Screening for Anal Dysplasia in HIV-Infected Men Who Have Sex with Men By Anal Cytology, Human Papillomavirus Testing and Anoscopy

Eefje Jong, Jan Willem Mulder, Anne Catherina Theresia Maria Depla, Eric Cornelis Maria van Gorp, Johan Westerga, Claudie Flohil, Anja Johanna Heijne-Tol, Paulus Henricus Marinus Smits

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DOI: 10.4236/wja.2011.12007                

Abstract

The incidence of anal cancer in HIV-infected men who have sex with men (MSM) is increasing and screening is advo-cated. In a cross-sectional study anal cytology specimens from 58 HIV-infected MSM were analyzed for adequacy, cy-tology and HPV DNA testing results and compared to findings on anoscopy. The adequacy of cytology specimens was high. In 34 (63%) of anal swab samples any grade of dysplasia was observed compared to 41 (71%) of biopsy speci-mens. The cytology specimens revealed high-grade dysplasia in 4 (7%) compared to 29 (50%) of biopsy specimens. The prevalence of high-risk HPV types was 90% by using the SPF10 PCR and 81% by using the Hybrid Capture II assay. Because of the high HPV prevalence, HPV DNA testing alone is not a suitable diagnostic screening tool for detecting anogenital lesions in this specific MSM population. Screening should include both anal cytology and anoscopy.

Keywords

HIV, Men, Human Papillomavirus, Anal Cancer, Screening

Conflicts of Interest

The authors declare no conflicts of interest.

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