Table of Contents
Journal of Sexually Transmitted Diseases
Volume 2013, Article ID 915169, 8 pages
http://dx.doi.org/10.1155/2013/915169
Clinical Study

HPV Infection in a Cohort of HIV-Positive Men and Women: Prevalence of Oncogenic Genotypes and Predictors of Mucosal Damage at Genital and Oral Sites

1Department of Health Sciences, Institute of Infectious and Tropical Diseases, San Paolo Hospital, University of Milan, Via A Di Rudinì 8, 20142 Milan, Italy
2Surgery Chair, Department of Health Sciences, San Paolo Hospital, University of Milan, 20142 Milan, Italy
3Pathology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, 20142 Milan, Italy
4Department of Health Sciences, Institute of Obstetrics and Gynecology, San Paolo Hospital, University of Milan, 20142 Milan, Italy
5Dentistry Chair, Department of Health Sciences, San Paolo Hospital, University of Milan, 20142 Milan, Italy
6Pathology Unit, Department of Medicine, Surgery and Dentistry, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20142 Milan, Italy

Received 11 December 2012; Revised 1 February 2013; Accepted 1 February 2013

Academic Editor: Jose L. (Toti) Sanchez

Copyright © 2013 Giulia Marchetti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of this study was to assess the prevalence of HPV infection and determinants of abnormal cytology in HIV-positive patients. In a cross-sectional study, patients of both sexes, asymptomatic for HPV, underwent anorectal (men)/cervical (women) and oral swabs. Cytology and HPV-PCR detection/genotyping (high- and low-risk genotypes, HR-LR/HPV) were performed. A total of 20% of the 277 enrolled patients showed oral HPV, with no atypical cytology; in men, anal HPV prevalence was 81% with 64% HR genotypes. In women, cervical HPV prevalence was 58% with 37% HR-HPV. The most frequent genotypes were HPV-16 and HPV-18; 37% of men and 20% of women harbored multiple genotypes. Also, 47% of men showed anal squamous intraepithelial lesions (SILs); 6% had high- and 35% low-grade SILs (HSILs/LSILs); 5% had atypical squamous cells of undetermined significance (ASC-US). HR-HPV was independently associated with anal-SIL in men ( ). Moreover, 37% of women showed cervical SIL: 14 ASC-US, 15 LSILs, 4 HSILs, and 1 in situ cancer. The presence of both LR and HR-HPV in women was independently associated with SIL ( and ). HR-HPV and atypical cytology were frequently identified in our cohort. HPV screening should be mandatory in HIV-infected subjects, and vaccine programs for HPV-negative patients should be implemented.