Anal HPV genotypes and related displasic lesions in Italian and foreign born high-risk males

Abstract

Anal intraepithelial neoplasia and anal cancer are closely related to infection from high-risk Human Papilloma Virus (HPV) genotypes. Since HPVs involved in disease progression are reported to vary by geographical regions, this study focuses on HPV genotypes spectrum in 289 males attending a Sexual Transmitted Diseases (STD) unit according to their nationality. Anal cytology, Digene Hybrid Capture Assay (HC2) and HPV genotyping were evaluated in 226 Italian (IT) and 63 foreign born (FB) subjects, recruited between January 2003 and December 2006. FB people were younger (median 32y-IQR 27–35 vs 36y-IQR 31–43, respectively; Mann–Whitney test p < 0.0001) and had a higher rate of abnormal results (≥atypical squamous cells of undetermined significance (ASCUS)) on anal cytology (95.0% vs 84.04%) ( p = 0.032; OR 3.61; 95% CI 1.04–1.23). HPV-16 is by far the most common genotype found in anal cytological samples independently from nationality while differences in distribution of other HPV genotypes were observed. The probability of infection from high-risk HPVs was higher in FB (OR 1.69; 95% CI 1.07–2.68) and is due to a higher rate of HPV-58 (OR 4.98; 95% CI 2.06–12.04), to a lower rate of HPV-11 (OR 0.35; 95% CI 0.16–0.77), to the presence of other high-risk genotypes (HPV-45, HPV-66, HPV-69). Multiple infections rate was high and comparable between IT and FB people. The relative contribution of each HPV genotype in the development of pre-neoplastic disease to an early age in the FB group cannot be argued by this study and more extensive epidemiological evaluations are needed to define the influence of each genotype and the association with the most prevalent high-risk HPVs on cytological intraepithelial lesions development.