Anal Dysplasia in Human Immunodeficiency Virus-Infected Men Who Have Sex With Men With Sexually Acquired Early Hepatitis C Virus Infection
Author:
Jacobson Karen B1, Gaisa Michael M1, Sigel Keith1, Foster Andrew L1, Fierer Daniel S1, Akil Bisher, Bailey Juan, Bellman Paul, Bowers Daniel, Bungay Krisczar, Burger Susanne, Carpenter Ward, Cantor Aviva, Chasan Rachel, Chavez Robert, Chow Rita, Cohen Robert, Dalton Patrick, Dellosso John, Demidont Adrian, Dillon Stephen, Donlon Eileen, Farrow Terry, Fefer Jose, Gaisa Michael, Guadron Rodolfo, Haber Stuart, Hefron Susan, Higgins Lawrence, Hitzeman Lawrence, Hsu Ricky, Huprikar Shirish, Inada Victor, Jacob Sneha, Johnson Livette, Johnston Barbara, Kaminsky Donald, Klein Oscar, Kwong Jeffrey, Lares-Guia Jose, Leach Eric, Levine Randy, Linetskaya Irina, Litvinova Larisa, Malhotra Amisha, Mandell William, Markowitz Martin, Mayer Gal, Meraz Eddie, Mortensen Erik, Olivieri Joseph, Paolino Charles, Photangtham Punyadech, Psevdos George, Radix Asa, Rapaport Steven, Ray Roona, Rodriguez-Caprio Gabriela, Shay William, Somasundaram Nirupama, Sorra Lembitu, Stivala Alicia, Tran Richie, Urbina Antonio, Vail Rona, Wallach Francis, Wang Wen, Weiss Susan, Wiener Melissa,
Affiliation:
1. Division of Infectious Diseases, Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
Abstract
AbstractBackgroundHuman immunodeficiency virus (HIV)-infected men who have sex with men (MSM) are at increased risk of anorectal infection with high-risk human papillomavirus and subsequent high-grade squamous intraepithelial lesions (HSIL), the putative precursor to anal cancer. Recently, an epidemic of sexually transmitted hepatitis C virus (HCV) has emerged that shares this anorectal route of transmission. We hypothesized that the prevalence of anal HSIL would be high in HIV-infected MSM with sexually acquired early HCV infection.MethodsHigh-resolution anoscopy (HRA) findings from a cohort of HIV-infected MSM with sexually acquired early HCV infection were compared with HRA findings from a contemporary cohort of HIV-infected MSM without HCV infection who underwent HRA due to abnormal anal cytology found during routine screening.ResultsSixty HIV-infected MSM with sexually acquired early HCV infection and the comparator group of 1150 HIV-infected MSM with abnormal anal cytology but without HCV underwent HRA. The HIV-infected MSM with sexually acquired early HCV had higher CD4 counts compared with the comparator group (656 and 541 cells/μL, respectively; P = .02). Despite this, the prevalence of anal dysplasia was as high among MSM with early HCV as in the comparator group of MSM with abnormal cytology (47 [78%] and 941 [82%], respectively; P = .50), as was the proportion with HSIL (25 [42%] and 379 [33%], respectively; P = .17).ConclusionsThe prevalence of anal dysplasia in HIV-infected MSM with sexually acquired early HCV infection was as high as that of HIV-infected MSM with abnormal anal cytology. These findings suggest that primary screening with HRA may be warranted for HIV-infected MSM with early HCV.
Funder
National Cancer Institute National Institutes of Health
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
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