7th Conference on Retroviruses and Opportunistic Infections San Francisco, CA - January 30 -February 4, 2000

Conf Retroviruses Opportunistic Infect 2000 Jan 30-Feb 2; 7:76 (abstract no. 8)

A. B. Moscicki, J. Houser, Y. Ma, C. Wilson, And D. A. Murphy
Univ. of California, San Francisco and Los Angeles; Westat, Rockville, MD; and Univ. of Alabama at Birmingham

BACKGROUND: Studies of anal HPV infection to date have primarily involved adults who have had prolonged HIV as well as HPV infections because of their longer period of sexual activity. We examined the association between prevalence of anal HPV infection, squamous intra-epithelial lesions (SIL), and HIV status in a population of non injection drug using adolescents.

METHODS: Adolescents aged 13-19 years participating in a national study of HIV infection (REACH) were sampled for anal HPV DNA and cytology. HPV DNA was detected by a polymerase chain reaction technique using generic and 15 specific probes for low risk (LR) and high risk types.

RESULTS: Anal HPV infections were more common in the males [37/83 (45%)] than the females [70/265 (26%)]; p=0.002. HIV status and CD4 cell count were associated with HPV infection for females only: 13% (11/82) of HIV negative (-) compared to 32% (59/183) of HIV positive (+) females had anal HPV infection (p<0.001) and 65% of the HIV+ females with a CD4 count <200 cells/ml compared to 19% with a CD4 count >500 had anal HPV (p<0.001). HIV status was not associated with HPV type or with number of types detected. Anal receptive sex was also not associated with anal HPV infection in males or females. In the multivariate models, same sex activities reported by males (OR=5.2, 95% CI 1.3, 20.6) and current anal warts (OR=15.5, 95% CI 1.6, 149) were significant predictors for anal HPV in males. For females, current anal warts (OR=8.3, 95% Cl 1.6, 42.9), genital warts (OR=3.7, 95% CI 1.4, 9.6), HIV status, (OR=2.0, 95% CI .9, 4.4), and HPV cervical infection (OR=1.9, 95% CI 0.9, 4.0) were associated with anal HPV. Anal SIL was strongly associated with HPV status in both males and females (p<.001). Among those with anal HPV, 34% of HIV + and 13% of HIV- females had anal SIL (p=0.4) and 67% of HIV+ and 33% of HIV- males had SIL (p=0.1).

CONCLUSIONS: The presence of ano-genital warts was a significant risk for both males and females. HIV status and cervical HPV also appeared important for females. Regardless of gender, adolescents with anal HPV were at significant risk for anal SIL.

2000-01-30
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