Anal Cytology Screening in Men Who Have Sex with Men with HIV at a University Hospital in Bogotá, Colombia

Overview

Journal Int J STD AIDS

Specialty Infectious Diseases

Date 2022 May 2

PMID 35491739

Authors

I Tatiana Ordonez-Blanco

Samuel Martinez-Vernaza

Kevin J Blair

Camilo Quiroga

Ellen Lowenstein

Luis J Lombana Amaya

Jesse Clark

Jordan E Lake

Sandra Liliana Valderrama-Beltran

Affiliations

Soon will be listed here.

Abstract

Background: Risk of anal squamous cell carcinoma (anal cancer) is greater among men who have sex with men (MSM) living with human immunodeficiency virus (HIV). We describe the frequency of and factors associated with abnormal anal cytology results in Colombian MSM living with HIV.

Methods: This retrospective observational cohort study included MSM ≥18 years old living with HIV screened with anal cytology at Hospital Universitario San Ignacio in Bogotá, Colombia between January 2019 and February 2020. A multivariable log-binomial regression model estimated associations with abnormal anal cytology.

Results: A total of 211 patients were included. Mean age was 35.6 years. Sixty-eight (32.3%) had an abnormal anal cytology result: ASC-US 33.8% ( = 23); LSIL 60.3% ( = 41); and HSIL 5.9% ( = 4). MSM with an STI diagnosis in the previous 12 months (RR 1.48, [95% CI 1.03-2.12], = 0.032) or with a CD4 T cell count <200 (RR 2.08 [95% CI 1.16-3.73], = 0.014) were significantly more likely to have abnormal anal cytology.

Conclusions: These data provide crucial information to guide scale up of anal cancer screening at select centers in Colombia. Our results also suggest STI prevention efforts and improved virological control among MSM living with HIV may have the secondary benefit of reducing the risk of anal cancer.

References

Koskan A, Brennhofer S, Helitzer D . Screening for anal cancer precursors among patients living with HIV in the absence of national guidelines: practitioners' perspectives. Cancer Causes Control. 2019; 30(9):989-996. DOI: 10.1007/s10552-019-01209-8. View

Maia L, Marinho L, Wanderley Paes Barbosa T, Batalha Filho E, Velasco L, Costa P . A comparative study between conventional and liquid-based cytology in screening for anal intraepithelial lesions in HIV-positive patients. Diagn Cytopathol. 2014; 42(10):840-5. DOI: 10.1002/dc.23130. View

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

Siddharthan R, Lanciault C, Tsikitis V . Anal intraepithelial neoplasia: diagnosis, screening, and treatment. Ann Gastroenterol. 2019; 32(3):257-263. PMC: 6479653. DOI: 10.20524/aog.2019.0364. View

Gilbert M, Kwag M, Mei W, Rank C, Kropp R, Severini A . Feasibility of incorporating self-collected rectal swabs into a community venue-based survey to measure the prevalence of HPV infection in men who have sex with men. Sex Transm Dis. 2011; 38(10):964-9. DOI: 10.1097/OLQ.0b013e318222899d. View

Apaydin K, Fontenot H, Shtasel D, Mayer K, Keuroghlian A . Primary Care Provider Practices and Perceptions Regarding HPV Vaccination and Anal Cancer Screening at a Boston Community Health Center. J Community Health. 2018; 43(4):792-801. PMC: 6033675. DOI: 10.1007/s10900-018-0486-0. View

Boldrini N, Volpini L, de Freitas L, Musso C, Mercon de Vargas P, Cruz Spano L . Anal HPV infection and correlates in HIV-infected patients attending a Sexually Transmitted Infection clinic in Brazil. PLoS One. 2018; 13(7):e0199058. PMC: 6033400. DOI: 10.1371/journal.pone.0199058. View

Harris P, Taylor R, Minor B, Elliott V, Fernandez M, ONeal L . The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019; 95:103208. PMC: 7254481. DOI: 10.1016/j.jbi.2019.103208. View

Gimenez F, Costa-e-Silva I, Daumas A, Araujo J, Medeiros S, Ferreira L . The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in HIV-positive patients. Arq Gastroenterol. 2011; 48(2):136-45. DOI: 10.1590/s0004-28032011000200010. View

10.

Palefsky J . Practising high-resolution anoscopy. Sex Health. 2013; 9(6):580-6. DOI: 10.1071/SH12045. View

11.

Revollo B, Videla S, Llibre J, Paredes R, Pinol M, Garcia-Cuyas F . Routine Screening of Anal Cytology in Persons With Human Immunodeficiency Virus and the Impact on Invasive Anal Cancer: A Prospective Cohort Study. Clin Infect Dis. 2019; 71(2):390-399. DOI: 10.1093/cid/ciz831. View

12.

Zhang X, Yu J, Li M, Sun X, Han Q, Li M . Prevalence and related risk behaviors of HIV, syphilis, and anal HPV infection among men who have sex with men from Beijing, China. AIDS Behav. 2011; 17(3):1129-36. DOI: 10.1007/s10461-011-0085-x. View

13.

Rubio Mendoza M, Jacobson J, Morales-Miranda S, Sierra Alarcon C, Nunez R . High HIV Burden in Men Who Have Sex with Men across Colombia's Largest Cities: Findings from an Integrated Biological and Behavioral Surveillance Study. PLoS One. 2015; 10(8):e0131040. PMC: 4529092. DOI: 10.1371/journal.pone.0131040. View

14.

Daling J, Madeleine M, Johnson L, Schwartz S, Shera K, Wurscher M . Human papillomavirus, smoking, and sexual practices in the etiology of anal cancer. Cancer. 2004; 101(2):270-80. DOI: 10.1002/cncr.20365. View

15.

Stewart D, Gaertner W, Glasgow S, Herzig D, Feingold D, Steele S . The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Anal Squamous Cell Cancers (Revised 2018). Dis Colon Rectum. 2018; 61(7):755-774. DOI: 10.1097/DCR.0000000000001114. View

16.

Goncalves J, Macedo A, Madeira K, Bavaresco D, Dondossola E, Grande A . Accuracy of Anal Cytology for Diagnostic of Precursor Lesions of Anal Cancer: Systematic Review and Meta-analysis. Dis Colon Rectum. 2018; 62(1):112-120. DOI: 10.1097/DCR.0000000000001231. View

17.

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

18.

Conley L, Bush T, Darragh T, Palefsky J, Unger E, Patel P . Incidence and Predictors of Abnormal Anal Cytology Findings Among HIV-Infected Adults Receiving Contemporary Antiretroviral Therapy. J Infect Dis. 2015; 213(3):351-60. PMC: 6103209. DOI: 10.1093/infdis/jiv408. View

19.

Rosa-Cunha I, Cardenas G, Dickinson G, Metsch L . Addressing anal health in the HIV primary care setting: a disappointing reality. AIDS Patient Care STDS. 2010; 24(9):533-8. PMC: 2958442. DOI: 10.1089/apc.2010.0032. View

20.

Silverberg M, Lau B, Justice A, Engels E, Gill M, Goedert J . Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America. Clin Infect Dis. 2012; 54(7):1026-34. PMC: 3297645. DOI: 10.1093/cid/cir1012. View