AEGiS-15IAC: Anal squamous intraepithelial lesions and HPV infection in HIV-positive men in Brazil.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Anal squamous intraepithelial lesions and HPV infection in HIV-positive men in Brazil.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoPeB3276)

Chin-Hong PV, Guimaraes MD, Bonfim D, Da Costa M, Darragh T, Grinsztejn B, May SB, Pilotto JH, Palefsky JM
University of California, San Francisco, United States

BACKGROUND: The incidence of anal cancer is increasing worldwide in men and women. HPV associated anal squamous intraepithelial lesions (ASIL), particularly high-grade lesions (HSIL), are the putative precursor lesions of anal cancer. Previous work has characterized a high prevalence of anal HPV infection and ASIL in HIV-positive men and women in North America. Little is known about the prevalence in developing countries such as Brazil or among bisexual men.

METHODS: We examined 33 HIV-positive men in three urban clinics in Rio de Janeiro and Belo Horizonte, Brazil. Trained interviewers ascertained sexual behavior. We assessed anal HPV infection status using polymerase chain reaction, and anal cytology using Bethesda criteria.

RESULTS: Of the 33 men enrolled, 60% reported sex with both men and women, 33% with women only and 6% with men only. Anal HPV infection was found in 38% of bisexual and 44% of heterosexual men. Abnormal anal cytology was diagnosed in 41% of bisexual and 27% of heterosexual men, and HSIL in 18% of bisexual and 9% of heterosexual participants. Abnormal cytology was strongly related to any history of receptive anal intercourse (OR 6.25, P 0.03), and moderately related to the number of lifetime male sexual partners (P=0.09). There was no relationship between sexual orientation and anal HPV or sexual orientation and anal cytology (P>0.15).

CONCLUSIONS: HIV-positive men in Brazil have a high prevalence of anal HPV infection, ASIL and HSIL regardless of sexual preference. Given the limited sensitivity of anal cytology, this is likely an underestimate. Anal cancer screening programs are needed as the proportion of individuals living with HIV in Brazil continues to increase with widespread availability of HAART.

Keywords: AEGIS, Papillomavirus, Human, HIV Seropositivity, Anus Neoplasms, Anus, Bisexuality, Prevalence, Communicable Diseases, Infection, Anus Diseases, Sexual Behavior, HIV Infections, Antiretroviral Therapy, Highly Active, Incidence, Anti-HIV Agents, HIV, Brazil, North America, Humans, Male, Female

040711
MoPeB3276