AEGiS-13IAC: Adolescent males and females with HIV at high risk for anal squamous intra-epithelial lesions.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Adolescent males and females with HIV at high risk for anal squamous intra-epithelial lesions.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrB305)

Moscicki A-B, Houser J, Ma Y, Murphy D, Wilson C
A.-B. Moscicki, University of California, San Francisco, 3333 California Street, Suite 245, San Francisco, CA 94118-0503, United States, Tel.: +1 415 476 5139, Fax: +1 415 502 4858, E-mail: annam@itsa.ucsf.edu

BACKGROUND: Adolescents, in general, have not been regarded at high risk for anal human papillomavirus (HPV) associated precancers and cancers. We examined the association between anal HPV infection, squamous intra-epithelial lesions (SIL), and HIV status in adolescents and examined risk factors for anal SIL.

METHODS: Adolescents aged 13-18 years in a national study of HIV infection were sampled for anal cytology and HPV DNA using amplification techniques using generic and 15 specific probes for HPV types.

RESULTS: Anal HPV infections were more common in the males `37/83 (45%' than the females `70/ 265 (26%)'; p = .002. HIV status (O.R. = 3.1; 95% C.I. `1.5,6.2') and CD4 cell count > 200 cells/ml (O.R. = 4.5; 95% C.I. `1.6,13.0') were associated with anal HPV for females only. Anal SIL was also more common among males `25/77(32%)' compared to females `20/230 (9%)' (p>.001). Anal SIL was associated with HIV status and HPV infection: 42% of HIV+ males and 11.3% of HIV+ females had anal SIL compared to 13% of HIV- males and 3% of HIV-females (p = .01 and p = .04, respectively). For males and females, 84% and 90%, respectively, of anal SIL were HPV + compared to 29% and 19%, respectively, of those with normal cytology (p>0.001 for both males and females). Among males, the multivariate analysis showed that only HIV status (O.R. = 5.4; 95% C.I. `1.2,23.5') and HPV infection (O.R. = 13.5; 95% C.I. `3.8, 48.4' remained significant risks for anal SIL. Among females, only anal HPV infection (O.R. = 47.4; 95%C.I. `10.2-220.9' and having ever smoked cigarettes (O.R = 3.81; 95% C.I. `1.3,11.5' remained significant risks for anal SIL.

CONCLUSIONS: The high rates of anal HPV and SIL were common in adolescent males and females with HIV infection suggesting that anal cytology screening should be a part of regular health care of HIV infected youth. In addition to HIV status and anal HPV, cigarette smoking was a significant risk for anal SIL in females.

Keywords: AEGIS, HIV, Anus Diseases, Papillomavirus, Human, HIV Seropositivity, HIV Infections, Anus, Risk Factors, CD4 Lymphocyte Count, HIV Seronegativity, Adolescent, Human, Female, Male, Adolescence, immunology
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TuOrB305