Wang Chi-Chao, Chang Shih-Lung, Chu Fang-Yeh, Cheng Chien-Yu, Cheng Shu-Hsing
Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
Department of Pathology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
J Infect Dev Ctries. 2019 Apr 30;13(4):318-325. doi: 10.3855/jidc.11162.
Anal cancer screening has not been adopted by Taiwanese care providers. The study aim was to explore the differences of anal cytology and HPV detection among men with and without HIV.
In this case-control study, men with HIV who attended one of the outpatient clinics of Taoyuan General Hospital were enrolled as cases. Men who had experienced condomless sex and tested HIV negative were enrolled as controls. Anal swabs were collected for thin-preparation anal cytology and HPV genotyping.
A total of 288 men who had tested positive for HIV and 208 who had tested HIV negative were enrolled; 75% of subjects with HIV and 30.3% of those without HIV had tested positive for various types of HPV (P < 0.001). Anal cell dysplasia, including atypical squamous cells with undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LSILs), high-grade squamous intraepithelial lesions (HSILs), or atypical squamous cells cannot exclude HSIL (ASC-H), were noted in 20.8% of men with HIV and 4.8% of those without HIV (P < 0.001). In multivariate analysis, HIV serostatus, history of sexually transmitted infections, having male sexual partners, and practice of anal sex were correlated significantly with detection of any type of HPV. Additionally, both oncogenic and non-oncogenic HPV types were significantly associated with anal cytology dysplasia.
We strongly suggest that there should be awareness of anal HPV infection and related anal cellular dysplasia in at-risk populations.
台湾医疗服务提供者尚未采用肛门癌筛查。本研究旨在探讨感染和未感染艾滋病毒男性的肛门细胞学和人乳头瘤病毒（HPV）检测结果差异。
在这项病例对照研究中，将就诊于桃园总医院门诊的艾滋病毒感染者纳入病例组。将有过无保护性行为且艾滋病毒检测呈阴性的男性纳入对照组。采集肛门拭子用于薄层液基肛门细胞学检查和HPV基因分型。
共纳入288名艾滋病毒检测呈阳性的男性和208名艾滋病毒检测呈阴性的男性；75%的艾滋病毒感染者和30.3%的未感染者检测出多种类型的HPV呈阳性（P<0.001）。20.8%的艾滋病毒感染者和4.8%的未感染者出现肛门细胞发育异常，包括意义不明确的非典型鳞状细胞（ASCUS）、低级别鳞状上皮内病变（LSIL）、高级别鳞状上皮内病变（HSIL）或不能排除HSIL的非典型鳞状细胞（ASC-H）（P<0.001）。多因素分析显示，艾滋病毒血清学状态、性传播感染史、有男性性伴侣和肛交行为与任何类型HPV的检测显著相关。此外，致癌和非致癌HPV类型均与肛门细胞学发育异常显著相关。
我们强烈建议，高危人群应提高对肛门HPV感染及相关肛门细胞发育异常的认识。
