Anal high-grade intraepithelial neoplasia and cancer in women living with HIV and HIV-negative women with other risk factors.

IF 3.4 2区医学 Q3 IMMUNOLOGY AIDS Pub Date : 2024-08-14 DOI:10.1097/QAD.0000000000003995

Montserrat Capell-Morell, Melissa Bradbury, Maria Carme Dinares, Javier Hernandez, Montserrat Cubo-Abert, Cristina Centeno-Mediavilla, Antonio Gil-Moreno

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Abstract

Objective: To determine the prevalence and the risk factors for anal high-grade intraepithelial neoplasia and anal cancer (HSIL+) in women living with HIV (WLWHIV), and to compare them to HIV-negative women with other risk factors.

Design: Prospective cohort study.

Methods: WLWHIV and HIV-negative women with other risk factors were included. Screening for anal HSIL+ using anal cytology and HPV testing was performed. A high-resolution anoscopy with directed biopsy was also performed in patients with an abnormal cytology result or a positive HPV testing for high-risk (HR) genotypes, and in those with anal symptoms.

Results: The period prevalence of anal HR-HPV infection and histological HSIL was 57.9% and 10.9% among WLWHIV, and 60.8% and 9.2% among HIV-negative women. The prevalence of anal HPV 18 infection was higher in WLWHIV. The risk factors for anal HSIL+ in WLWHIV included anal HPV 16, other HR genotypes and low-risk genotypes infection, as well as a history of vulvar HSIL+. In HIV-negative women, the risk factors included anal HPV 16 infection, history of anogenital warts and of vulvar HSIL+, and immunosuppressive treatment.

Conclusions: A high prevalence of anal HPV infection and HSIL was observed in WLWHIV and women with other risk factors. Both groups share anal HPV 16 infection and history of vulvar HSIL+ as risk factors for the development of anal HSIL+. Genotyping for anal HPV 16 may help identify women at higher risk of anal cancer.

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感染艾滋病毒的妇女和有其他风险因素的艾滋病毒阴性妇女的肛门高级别上皮内瘤变和癌症。

目的确定女性艾滋病病毒感染者（WLWHIV）中肛门高级别上皮内瘤变和肛门癌（HSIL+）的患病率和风险因素，并将其与具有其他风险因素的HIV阴性女性进行比较：设计：前瞻性队列研究：方法：纳入 WLWHIV 和具有其他风险因素的 HIV 阴性女性。通过肛门细胞学和 HPV 检测筛查肛门 HSIL+。对于细胞学结果异常或高危（HR）基因型 HPV 检测呈阳性的患者以及有肛门症状的患者，还进行了高分辨率肛门镜检查和定向活检：结果：在 WLWHIV 妇女中，肛门 HR-HPV 感染率和组织学 HSIL 患病率分别为 57.9% 和 10.9%，在 HIV 阴性妇女中分别为 60.8% 和 9.2%。WLWHIV 感染肛门 HPV 18 的比例更高。WLWHIV 感染肛门 HSIL+ 的风险因素包括肛门 HPV 16、其他 HR 基因型和低风险基因型感染，以及外阴 HSIL+ 病史。在HIV阴性女性中，风险因素包括肛门HPV 16感染、肛门尖锐湿疣和外阴HSIL+病史以及免疫抑制治疗：结论：在 WLWHIV 和有其他风险因素的妇女中，肛门 HPV 感染和 HSIL 的发病率很高。这两类人群都有肛门HPV 16感染和外阴HSIL+病史，这是导致肛门HSIL+的危险因素。对肛门 HPV 16 进行基因分型可能有助于识别罹患肛门癌风险较高的女性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AIDS 医学-病毒学

CiteScore

5.90

自引率

5.30%

发文量

478

审稿时长

3 months

期刊介绍： Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.