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The male Screen ING Study: prevalence of HPV ‐related genital and anal lesions in an urban cohort of HIV ‐positive men in Germany
Author(s) -
Fuchs W.,
Wieland U.,
SkaletzRorowski A.,
Brockmeyer N.H.,
Swoboda J.,
Kreuter A.,
Michalik C.,
Potthoff A.
Publication year - 2016
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.13539
Subject(s) - medicine , anal cancer , penile cancer , men who have sex with men , anus , dysplasia , anal canal , sex organ , genital warts , gynecology , prospective cohort study , hpv infection , human immunodeficiency virus (hiv) , cancer , cervical cancer , surgery , rectum , syphilis , virology , biology , genetics
Background Human papillomaviruses ( HPV ) induce condylomata, anogenital cancers and their precursor lesions as anal or penile intraepithelial neoplasia ( AIN / PIN ). HIV ‐positive individuals have an increased risk for the development of anogenital HPV ‐induced lesions. Objective Estimation of the prevalence of HPV ‐related anogenital benign and malignant lesions in HIV ‐infected men attending a screening programme. Methods Four hundred HIV ‐positive men [98% men who have sex with men ( MSM )] were enrolled in this prospective study from 2008 to 2011. All patients received an inspection of the anogenital region, digital rectal examination, high‐resolution anoscopy ( HRA ), anal cytology, anal/penile histology if required, and HPV ‐typing of anal and penile swabs. Results At baseline, 75% ( n = 302) of the men had abnormal anal cytological/histological results. 41% presented with low‐grade ( n = 164), 24% with high‐grade anal dysplasia ( n = 95) and two men with invasive anal cancer. 2.3% had PIN ( n = 9) and one patient had penile cancer at baseline. Throughout the study period, 75% had anal dysplasia (low‐grade n = 177, high‐grade n = 125), 3.3% ( n = 13) had PIN and two further patients developed anal cancer. Within the study period, 52.8% ( n = 211) had condylomata (49% anal, 15% penile, 11% anal plus penile condylomata). At baseline, 88.5% of anal and 39.3% of penile swabs were HPV ‐ DNA positive, and 77.8% of anal and 26.5% of penile swabs carried high‐risk HPV ‐types. HPV 16 was the most frequent HPV ‐type. Conclusion HIV ‐positive MSM have a high risk for HPV ‐induced condylomata, (pre)malignant anogenital lesions and anogenital cancers. Screening for HPV ‐induced dysplasia is crucial to avoid progression to invasive carcinomas. Additionally, HPV ‐vaccination recommendations should be extended to high‐risk populations.