The effect of HIV infection on anal and penile human papillomavirus incidence and clearance: a cohort study among MSM

Sofie H Mooij; Daniëla K van Santen; Ronald B Geskus; Marianne van der Sande; Roel A Coutinho; Ineke G Stolte; Peter J F Snijders; Chris J L M Meijer; Arjen G C L Speksnijder; Henry J C de Vries; Audrey J King; Arne van Eeden; Maarten F Schim van der Loeff

doi:10.1097/QAD.0000000000000909

The effect of HIV infection on anal and penile human papillomavirus incidence and clearance: a cohort study among MSM

Sofie H Mooij, Daniëla K van Santen, Ronald B Geskus, Marianne van der Sande, Roel A Coutinho, Ineke G Stolte, Peter J F Snijders, Chris J L M Meijer, Arjen G C L Speksnijder, Henry J C de Vries, Audrey J King, Arne van Eeden, Maarten F Schim van der Loeff

Department of Public Health

Research output: Contribution to journal › A1: Web of Science-article › peer-review

Abstract

OBJECTIVES: A large portion of anogenital cancers is caused by high-risk human papillomavirus (hrHPV) infections, which are especially common in HIV-infected men. We aimed to compare the incidence and clearance of anal and penile hrHPV infection between HIV-infected and HIV-negative MSM.

DESIGN: Analyses of longitudinal data from a prospective cohort study.

METHODS: MSM aged 18 years or older were recruited in Amsterdam, the Netherlands, and followed-up semi-annually for 24 months. At each visit, participants completed risk-factor questionnaires. Anal and penile self-samples were tested for HPV DNA using the SPF10-PCR DEIA/LiPA25 system. Effects on incidence and clearance rates were quantified via Poisson regression, using generalized estimating equations to correct for multiple hrHPV types.

RESULTS: Seven hundred and fifty MSM with a median age of 40 years (interquartile 35-48) were included in the analyses, of whom 302 (40%) were HIV-infected. The incidence rates of hrHPV were significantly higher in HIV-infected compared with HIV-negative MSM [adjusted incidence rate ratio (aIRR) 1.6; 95% confidence interval (CI) 1.3-2.1 for anal and aIRR 1.4; 95%CI 1.0-2.1 for penile infection]. The clearance rate of hrHPV was significantly lower for anal [adjusted clearance rate ratio (aCRR) 0.7; 95%CI 0.6-0.9], but not for penile infection (aCRR 1.3; 95%CI 1.0-1.7). HrHPV incidence or clearance did not differ significantly by nadir CD4 cell count.

CONCLUSION: Increased anal and penile hrHPV incidence rates and decreased anal hrHPV clearance rates were found in HIV-infected compared with HIV-negative MSM, after adjusting for sexual behavior. Our findings suggest an independent effect of HIV infection on anal hrHPV infections.

Original language	English
Journal	AIDS
Volume	30
Issue number	1
Pages (from-to)	121-132
Number of pages	12
ISSN	0269-9370
DOIs	https://doi.org/10.1097/QAD.0000000000000909
Publication status	Published - 2016

Keywords

Adult
Anal Canal/virology
DNA, Viral/isolation & purification
HIV Infections/complications
Homosexuality, Male
Humans
Incidence
Longitudinal Studies
Male
Middle Aged
Netherlands/epidemiology
Papillomaviridae/isolation & purification
Papillomavirus Infections/epidemiology
Penis/virology
Prospective Studies

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10.1097/QAD.0000000000000909

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Mooij, S. H., van Santen, D. K., Geskus, R. B., van der Sande, M., Coutinho, R. A., Stolte, I. G., Snijders, P. J. F., Meijer, C. J. L. M., Speksnijder, A. G. C. L., de Vries, H. J. C., King, A. J., van Eeden, A., & van der Loeff, M. F. S. (2016). The effect of HIV infection on anal and penile human papillomavirus incidence and clearance: a cohort study among MSM. AIDS, 30(1), 121-132. https://doi.org/10.1097/QAD.0000000000000909

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title = "The effect of HIV infection on anal and penile human papillomavirus incidence and clearance: a cohort study among MSM",

abstract = "OBJECTIVES: A large portion of anogenital cancers is caused by high-risk human papillomavirus (hrHPV) infections, which are especially common in HIV-infected men. We aimed to compare the incidence and clearance of anal and penile hrHPV infection between HIV-infected and HIV-negative MSM.DESIGN: Analyses of longitudinal data from a prospective cohort study.METHODS: MSM aged 18 years or older were recruited in Amsterdam, the Netherlands, and followed-up semi-annually for 24 months. At each visit, participants completed risk-factor questionnaires. Anal and penile self-samples were tested for HPV DNA using the SPF10-PCR DEIA/LiPA25 system. Effects on incidence and clearance rates were quantified via Poisson regression, using generalized estimating equations to correct for multiple hrHPV types.RESULTS: Seven hundred and fifty MSM with a median age of 40 years (interquartile 35-48) were included in the analyses, of whom 302 (40%) were HIV-infected. The incidence rates of hrHPV were significantly higher in HIV-infected compared with HIV-negative MSM [adjusted incidence rate ratio (aIRR) 1.6; 95% confidence interval (CI) 1.3-2.1 for anal and aIRR 1.4; 95%CI 1.0-2.1 for penile infection]. The clearance rate of hrHPV was significantly lower for anal [adjusted clearance rate ratio (aCRR) 0.7; 95%CI 0.6-0.9], but not for penile infection (aCRR 1.3; 95%CI 1.0-1.7). HrHPV incidence or clearance did not differ significantly by nadir CD4 cell count.CONCLUSION: Increased anal and penile hrHPV incidence rates and decreased anal hrHPV clearance rates were found in HIV-infected compared with HIV-negative MSM, after adjusting for sexual behavior. Our findings suggest an independent effect of HIV infection on anal hrHPV infections.",

keywords = "Adult, Anal Canal/virology, DNA, Viral/isolation & purification, HIV Infections/complications, Homosexuality, Male, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Netherlands/epidemiology, Papillomaviridae/isolation & purification, Papillomavirus Infections/epidemiology, Penis/virology, Prospective Studies",

author = "Mooij, {Sofie H} and {van Santen}, {Dani{\"e}la K} and Geskus, {Ronald B} and {van der Sande}, Marianne and Coutinho, {Roel A} and Stolte, {Ineke G} and Snijders, {Peter J F} and Meijer, {Chris J L M} and Speksnijder, {Arjen G C L} and {de Vries}, {Henry J C} and King, {Audrey J} and {van Eeden}, Arne and {van der Loeff}, {Maarten F Schim}",

note = "NPP",

year = "2016",

doi = "10.1097/QAD.0000000000000909",

language = "English",

volume = "30",

pages = "121--132",

journal = "AIDS",

issn = "0269-9370",

publisher = "Lippincott Williams & Wilkins",

number = "1",

}

Mooij, SH, van Santen, DK, Geskus, RB, van der Sande, M, Coutinho, RA, Stolte, IG, Snijders, PJF, Meijer, CJLM, Speksnijder, AGCL, de Vries, HJC, King, AJ, van Eeden, A & van der Loeff, MFS 2016, 'The effect of HIV infection on anal and penile human papillomavirus incidence and clearance: a cohort study among MSM', AIDS, vol. 30, no. 1, pp. 121-132. https://doi.org/10.1097/QAD.0000000000000909

TY - JOUR

T1 - The effect of HIV infection on anal and penile human papillomavirus incidence and clearance: a cohort study among MSM

AU - Mooij, Sofie H

AU - van Santen, Daniëla K

AU - Geskus, Ronald B

AU - van der Sande, Marianne

AU - Coutinho, Roel A

AU - Stolte, Ineke G

AU - Snijders, Peter J F

AU - Meijer, Chris J L M

AU - Speksnijder, Arjen G C L

AU - de Vries, Henry J C

AU - King, Audrey J

AU - van Eeden, Arne

AU - van der Loeff, Maarten F Schim

N1 - NPP

PY - 2016

Y1 - 2016

N2 - OBJECTIVES: A large portion of anogenital cancers is caused by high-risk human papillomavirus (hrHPV) infections, which are especially common in HIV-infected men. We aimed to compare the incidence and clearance of anal and penile hrHPV infection between HIV-infected and HIV-negative MSM.DESIGN: Analyses of longitudinal data from a prospective cohort study.METHODS: MSM aged 18 years or older were recruited in Amsterdam, the Netherlands, and followed-up semi-annually for 24 months. At each visit, participants completed risk-factor questionnaires. Anal and penile self-samples were tested for HPV DNA using the SPF10-PCR DEIA/LiPA25 system. Effects on incidence and clearance rates were quantified via Poisson regression, using generalized estimating equations to correct for multiple hrHPV types.RESULTS: Seven hundred and fifty MSM with a median age of 40 years (interquartile 35-48) were included in the analyses, of whom 302 (40%) were HIV-infected. The incidence rates of hrHPV were significantly higher in HIV-infected compared with HIV-negative MSM [adjusted incidence rate ratio (aIRR) 1.6; 95% confidence interval (CI) 1.3-2.1 for anal and aIRR 1.4; 95%CI 1.0-2.1 for penile infection]. The clearance rate of hrHPV was significantly lower for anal [adjusted clearance rate ratio (aCRR) 0.7; 95%CI 0.6-0.9], but not for penile infection (aCRR 1.3; 95%CI 1.0-1.7). HrHPV incidence or clearance did not differ significantly by nadir CD4 cell count.CONCLUSION: Increased anal and penile hrHPV incidence rates and decreased anal hrHPV clearance rates were found in HIV-infected compared with HIV-negative MSM, after adjusting for sexual behavior. Our findings suggest an independent effect of HIV infection on anal hrHPV infections.

AB - OBJECTIVES: A large portion of anogenital cancers is caused by high-risk human papillomavirus (hrHPV) infections, which are especially common in HIV-infected men. We aimed to compare the incidence and clearance of anal and penile hrHPV infection between HIV-infected and HIV-negative MSM.DESIGN: Analyses of longitudinal data from a prospective cohort study.METHODS: MSM aged 18 years or older were recruited in Amsterdam, the Netherlands, and followed-up semi-annually for 24 months. At each visit, participants completed risk-factor questionnaires. Anal and penile self-samples were tested for HPV DNA using the SPF10-PCR DEIA/LiPA25 system. Effects on incidence and clearance rates were quantified via Poisson regression, using generalized estimating equations to correct for multiple hrHPV types.RESULTS: Seven hundred and fifty MSM with a median age of 40 years (interquartile 35-48) were included in the analyses, of whom 302 (40%) were HIV-infected. The incidence rates of hrHPV were significantly higher in HIV-infected compared with HIV-negative MSM [adjusted incidence rate ratio (aIRR) 1.6; 95% confidence interval (CI) 1.3-2.1 for anal and aIRR 1.4; 95%CI 1.0-2.1 for penile infection]. The clearance rate of hrHPV was significantly lower for anal [adjusted clearance rate ratio (aCRR) 0.7; 95%CI 0.6-0.9], but not for penile infection (aCRR 1.3; 95%CI 1.0-1.7). HrHPV incidence or clearance did not differ significantly by nadir CD4 cell count.CONCLUSION: Increased anal and penile hrHPV incidence rates and decreased anal hrHPV clearance rates were found in HIV-infected compared with HIV-negative MSM, after adjusting for sexual behavior. Our findings suggest an independent effect of HIV infection on anal hrHPV infections.

KW - Adult

KW - Anal Canal/virology

KW - DNA, Viral/isolation & purification

KW - HIV Infections/complications

KW - Homosexuality, Male

KW - Humans

KW - Incidence

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Netherlands/epidemiology

KW - Papillomaviridae/isolation & purification

KW - Papillomavirus Infections/epidemiology

KW - Penis/virology

KW - Prospective Studies

U2 - 10.1097/QAD.0000000000000909

DO - 10.1097/QAD.0000000000000909

M3 - A1: Web of Science-article

C2 - 26474302

SN - 0269-9370

VL - 30

SP - 121

EP - 132

JO - AIDS

JF - AIDS

IS - 1

ER -

The effect of HIV infection on anal and penile human papillomavirus incidence and clearance: a cohort study among MSM

Abstract

Keywords

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