Anal human papillomavirus infection (HPV) is prevalent in men with HIV. While there are HPV vaccines available, it’s not totally clear if the HPV types most commonly found in HIV-infected men are covered by those vaccines.
Pragna Patel, MD, MPH, of the Centers for Disease Control and Prevention (CDC), and colleagues set out to uncover prominent types of HPV in both men who have sex (MSM) with men and men who have sex with women (MSW). Their findings were presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2017
) in Seattle, Washington.
Most squamous cell anal cancers have been linked to HPV, which is a group of over 150 related viruses. The American Cancer Society identified HPV-16 as being the most likely to cause anal cancer. HPV-18, HPV-31, HPV-33, and HPV-45 are also strongly connected to cancer.
The nonavalent (9V) vaccine covers seven high-risk types of HPV—16, 18, 31, 33, 45, 52, and 58. Patel and team compared these types with the ones found in the HIV-positive men.
The cohort was made up of 403 MSM and 96 MSW with a median age of 42. Baseline characteristics were similar between the groups: prescribed antiretroviral therapy (ART) (78% vs. 81%), median CD4 cell count (454 cells/mm³ and 379 cells/mm³), CD4 counts >
200 cells/mm³ (90% and 83%), and undetectable viral load (74% and 75%), respectively. The Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (known as the SUN Study) participants came from seven clinics in Minneapolis, Minnesota; Denver, Colorado; St. Louis, Missouri; and Providence, Rhode Island.
From March 1, 2004 to June 30, 2006, the researchers collected anal swabs from study participants. Follow-up occurred every six months until June 1, 2012. They found that 74% of MSM and 32% MSW had any 9v high risk HPV type. Of those participants, 63% and 44% in each group had abnormal anal cytology.
In addition, demographic and sexual behavior data were gathered using an audio computer-assisted self-interview.