (36 men and 14 women) were tested at entry and followed-up every 3 months for one year for the presence of anal HPV DNA by the Hybrid Capture II TM assay. A series of 50 HIV-negative subjects matched for age and sex served as controls. At enrolment, anal HPV DNA was present in 29/50 HIV-positive patients (58 %) and in 3/50 control subjects (6 %). High risk (HR) HPV genotypes were detected in 20/50 HIV-positive patients (40 %) with no difference in homosexual men and other HIV-positive patients. Risk factors for HPV infection were CD4 + cell counts less than 500/μL (RR: 2.13 [95 % CI: 1.0-4.7]) and history of anogenital warts (RR: 2.36 [95 % CI: 1.2-4.6]). The HPV load was higher in patients with CD4+  500/μL than in patients with CD4 + > 500/μL (p <\; 0.04). During the follow-up, anal HR HPV DNA was repeatedly identified at high levels in 5 HIV-positive patients. There is some convincing evidence that HIV-positive patients with low CD4+ cells, whatever the routes of HIV transmission, have a high rate of anal HPV infection and might be at increased risk of developing anal neoplastic lesions. Identifying HR HPV infection might be warranted in immunosuppressed patients.

Keywords : human papillomavirus\; HIV\; anal HPV infection\; anal cancer\; hybrid capture II.

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