Factors associated with anal/cervical HPV infection and dysplasia in a cohort of HIV-infected male and female patients

Francesca Bai

In HIV+ patients (pts) there is as increased prevalence of HPV and HPV-associated intraepithelial lesions (SIL), due to defective immune responses. The role of cART in accelerating SIL regression isn’t clear. We studied the prevalence and factors associated with HPV and SIL in cART-naïve and treated HIV+ male (M) and female (F) pts enrolled from Dec-2008 to Mar-2015. We evaluated also the association between cART and SIL. Anal/cervical brushing (HPV-PCR genotyping and cytologic abnormalities, Bethesda System 2001) and blood sample (CD4+ T-cells, HIV-RNA, CD127+CD4+%, CD127+CD8+%, CD38+CD8+%) were collected at enrolment. 472 pts were enrolled (327, 69% M and 145, 31% F): 350 (74%) were HPV+ with HR-HPV in 265 (56%) and 248 (52%) were SIL+ (218, 88% ASCUS/LSIL; 29, 11.6% HSIL; 1, 0.4% in situ carcinoma) (Tab1). M were more commonly HPV+ and SIL+ than F. In M HPV was associated with being MSM, less AIDS events and shorter time since HIV diagnosis (Tab4a). F HPV+ displayed higher HIV-RNA with lower CD127+CD8+% T-cells, not confirmed by multivariate (Tab2b). HPV and younger age resulted associated with SIL in M (Tab4b), while F SIL+ presented more commonly lower CD4+ count and HPV by multivariate (Tab4c). MSM and shorter cART length were independently associated with SIL in treated M (Tab4d). Risky sexual behavior in M and immunosuppression in F are associated with HPV and SIL. A shorter cART exposure seems to be related to higher SIL prevalence.

Simone Agnello
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