Abstract
Women living with HIV (WLHIV) are at increased risk for human papillomavirus (HPV)-associated anal cancer. Given the "field effect" of HPV pathogenesis, some recommend that anal cancer screening should be limited to WLHIV with prior genital disease. This study aimed to characterize the relationship between anal and genital disease in WLHIV in order to better inform anal cancer screening guidelines. We retrospectively studied 153 WLHIV with biopsy-proven anal high-grade squamous intraepithelial lesions (AHSIL) and long-term evaluable cervical/vaginal/vulvar histopathology. Based on the absence or presence of genital HSIL, subjects were categorized as having isolated AHSIL or multicentric HSIL. Demographics, HIV parameters and cervical/anal HPV status were recorded. Chi-square test was used for bivariate analyses. Of 153 WLHIV with AHSIL, 110 (72%) had isolated AHSIL, while 43 (28%) had multicentric HSIL (28 cervical, 16 vulvar, and 8 vaginal HSIL). The median genital surveillance was 8 years (range 1-27). Cervical HPV16/18 infection was associated with multicentric disease (P = 0.001). Overall, 53% of multicentric cases presented genital HSIL preceding AHSIL with median interval 13 years (range 2-23). Paired anal and cervical hi...Continue Reading
References
Aug 1, 1997·Diseases of the Colon and Rectum·N JayJ M Palefsky
May 26, 1999·JAMA : the Journal of the American Medical Association·S J GoldieJ M Palefsky
Jun 25, 2003·Gynecologic Oncology·H S EvansH Møller
Dec 22, 2005·Journal of the National Cancer Institute·Svetlana VinokurovaMagnus von Knebel Doeberitz
Mar 31, 2007·The Lancet Oncology·Gustaf Edgren, Pär Sparén
Oct 23, 2010·Sexually Transmitted Diseases·Erna Milunka KojicJohn T Brooks
Feb 24, 2011·Obstetrics and Gynecology·Abdulaziz M SaleemRocco Ricciardi
Dec 4, 2012·International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists·Teresa M DarraghUNKNOWN Members of the LAST Project Work Groups
Jun 28, 2013·AIDS·Nancy A HessolJoel M Palefsky
Nov 16, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Judith A Aberg Infectious Diseases Society of America
Aug 26, 2014·Journal of Lower Genital Tract Disease·Rosa CatarinoPatrick Petignat
Mar 24, 2015·American Journal of Obstetrics and Gynecology·Elizabeth A StierElizabeth Y Chiao
Dec 15, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Michael GaisaMichelle Cespedes
Oct 3, 2017·The Journal of Infectious Diseases·Yuxin LiuKeith Sigel
Oct 17, 2017·Best Practice & Research. Clinical Obstetrics & Gynaecology·T S Adams, N H Mbatani
Jun 7, 2018·Journal of the International AIDS Society·Katharine J LookerMarie-Claude Boily
Aug 24, 2018·MMWR. Morbidity and Mortality Weekly Report·Elizabeth A Van DyneVicki B Benard
Jan 16, 2019·JAMA Network Open·Ryan SukAshish A Deshmukh
Jun 18, 2019·The Lancet Infectious Diseases·Chunqing LinGary M Clifford
Jul 12, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Elizabeth A StierElizabeth Chiao