Dysplasia Department, Instituto Nacional de Cancerología, Mexico City, Mexico.
Laboratory of Virus and Cancer, Unidad de Investigación Biomédica en Cáncer, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México & Instituto Nacional de Cancerología, Mexico City, Mexico.
HIV Med. 2024 Oct;25(10):1145-1153. doi: 10.1111/hiv.13684. Epub 2024 Jun 20.
This study aimed to describe the prevalence of high-risk human papillomavirus (HR-HPV) types in the anal canal in a cohort of people living with HIV (PLWHIV) with a history of malignancy.
Referral tertiary care hospital for adult patients with cancer.
We reviewed data of patients from the AIDS Cancer Clinic on antiretroviral therapy in chronic control who were consecutively referred for high-resolution anoscopy (HRA), where they underwent anal evaluation, collection of specimens for anal cytology and anal human papillomavirus (HPV) followed by HRA with directed biopsy if needed.
A total of 155 patients were included; 149 (96.1%) were men, all of them men who have sex with men (MSM); the median age was 39 (IQR 32-47) years; 105 (67.7%) with Kaposi sarcoma, 40 (25.8%) with non-Hodgkin lymphoma and 10 (6.4%) with other neoplasms; only 7 (4.5%) had active cancer. The prevalence of HR-HPV infection was 89% (n=138) (95% CI 83-93) with at least one HR-HPV infection, and 62% (96) had coinfection with at least two types; the median HR-HPV types of coinfection were 3 (IQR 2-4). The number of patients infected with HPV 16 was 64 (41.3%, 95% CI 33.8-49.3), HPV 18 was 74 (47.7%, 95% CI 39.9-55.7) and with both 35 (22.6%). Some 59 patients (38%) had high-grade squamous intraepithelial lesions (HSIL) and 49 (31.6%) had low-grade squamous intraepithelial lesions (LSIL). The prevalence of HR-HPV and HSIL among patients aged ≤35 and >35 years was the same.
In this cohort of PLWHIV with a history of malignancy we found a high prevalence of HR-HPV 16 and 18 and anal HSIL, even in persons aged ≤35 years. These data highlight the importance of anal cancer screening in PLWHIV and history of malignancy.
本研究旨在描述恶性肿瘤史的 HIV 感染者（PLWHIV）肛管中高危型人乳头瘤病毒（HR-HPV）的流行情况。
这是一家成人癌症患者的三级转诊治疗医院。
我们回顾了 AIDS 癌症诊所中连续接受高分辨率肛门镜检查（HRA）的慢性控制下接受抗逆转录病毒治疗的患者的数据，这些患者接受了肛门评估、采集肛门细胞学标本和肛门 HPV 检测，如果需要则进行 HRA 引导下活检。
共纳入 155 例患者；149 例（96.1%）为男性，均为男男性接触者（MSM）；中位年龄为 39 岁（IQR 32-47）；105 例（67.7%）为卡波西肉瘤，40 例（25.8%）为非霍奇金淋巴瘤，10 例（6.4%）为其他肿瘤；仅有 7 例（4.5%）为活动性癌症。HR-HPV 感染率为 89%（n=138）（95%CI 83-93%），至少有一种 HR-HPV 感染，62%（96 例）合并两种以上 HR-HPV 感染；合并感染的 HR-HPV 中位类型为 3 种（IQR 2-4）。HPV 16 感染患者 64 例（41.3%，95%CI 33.8-49.3%），HPV 18 感染 74 例（47.7%，95%CI 39.9-55.7%），两种均感染 35 例（22.6%）。59 例（38%）患者有高级别鳞状上皮内病变（HSIL），49 例（31.6%）有低级别鳞状上皮内病变（LSIL）。≤35 岁和＞35 岁患者的 HR-HPV 和 HSIL 患病率相同。
在本队列中，有恶性肿瘤史的 PLWHIV 中 HR-HPV 16 和 18 以及肛门 HSIL 患病率较高，即使是在≤35 岁的人群中。这些数据突出了在 PLWHIV 和有恶性肿瘤史的人群中进行肛门癌筛查的重要性。
