Infectious Disease

High anal HPV prevalence among young MSM regardless of HIV status

August 21, 2021

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Wei does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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The prevalence of anal HPV is high in men who have sex with men regardless of their HIV status, according to a systematic review published in The Lancet HIV.

The result of a pooled analysis of more than 60 studies with almost 30,000 participants “highlights the advantages of a gender-neutral HPV vaccination before sexual activity compared to a catch-up vaccination”. Feixue Wei, PhD, a postdoctoral fellow at the WHO International Agency for Research on Cancer, and colleagues wrote.

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The prevalence of anal HPV was high in men who have sex with men, regardless of their HIV status. Source: Adobe Stock.

“Robust age-specific estimates of anal human papillomavirus and high-grade squamous-cell intraepithelial lesions (HSIL) in men can aid anal cancer prevention efforts,” they wrote. “Our aim was to assess the age-specific prevalence of anal HPV, HSIL and their combination in men, stratified by HIV status and sexuality.”

Wei and colleagues conducted a systematic review of studies of anal HPV infection in men and a pooled analysis of individual data from eligible studies of four groups of HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV- positive men who have sex with women (MSW) and HIV-negative MSW.

Weis and colleagues said they invited authors from eligible studies with 200 or more participants to submit anonymized, individual-level data on “type-specific HPV infection (at least HPV16) detected using a PCR-based anal swab test, HIV status “To share sexuality (MSM, including those who only have sex with men or women, or MSW) and age.”

They also urged authors of studies of 40 or more HIV-positive MSW or 40 or more African men – regardless of their HIV status or sexuality – to share this data.

The analysis comprised a total of 64 studies with data on 29,900 men.

According to the study, the prevalence of HPV16 among HIV-negative MSW, HIV-negative MSM, HIV-positive MSW, and HIV-positive MSM were 1.8%, 8.7%, 13.7% and 28.5%, respectively Prevalence of high-risk anal (HR) HPV were 6.9%, 26.9%, 41.2% and 74.3%, respectively.

Broken down by age, the study showed that the HPV16 prevalence among HIV-positive MSM was 5.6% among 15- to 18-year-olds and 28.8% (Ptrend = 0.0091) among 23- to 24-year-olds in the age groups 31.7% was 25 to 34 years and 22.8% in the over 55-year-olds (Ptrend <0.0001).

Among HIV-negative MSM, the prevalence of HPV16 in 15 to 18 year olds was 6.7%, in 23 to 24 year olds 13.9% (Ptrend = 0.0076) and then a plateau (Ptrend = 0 , 72). Wei and colleagues found no significant age differences for HPV16 or HR-HPV, neither for HIV-positive nor for HIV-negative MSW.

In addition, the study showed that HSIL + detection in HIV-positive MSM ranged from 7.5% to 54.5%. After adjusting the heterogeneity, the researchers found that HIV was a significant predictor of HSIL + (aPR = 1.54; 95% CI 1.36-1.73), HPV16-positive HSIL + (aPR = 1.66; 95% – KI, 1.36-2.03) and HSIL + was HPV16 positive MSM (aPR = 1.19%; 95% CI 1.04-1.37). This HSIL + prevalence increased with age in HPV16-positive MSM.

“These data can feed into the development of various anal cancer prevention efforts, both through primary prevention (i.e. vaccination against HPV or prevention and control of HIV infection) and secondary prevention (e.g. potential screening of high-risk groups, such as living with HIV), with the aim of detecting and treating HSIL, especially HPV16-positive HSIL, ”the authors write. “Our results show that the prevalence of HPV16-positive anal HSIL in the HIV-positive MSM population is high and that research and initiatives into the early detection of anal cancer in this group should be a priority.”

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