Effect of combined antiretroviral therapy on the prevalence of anal human papillomavirus infection in human immunodeficiency virus-infected men who have sex with men

Abstract

Objective To investigate the effect of combined antiretroviral therapy (cART) on anal human papillomavirus (HPV) infection in human immunodeficiency virus (HIV)-infected men who sex with men (MSM). Methods HIV-infected MSM naive of cART who visited Wuhan Dermatological Hospital from June 2012 to December 2013 were enrolled in a longitudinal study before starting cART, including 81 HIV-positive and 50 HIV-negative cases. HPV infection situations between HIV-positive and HIV-negative MSM were compared. And anal HPV infection rate and condyloma acuminate incidence of HIV-positive MSM before and after cART were also compared. HPV genotyping was performed by universal primer PCR and reverse dot hybridization. The statistical analysis was done by t test or χ2 test. Results The prevalence rates of HPV infection, high-risk HPV infection and multiple HPV subtypes infection in HIV-positive MSM were all significantly higher than those in HIV-negative MSM (91.4% vs 62.0%, 75.3% vs 30.0%, 56.8% vs 20.0%, respectively, χ2=16.75, 26.05, and 19.10, respectively, all P<0.05). The prevalence rates of anal HPV infection, high-risk HPV infection and multiple HPV subtypes infection in 77 HIV-positive MSM at month 36 of cART were all significantly decreased than baseline (90.9% vs 74.0%, 75.3% vs 44.2% and 57.1% vs 41.5%, respectively, χ2=7.590, 15.551, and 3.741, respectively, all P<0.05). HPV16 and HPV43 infection rates were reduced from 27.3% at baseline to 15.6% and 13.0%, respectively at month 36 of cART (χ2=16.92 and 14.86, respectively, both P<0.05). Condyloma acuminate incidence also reduced from 16.9% at baseline to 5.2% at month 36 (χ2=4.069, P<0.05). Conclusions The prevalence of anal HPV infection in HIV-positive MSM is higher than HIV-negative MSM. cART could reduce the prevalence of anal HPV infection rate and condyloma acuminate incidence , especially high-risk HPV infection. Key words: Combined antiretroviral therapy; Human papillomavirus; Human immunodeficiency virus; Condyloma acuminatum; Infections