Risk Factors for Abnormal Anal Cytology over Time in HIV-infected Women

Overview

Journal Am J Obstet Gynecol

Publisher Elsevier

Specialty Gynecology & Obstetrics

Date 2012 Apr 24

PMID 22520651

Citations 9

Authors

Amy S Baranoski

Richa Tandon

Janice Weinberg

Faye F Huang

Elizabeth A Stier

Affiliations

Soon will be listed here.

Abstract

Objective: The objective of the study was to assess the incidence of, and risk factors for, abnormal anal cytology and anal intraepithelial neoplasia (AIN) 2-3 in human immunodeficiency virus (HIV)-infected women.

Study Design: This prospective study assessed 100 HIV-infected women with anal and cervical specimens for cytology and high-risk human papillomavirus (HPV) testing over 3 semiannual visits.

Results: Thirty-three women were diagnosed with an anal cytologic abnormality at least once. Anal cytology abnormality was associated with current CD4 count less than 200 cells/mm(3), anal HPV infection, and a history of other sexually transmitted infections (STIs). Twelve subjects were diagnosed with AIN2-3: 4 after AIN1 diagnosis and 4 after 1 or more negative anal cytology. AIN2-3 trended toward an association with history of cervical cytologic abnormality and history of STI.

Conclusion: Repeated annual anal cytology screening for HIV-infected women, particularly for those with increased immunosuppression, anal and/or cervical HPV, a history of other STIs, or abnormal cervical cytology, will increase the likelihood of detecting AIN2-3.

Citing Articles

DNA high-risk HPV, mRNA HPV and P16 tests for diagnosis of anal cancer and precursor lesions: a systematic review and meta-analysis.

Macedo A, Grande A, Figueiredo T, Colonetti T, Goncalves J, Testoni E EClinicalMedicine. 2023; 62:102128.

PMID: 37588624 PMC: 10425667. DOI: 10.1016/j.eclinm.2023.102128.

Human Papillomavirus Correlates With Histologic Anal High-Grade Squamous Intraepithelial Lesions in Hispanics With HIV.

Medina-Laabes D, Suarez-Perez E, Guiot H, Munoz C, Colon-Lopez V, Tirado-Gomez M J Low Genit Tract Dis. 2018; 22(4):320-325.

PMID: 29975333 PMC: 7375752. DOI: 10.1097/LGT.0000000000000416.

Prevalence of Anal HPV and Anal Dysplasia in HIV-Infected Women From Johannesburg, South Africa.

Goeieman B, Firnhaber C, Jong E, Michelow P, Kegorilwe P, Swarts A J Acquir Immune Defic Syndr. 2017; 75(3):e59-e64.

PMID: 28141783 PMC: 5472492. DOI: 10.1097/QAI.0000000000001300.

The Role of Sexually Transmitted Infections in HIV-1 Progression: A Comprehensive Review of the Literature.

Chun H, Carpenter R, Macalino G, Crum-Cianflone N J Sex Transm Dis. 2015; 2013:176459.

PMID: 26316953 PMC: 4437436. DOI: 10.1155/2013/176459.

Incidence and Predictors of Abnormal Anal Cytology Findings Among HIV-Infected Adults Receiving Contemporary Antiretroviral Therapy.

Conley L, Bush T, Darragh T, Palefsky J, Unger E, Patel P J Infect Dis. 2015; 213(3):351-60.

PMID: 26268855 PMC: 6103209. DOI: 10.1093/infdis/jiv408.

References

Goldstone S, Lowe B, Rothmann T, Nazarenko I . Evaluation of the hybrid capture 2 assay for detecting anal high-grade dysplasia. Int J Cancer. 2012; 131(7):1641-8. DOI: 10.1002/ijc.27431. View

Nathan M, Singh N, Garrett N, Hickey N, Prevost T, Sheaff M . Performance of anal cytology in a clinical setting when measured against histology and high-resolution anoscopy findings. AIDS. 2010; 24(3):373-9. DOI: 10.1097/QAD.0b013e328333ab8e. View

Palefsky J, Holly E, Ralston M, Da Costa M , Greenblatt R . Prevalence and risk factors for anal human papillomavirus infection in human immunodeficiency virus (HIV)-positive and high-risk HIV-negative women. J Infect Dis. 2001; 183(3):383-91. DOI: 10.1086/318071. View

Berry J, Palefsky J, Jay N, Cheng S, Darragh T, Chin-Hong P . Performance characteristics of anal cytology and human papillomavirus testing in patients with high-resolution anoscopy-guided biopsy of high-grade anal intraepithelial neoplasia. Dis Colon Rectum. 2009; 52(2):239-47. DOI: 10.1007/DCR.0b013e31819793d9. View

Chaturvedi A, Madeleine M, Biggar R, Engels E . Risk of human papillomavirus-associated cancers among persons with AIDS. J Natl Cancer Inst. 2009; 101(16):1120-30. PMC: 2728745. DOI: 10.1093/jnci/djp205. View

Wilkin T, Palmer S, Brudney K, Chiasson M, Wright T . Anal intraepithelial neoplasia in heterosexual and homosexual HIV-positive men with access to antiretroviral therapy. J Infect Dis. 2004; 190(9):1685-91. DOI: 10.1086/424599. View

Holly E, Ralston M, Darragh T, Greenblatt R, Jay N, Palefsky J . Prevalence and risk factors for anal squamous intraepithelial lesions in women. J Natl Cancer Inst. 2001; 93(11):843-9. DOI: 10.1093/jnci/93.11.843. View

Gingelmaier A, Weissenbacher T, Kost B, Kaestner R, Sovric M, Mylonas I . Anal cytology as a screening tool for early detection of anal dysplasia in HIV-infected women. Anticancer Res. 2010; 30(5):1719-23. View

Palefsky J, Holly E, Efirdc J, Da Costa M, Jay N, Berry J . Anal intraepithelial neoplasia in the highly active antiretroviral therapy era among HIV-positive men who have sex with men. AIDS. 2005; 19(13):1407-14. DOI: 10.1097/01.aids.0000181012.62385.4a. View

10.

DSouza G, Wiley D, Li X, Chmiel J, Margolick J, Cranston R . Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study. J Acquir Immune Defic Syndr. 2008; 48(4):491-9. PMC: 3991563. DOI: 10.1097/QAI.0b013e31817aebfe. View

11.

Diamond C, Taylor T, Aboumrad T, Bringman D, Anton-Culver H . Increased incidence of squamous cell anal cancer among men with AIDS in the era of highly active antiretroviral therapy. Sex Transm Dis. 2005; 32(5):314-20. DOI: 10.1097/01.olq.0000162366.60245.02. View

12.

Moscicki A, Schiffman M, Kjaer S, Villa L . Chapter 5: Updating the natural history of HPV and anogenital cancer. Vaccine. 2006; 24 Suppl 3:S3/42-51. DOI: 10.1016/j.vaccine.2006.06.018. View

13.

Conley L, Bush T, Darragh T, Palefsky J, Unger E, Patel P . Factors associated with prevalent abnormal anal cytology in a large cohort of HIV-infected adults in the United States. J Infect Dis. 2010; 202(10):1567-76. DOI: 10.1086/656775. View

14.

Cranston R, Hart S, Gornbein J, Hirschowitz S, Cortina G, Moe A . The prevalence, and predictive value, of abnormal anal cytology to diagnose anal dysplasia in a population of HIV-positive men who have sex with men. Int J STD AIDS. 2007; 18(2):77-80. DOI: 10.1258/095646207779949772. View

15.

Salit I, Lytwyn A, Raboud J, Sano M, Chong S, Diong C . The role of cytology (Pap tests) and human papillomavirus testing in anal cancer screening. AIDS. 2010; 24(9):1307-13. DOI: 10.1097/QAD.0b013e328339e592. View

16.

Goldstone S, Kawalek A, Goldstone R, Goldstone A . Hybrid Capture II detection of oncogenic human papillomavirus: a useful tool when evaluating men who have sex with men with atypical squamous cells of undetermined significance on anal cytology. Dis Colon Rectum. 2008; 51(7):1130-6. DOI: 10.1007/s10350-008-9306-4. View

17.

Kojic E, Cu-Uvin S, Conley L, Bush T, Onyekwuluje J, Swan D . Human papillomavirus infection and cytologic abnormalities of the anus and cervix among HIV-infected women in the study to understand the natural history of HIV/AIDS in the era of effective therapy (the SUN study). Sex Transm Dis. 2010; 38(4):253-9. DOI: 10.1097/OLQ.0b013e3181f70253. View

18.

Hessol N, Holly E, Efird J, Minkoff H, Schowalter K, Darragh T . Anal intraepithelial neoplasia in a multisite study of HIV-infected and high-risk HIV-uninfected women. AIDS. 2008; 23(1):59-70. PMC: 2614220. DOI: 10.1097/QAD.0b013e32831cc101. View

19.

Guiguet M, Boue F, Cadranel J, Lang J, Rosenthal E, Costagliola D . Effect of immunodeficiency, HIV viral load, and antiretroviral therapy on the risk of individual malignancies (FHDH-ANRS CO4): a prospective cohort study. Lancet Oncol. 2009; 10(12):1152-9. DOI: 10.1016/S1470-2045(09)70282-7. View

20.

Crum-Cianflone N, Hullsiek K, Marconi V, Weintrob A, Ganesan A, Barthel R . Trends in the incidence of cancers among HIV-infected persons and the impact of antiretroviral therapy: a 20-year cohort study. AIDS. 2008; 23(1):41-50. PMC: 2727153. DOI: 10.1097/QAD.0b013e328317cc2d. View