One Lesion, One Virus: Individual Components of High-Grade Anal Intraepithelial Neoplasia in HIV-Positive Men Contain a Single HPV Type

• Published in: The Journal of infectious diseases Vol. 210; no. 1; pp. 111 - 120
• Main Authors: Richel, Olivier, Quint, Koen D., Lindeman, Jan, van Noesel, Carel J. M., De Koning, Maurits N. C., van den Munckhof, Henk A. M., De Vries, Henry J., Prins, Jan M., Quint, Wim G. V.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.07.2014
• Subjects: Adult; Anus neoplasms; Anus Neoplasms - virology; Biological and medical sciences; Biopsies; Carcinoma in Situ - virology; Cervical intraepithelial neoplasia; Fundamental and applied biological sciences. Psychology; Genotypes; Genotyping Techniques - methods; HIV Infections - complications; HIV/AIDS; Homosexuality, Male; Human immunodeficiency virus; Human papillomavirus; Human papillomavirus 16; Human viral diseases; Humans; Infectious diseases; Interstitial nephritis; Lesions; Male; Medical sciences; Microbiology; Middle Aged; Neoplasia; Papillomaviridae - classification; Papillomaviridae - genetics; Papillomaviridae - isolation & purification; Papillomavirus Infections - virology; Papillomavirus vaccines; Polymerase chain reaction; Specimens; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Virology - methods; Human; Infection; Immunopathology; Viral disease; AIDS; Lesion; Intraepithelial neoplasia; Immune deficiency
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiu052

Background. High-grade anal intraepithelial neoplasia (AIN) is present in many human immunodeficiency virus (HIV)-positive men who have sex with men. The major etiologic factor is infection with an oncogenic human papillomavirus (HPV) genotype. We investigated whether individual components of high-grade AIN are caused by single HPV types. Methods. DNA was isolated from whole-tissue sections of 31 high-grade AIN that were recovered from 21 HIV-positive men who have sex with men. The SPF10 PCR/LiPA25 HPV genotyping system was used for DNA analysis. In whole-tissue sections with multiple HPV types, polymerase chain reaction was repeated in regions of AIN sampled by laser-capture microdissection. The results were compared with HPV types in anal swabs. Results. A single HPV type was observed in 15 (48%) of 31 whole-tissue sections. In an additional 14 whole-tissue sections, 1 HPV type was found in each lesion sample evaluated by laser-capture microdissection. Consequently, in 29 of 31 biopsy specimens (94%), a single HPV type was found in each lesional component studied. Two wholetissue sections contained collision regions, each with 2 HPV types. HPV16 was presumed to be causative in 14 of 31 biopsy specimens (45%). More than half of the anal swabs did not contain all causative HPV types. Conclusions. Individual components of high-grade AIN are caused by single HPV types (the so-called one lesion, one virus concept). HPV 16 is causative in <50% of cases. Anal swabs are not useful for detecting lesion-specific HPV types.