Department of Family Medicine.
Chronic Viral Illness Service, McGill University Health Centre (MUHC).
J Infect Dis. 2017 Aug 15;216(4):447-456. doi: 10.1093/infdis/jix273.
The risk of anal cancer due to high-risk human papillomavirus (HR-HPV) is higher in women living with human immunodeficiency virus (HIV) than in the general population. We present findings of cervical and anal HPV and cytologic tests at baseline in the EVVA cohort study and HPV persistence data 6 months after baseline.
Semiannual visits included questionnaires, chart reviews, cervical/anal cytologic and cervical/anal HPV testing for 2 years. Genotyping for 36 HPV genotypes was performed using the Roche Linear Array HPV genotyping test.
A total of 151 women living with HIV were recruited. At baseline, 75% had anal HPV, 51% had anal HR-HPV, 50% had cervical HPV, and 29% had cervical HR-HPV. Anal HPV-16 and HPV-51 were more frequent in women born in Canada (31% and 29%, respectively, compared with ≤16% for other women). Most anal HR-HPV types detected at 6 months (57%-93%) were persistent from baseline. Findings of anal cytologic tests were abnormal for 37% of women.
Anal HPV is highly prevalent in women living with HIV, and type distribution varies by place of birth. High-resolution anoscopy was indicated in more than one third of results. As anal cancer is potentially preventable, these important findings need to be considered when selecting the best approach for anal cancer screening programs.
感染人类免疫缺陷病毒（HIV）的女性发生人乳头瘤病毒（HPV）相关肛门癌的风险高于普通人群。我们报告了 EVVA 队列研究中基线时宫颈和肛门 HPV 及细胞学检测的结果，以及基线后 6 个月的 HPV 持续感染数据。
每半年进行一次随访，包括问卷调查、病历回顾、宫颈/肛门细胞学检查以及宫颈/肛门 HPV 检测，共随访 2 年。采用罗氏线性阵列 HPV 基因分型检测对 36 种 HPV 基因型进行基因分型。
共招募了 151 名 HIV 感染者。基线时，75%的女性存在肛门 HPV 感染，51%存在肛门高危型 HPV 感染，50%存在宫颈 HPV 感染，29%存在宫颈高危型 HPV 感染。在加拿大出生的女性中，HPV-16 和 HPV-51 的感染率更高（分别为 31%和 29%，而其他女性的感染率≤16%）。6 个月时检测到的大多数肛门高危型 HPV 类型（57%-93%）均为持续性感染。37%的女性肛门细胞学检查结果异常。
HIV 感染者中肛门 HPV 感染非常普遍，且其分布类型因出生地而异。超过三分之一的结果需要进行高分辨率肛门镜检查。由于肛门癌是一种潜在可预防的疾病，因此在选择肛门癌筛查方案时，需要考虑这些重要发现。
