HIGH-RISK HUMAN PAPILLOMAVIRUS INFECTION AND P16 EXPRESSION IN MEN WITH ANOGENITAL LESIONS ATTENDING A DERMATOLOGY CLINIC

Abstract

Our study comprises a cases series of 71 men attending a dermatology clinic in Brazil during an 18-month period with anogenital HPV infection. Clinical manifestations, laboratory findings and sociodemographic factors were evaluated. Biopsy samples were subjected to histopathological analysis, generic and type-specific viral identification, and p16 INK4a quantification. The average age at diagnosis was 33 years. We observed little variation in identified viral types (HPVs 6, 11, 16 and 53), despite the inclusion of 16 HIV+ patients. The presence of high-risk HPV was associated with receptive anal sex (p<0.05), lesion malignancy (p<0.01) and p16 INK4a expression (p<0.05). HIV+ was correlated with HPV16 infection, presence of perianal lesions and high-grade lesions (p<0.05) diagnosed at a younger mean age than HIV– patients (p<0.05). Our results demonstrate the unequivocal relationship between high-risk HPV infection and the presence of high-grade lesions, HPV 16 tropism in the anal epithelium, and the role of receptive anal sex as a risk factor for development of high-grade anal lesions, that present early in HIV+ men who have sex with men. As the 5 high-grade lesions (1 AINII and 4 AIN III) showed p16 INK4a negativity but were related to HPV 16 presence, we believe that p16 INK4a is a promising biomarker, but its use remains controversial requiring further research. DOI:  http://dx.doi.org/10.17525/vrrjournal.v19i2.96