CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Poster and Themed Discussion Abstracts

594 MULTIPLE HPV INFECTIONS AND ANAL PRECANCEROUS LESIONS IN HIV-INFECTED MEN Shu-Hsing Cheng 1 , Chien-Yu Cheng 1 , Chi-Chao Wang 1 , Fang-Yeh Chu 2 , Yu-Mei Hsueh 3 1 Taoyuan General Hosp, Taoyuan, Taiwan, 2 Far Eastern Memorial Hosp, New Taipei, Taiwan, 3 Taipei Med Univ, Taipei, Taiwan Background: Men who were infected with HIV are at increased risk of developing anal cancer. Though previous reports had showed multiple HPV infections were common among HIV-infected patients, whether multiple HPV types are associated with precancerous anal lesions was not explored. Methods: Between March 2010 and June 2016, HIV-infected men who visited the outpatient clinics of Taoyuan General Hospital, Taiwan, had been enrolled. After informed consents obtained, the subjects inserted saline-wetted Dacron swabs approximately 5 cm beyond the anal verge. Rectal swabs were rinsed immediately in a vial containing PreservCyt solution (Cytyc, Marlborough, MA). Thin preparation Pap smears (ThinPrep; Hologic, Marlborough, MA) were interpreted according to the 2001 Bethesda System. HPV genotyping was performed by a reverse line blotting method (Linear Array HPV Genotyping Test; Roche Molecular System, Branchburg, NJ). Thirty-seven types of HPV were detected, including oncogenic types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68; and non-oncogenic types, 6, 11, 26, 40, 42, 53, 54, 55, 61, 62, 64, 66, 67, 69, 70, 71, 72, 73, 81, 82, 83, 84, IS39, and CP6108. Results: Totally 714 HIV-positive subjects were enrolled. Their mean ages were 30.7 years. Among them, 83.2%were men who have sex with men. There were 175 subjects (24.5%) had atypical squamous cells with undetermined significance (ASCUS) or higher grades (ASCUS+) in anal cytology, comprising 87 (49.7%) ASCUS, 73 (41.7%) low-grade squamous intraepithelial lesions (SIL), and 15 (8.6%) high-grade SIL (HSIL)/atypical squamous cells cannot exclude HSIL. Comparison between subjects who carried ASCUS+ and who did not revealed 97.7% vs. 81.4% had any type of HPV (p < .0001); and 94.8% vs. 63.6% had multiple HPV types (p < .0001). Among subjects who had 0, 1, 2, 3, 4, 5 and more than 5 types of HPV infection, frequencies of ASCUS+ (OR, 95% CI) were 3.8% , 5.0% (1.31, 0.43 – 5.04), 19.8% (6.24, 2.09 – 8.66), 26.8% (9.24, 3.09 – 27.65), 34.2% (24.22, 4.35 – 39.46), 35.9% (14.16, 4.61 – 43.50), and 44.6% (20.32, 7.11 – 58.10), respectively (p trend < .0001). Multivariate logistic regression analysis showed a significant association of ASCUS+ with numbers of HPV genotypes (OR 1.42; 95% CI 1.020 – 1.979, p =.037). Conclusion: Subjects who have more than 5 types of HPVs have 20 times of risk to have anal ASCUS+. Multiple HPV infections in anal sites among HIV-infected patients deserved aggressive follow-up.

CROI 2017 250