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

Research output: Contribution to journalA1: Web of Science-articlepeer-review


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 languageEnglish
Issue number1
Pages (from-to)121-132
Number of pages12
Publication statusPublished - 2016


  • 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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