Prevalence of anal Human Papillomavirus (HPV) infection and

Prevalence of anal Human Papillomavirus (HPV) infection and Prevalence of anal Human Papillomavirus (HPV) infection and - Start

Added : 2015-10-17 Views :92K

Download Presentation

Prevalence of anal Human Papillomavirus (HPV) infection and

Download Presentation - The PPT/PDF document "Prevalence of anal Human Papillomavirus ..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.

Presentations text content in Prevalence of anal Human Papillomavirus (HPV) infection and


Prevalence of anal Human Papillomavirus (HPV) infection and anal squamous intraepithelial lesions (SIL) in a Cohort of Brazilian HIV-infected women

Beatriz Grinsztejn1, Ruth Khalili Friedman1, Valdilea Veloso1, Monica Derrico1, Cynthia B. Cunha1, Carina Barillo1, Brenda Hoagland1, Sandra Wagner1, Angela C.V. de Andrade1, Andrea Cytryn1, José Eduardo Levi2, Thais Heinke3, Janice Mery C. de Oliveira Coelho1, Paula Mendes Luz1, Jose Ricardo Coutinho11 Fundação Oswaldo Cruz – Instituto de Pesquisa Clínica Evandro Chagas/IPEC, Rio de Janeiro, State of Rio de Janeiro, Brazil.2 Laboratório de Virologia - Instituto de Medicina Tropical, Universidade de São Paulo, State of São Paulo, Brazil.3 Salomão Zoppi Diagnósticos

Abstract no.




Anal cancer in specific populations, such as people living with HIV/AIDS, has been increasing at alarming rates.

The incidence of anal carcinoma (AC) has been increasing despite the implementation of ART, which has not been shown to consistently alter the course of HPV-associated





Study Design and Population

: Cross-sectional study conducted in the IPEC-


HIV+ women cohort in active follow-up between January 2011 and December 2012. Women aged ≥18 years without a history of anal cancer were accessed.

Data Collection

: Structured interviews were performed to access


characteristics and risk behaviors; data on HIV-related parameters and medical conditions were captured from the medical charts.

All procedures were performed after obtaining IRB approval and written informed consent from study participants.



Anal Liquid-based Cytology:


collected in


™ solution. Results reported according to Bethesda criteria;

HPV Testing using



HR-HPV: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 26, 53, 66,

70, 73, 82

LR-HPV: 6, 11, 40, 42, 43, 44/55

Anal examination and High Resolution




for women with an abnormal cytology result and/or visible


lesions on anal margin. Biopsies were performed as clinically required.



Statistical Analysis:

Anal HPV testing results, cytology results and the frequency of histological AIN and anal cancer (margin and/or canal) were calculated as simple proportions.

Women who had normal cytology and no visible lesions were considered as negative for AIN. Histological results were considered for the final diagnostic.

If multiple biopsies were obtained, the highest grade was used to denote the lesion status at that visit.

The STATA/SE 10.1 software package was used in the analysis.



Characteristics of participants in the IPEC/FIOCRUZ Women`s Cohort (N=816)

CharacteristicsTotalaAge ≥ 40. years - N (%)497 (60.9)Median (IQR)41.5 (34.6-48.6)Skin color non white - N (%)298 (36.9)No. of sexual partners in past 6 months - N (%)0235 (29)1531 (65.6)≥ 243 (5.3)Median (IQR)1 (0-1)Receptive anal intercourse in past 6 months - N (%)163 (20.3)Current smoker - N (%)172 (21.2)



Characteristics of participants in the IPEC/FIOCRUZ Women`s Cohort (N=816)

Characteristics TotalNadir CD4+ cell count. cells/mm3 – Median (IQR) 219 (103-326) Baseline CD4+ cell count. cells/mm3 – Median (IQR)Combined antiretroviral therapy (cART) 595 (408-837) 629 (77,1%) Time under cART (months) Mean (SD)90.4 (64.0)Median (IQR)77.5 (32.7-149)

< 200




CytologyN (%)No lesions571 (70)ASC-US111 (13.6)ASC-H11 (1.3)LSIL88 (10.8)HSIL35 (4.3)Total816 (100)

Anal cytology was abnormal in 245/816 (30%) women:

Of these, 204 (83.3%) were submitted to HRA.



Prevalence of anal histological HPV-related lesions.

HPV-related lesions N (%)Totala (n = 775)AIN 141 (5.3)21 (2.7)34 (4.4)55 (7.0)AIN 2AIN 3AIN2+

a 41 women were not considered as they presented abnormal cytology results and did not come to HRA.

Among all women with histological AIN2+, 7.3%, 70.9% and 21,8%

had lesions only in the anal margin, only in the anal canal and in

both sites, respectively.



Total of women with available HPV genotyping results

Prevalence of High risk HPV genotypes in all women (N=717)*



Total of women with available HPV genotyping results

Prevalence of Low Risk HPV genotypes in all women (N=717)*



The prevalence of abnormal anal cytology was high. Prevalence of histological AIN2+ may be underestimated as women with normal cytology were not referred to HRA.

Systematic screening for HPV-related anal lesions among women is warranted and may impact the increasing incidence of anal cancer, although a screening algorithm is not yet defined.

HIV+ women


benefit from the HPV vaccines already available. However, further studies are needed to investigate the role of other HPV types involved in high grade HPV-related lesions among HIV-infected women in developing countries.

About DocSlides
DocSlides allows users to easily upload and share presentations, PDF documents, and images.Share your documents with the world , watch,share and upload any time you want. How can you benefit from using DocSlides? DocSlides consists documents from individuals and organizations on topics ranging from technology and business to travel, health, and education. Find and search for what interests you, and learn from people and more. You can also download DocSlides to read or reference later.