Prevalence and risk factors associated with high-grade anal squamous intraepithelial lesions (HSIL)-AIN2 and HSIL-AIN3 in homosexual men

Dorothy A. Machalek; Fengyi Jin; I. Mary Poynten; Richard J. Hillman; David J. Templeton; Carmella Law; Jennifer M. Roberts; Sepehr N. Tabrizi; Suzanne M. Garland; Annabelle Farnsworth; Christopher K. Fairley; Andrew E. Grulich

Papillomavirus Research (Dec 2016)

Prevalence and risk factors associated with high-grade anal squamous intraepithelial lesions (HSIL)-AIN2 and HSIL-AIN3 in homosexual men

Dorothy A. Machalek,
Fengyi Jin,
I. Mary Poynten,
Richard J. Hillman,
David J. Templeton,
Carmella Law,
Jennifer M. Roberts,
Sepehr N. Tabrizi,
Suzanne M. Garland,
Annabelle Farnsworth,
Christopher K. Fairley,
Andrew E. Grulich

Affiliations

Dorothy A. Machalek: HIV Epidemiology and Prevention Program, The Kirby Institute for infection and immunity in society, University of New South Wales, Sydney, Australia; Department of Microbiology and Infectious Diseases, Royal Women's Hospital and Murdoch Childrens Research Institute, Melbourne, Australia
Fengyi Jin: HIV Epidemiology and Prevention Program, The Kirby Institute for infection and immunity in society, University of New South Wales, Sydney, Australia
I. Mary Poynten: HIV Epidemiology and Prevention Program, The Kirby Institute for infection and immunity in society, University of New South Wales, Sydney, Australia
Richard J. Hillman: Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales 2137, Australia; Centre for Infectious Diseases and Microbiology, Westmead Clinical School, University of Sydney, New South Wales 2006, Australia; St Vincent's Hospital, Sydney, New South Wales, Australia
David J. Templeton: HIV Epidemiology and Prevention Program, The Kirby Institute for infection and immunity in society, University of New South Wales, Sydney, Australia; RPA Sexual Health, Sydney Local Health District, Sydney, Australia
Carmella Law: St Vincent's Hospital, Sydney, New South Wales, Australia
Jennifer M. Roberts: Douglass Hanly Moir Pathology, Sydney, New South Wales, Australia
Sepehr N. Tabrizi: Department of Microbiology and Infectious Diseases, Royal Women's Hospital and Murdoch Childrens Research Institute, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
Suzanne M. Garland: Department of Microbiology and Infectious Diseases, Royal Women's Hospital and Murdoch Childrens Research Institute, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
Annabelle Farnsworth: Douglass Hanly Moir Pathology, Sydney, New South Wales, Australia
Christopher K. Fairley: Melbourne Sexual Health Centre, Carlton, Victoria, Australia and Central Clinical School Monash University, Victoria, Australia
Andrew E. Grulich: HIV Epidemiology and Prevention Program, The Kirby Institute for infection and immunity in society, University of New South Wales, Sydney, Australia; Correspondence to: HIV Epidemiology and Prevention Program, The Kirby Institute for Infection and Immunity in Society, Wallace Wurth Building, High Street, Kensington, NSW 2052, Australia.

Journal volume & issue: Vol. 2
pp. 97 – 105

Abstract

Read online

Background: Anal intraepithelial neoplasia grade 2 (AIN2) and AIN grade 3 (AIN3) are commonly grouped together as high grade squamous intraepithelial lesions (HSIL). We assessed risk factors for HSIL-AIN2 and HSIL-AIN3 in a cohort of homosexual men. Methods: At the baseline visit in the Study for the Prevention of Anal Cancer (SPANC), all men completed a questionnaire and underwent anal swabbing for cytology and HPV genotyping, followed by high resolution anoscopy. Results: Composite-HSIL prevalence was 47% and 32% among 220 HIV-positive and 396 HIV-negative men, respectively. HSIL-AIN3 (37.7% versus 24.7%; p<0.001), but not HSIL-AIN2 (9.5% versus 7.6%; p=0.395) was more common in HIV-positive men. Recent receptive anal partners (p-trend=0.045), and increasing number of high-risk (HR)-HPV types (p-trend<0.001) were associated with HSIL-AIN2. Lifetime receptive partners (p-trend<0.001), HIV status (OR 1.74; 95% CI: 1.05–2.87) and HPV16 (OR 3.00; 95% CI: 1.56–5.75) were associated with HSIL-AIN3. HPV16 was the most common HR-HPV type detected in men with HSIL-AIN3, both HIV-negative (61.1%) and HIV-positive (54.9%). HPV16 was less commonly detected in men with HSIL-AIN2. Conclusions: Grouping HSIL-AIN2 and HSIL-AIN3 as HSIL may mask considerable heterogeneity in anal cancer risk. Given the strong link between HPV16 and anal cancer, men with HSIL-AIN3 and HPV16 are likely to be at greatest risk of cancer. Keywords: Risk factors, Surrogate endpoints, HSIL, Cancer screening, Human papillomavirus

Published in Papillomavirus Research

ISSN: 2405-8521 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Infectious and parasitic diseases
Website: https://www.journals.elsevier.com/papillomavirus-research/

About the journal