European Journal of Dermatology


Anal human papillomavirus DNA screening by Hybrid Capture II TM in human immunodeficiency virus-positive patients with or without anal intercourse Volume 13, issue 4, July 2003

Service de Dermatologie, CHU, 25000 Besançon, France. Laboratoire de Biologie Cellulaire et Moléculaire, CHU Jean Minjoz, Boulevard Fleming, 25030 Besançon cedex, France. Département d’Informatique Médicale, CHU, 25000 Besançon, France

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.