Universitat Autónoma de Barcelona, Hospital Universitari Germans Trias i Pujol, Badalona, Spain, Department of Otorhinolaryngology.
Universitat Autónoma de Barcelona, Hospital Universitari Vall d'Hebron, Barcelona, Spain Department of Infectious Diseases.
AIDS. 2022 Aug 1;36(10):1383-1391. doi: 10.1097/QAD.0000000000003287. Epub 2022 Jun 22.
HIV-infected men who have sex with men (MSM) are at high risk to develop human papilloma virus (HPV)-related oropharyngeal cancer. The aim of our study was to assess the usefulness of a pilot oral dysplasia screening program and its correlation with an anal dysplasia screening program.
This was a prospective study with HIV-infected MSM. Oral and anal screenings were performed based on HPV determination, liquid cytology, direct and microscopy oral examinations, high-resolution anoscopy and biopsies, if necessary.
A total of 103 patients were included. The mean age of the patients was 44.6 years, 55.3% were smokers, and 57.3% had a history of previous anal high-grade squamous intraepithelial lesions (HSILs). The prevalence of oral HPV infections was 14% (9% HPV-high risk), the prevalence of abnormal cytology was 25.2%, and in 4.8% of the patients, oral examinations showed suspicious HSILs. Oral microscopy did not detect additional lesions that visual inspection. Five oral biopsies were performed and the results were normal. No risk factors for oral HPV infections were identified. The prevalence of anal HPV infections was 88.3% (76.7% HPV-high risk), 52.9% of the patients had altered cytology, and in 45.6% anoscopy showed changes suggestive of HSILs. Seventy-two anal biopsies were performed, detecting 25 cases of HSILs (24.3%).A poor correlation was observed between oral and anal HPV infections (κ = 0.037).
The prevalence of oral HPV infections, abnormal cytology and lesions in HIV-infected MSM was low, and their correlation with anal HPV-related lesions was slight. These results confirm the current barriers to oral dysplasia screening techniques.
男男性行为者（MSM）感染艾滋病毒后，患人乳头瘤病毒（HPV）相关口咽癌的风险很高。我们研究的目的是评估口腔黏膜病变筛查方案的实用性及其与肛门黏膜病变筛查方案的相关性。
这是一项针对 HIV 感染 MSM 的前瞻性研究。根据 HPV 检测、液基细胞学检查、直接和显微镜下口腔检查、高分辨率肛门镜检查和必要时的活检，对口腔和肛门进行筛查。
共纳入 103 例患者。患者的平均年龄为 44.6 岁，55.3%为吸烟者，57.3%有肛门高级别鳞状上皮内病变（HSIL）病史。口腔 HPV 感染的患病率为 14%（9%为高危型 HPV），异常细胞学的患病率为 25.2%，4.8%的患者口腔检查显示可疑 HSIL。口腔显微镜检查未发现肉眼检查遗漏的病变。对 5 例口腔活检结果均正常。未发现口腔 HPV 感染的危险因素。肛门 HPV 感染的患病率为 88.3%（76.7%为高危型 HPV），52.9%的患者细胞学检查异常，45.6%的肛门镜检查显示 HSIL 改变。共进行了 72 例肛门活检，发现 25 例 HSIL（24.3%）。口腔和肛门 HPV 感染之间的相关性较差（κ=0.037）。
HIV 感染 MSM 中口腔 HPV 感染、异常细胞学和病变的患病率较低，与肛门 HPV 相关病变的相关性较低。这些结果证实了目前口腔黏膜病变筛查技术存在的障碍。
