Identifying risk factors for prevalent anal human papillomavirus type 16 infection in women living with HIV

• Published in: PloS one Vol. 17; no. 5; p. e0268521
• Main Authors: Kaufman, Elaina, Williamson, Tyler, Mayrand, Marie-Hélène, Burchell, Ann N, Klein, Marina, Charest, Louise, Rodrigues-Coutlée, Sophie, Coutlée, François, de Pokomandy, Alexandra
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.05.2022; Public Library of Science (PLoS)
• Subjects: Algorithms; Alphapapillomavirus; Anal Canal; Anal cancer; Anogenital; Anus; Anus Neoplasms - complications; Biology and life sciences; Cancer; Cancer screening; Care and treatment; CD4 antigen; Cervical cancer; Cervix; Cohort Studies; Colorectal cancer; Complications and side effects; Computer and Information Sciences; Deoxyribonucleic acid; DNA; Female; Genotyping; Health risks; Hepatitis; HIV; HIV (Viruses); HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; Human immunodeficiency virus; Human papillomavirus; Humans; Infections; Medical research; Medicine and Health Sciences; Papillomaviridae - genetics; Papillomavirus infections; Papillomavirus Infections - complications; Papillomavirus Infections - epidemiology; Prevalence; Questionnaires; Regression analysis; Risk analysis; Risk Factors; Screening; Smoking; Statistical analysis; Subgroups; Vaccines; Womens health; Canada
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0268521

Women living with HIV (WLHIV) have a high risk of anal cancer. Identifying risk factors for anal HPV 16 infection, the most significant risk factor for anal cancer, is essential for prevention and screening strategies. In the EVVA Cohort study, 151 WLHIV had cervical and anal HPV testing with genotyping every 6 months for 2 years, while demographic and clinical data were collected via questionnaires and chart reviews. Here, we present results of baseline data analyzed using multivariable logistic regression. Among 150 women with adequate HPV test results at baseline, HPV 16 DNA was detected anally in 23 (15.3%; 95%CI:10.4-22.1) and cervically in 5 (3.3%; 95%CI:1.4-7.8). In multivariable analysis, current smoking (OR = 6.0; 95%CI: 1.5-23.9), nadir CD4 count ≤ 200 cells/μL (OR = 8.4; 95%CI: 2.0-34.3), prevalent cervical HPV 16 (OR = 14.7; 95%CI: 1.0-222.5) and anogenital herpes in previous 6 months (OR = 9.8, 95%CI: 1.7-56.8) were associated with prevalent anal HPV 16. Knowledge of risk factors can help identify WLHIV at greatest risk of anal HPV 16 infection and, potentially, developing subsequent anal cancer. Identification of the subgroup of these women in whom HPV 16 persists could be an early step in the algorithm of anal cancer screening.