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The role of polymerase chain reaction of high-risk human papilloma virus in the screening of high-grade squamous intraepithelial lesions in the anal mucosa of human immunodeficiency virus-positive males having sex with males.
Open accessAbstract
OBJECTIVES: To evaluate the advantages of cytology and PCR of high-risk human papilloma virus (PCR HR-HPV) infection in biopsy-derived diagnosis of high-grade squamous intraepithelial lesions (HSIL = AIN2/AIN3) in HIV-positive men having sex with men (MSM). METHODS: This is a single-centered study conducted between May 2010 and May 2014 in patients (n = 201, mean age 37 years) recruited from our outpatient clinic. Samples of anal canal mucosa were taken into liquid medium for PCR HPV analysis and for cytology. Anoscopy was performed for histology evaluation. RESULTS: Anoscopy showed 33.8% were normal, 47.8% low-grade squamous intraepithelial lesions (LSIL), and 18.4% HSIL; 80.2% had HR-HPV. PCR of HR-HPV had greater sensitivity than did cytology (88.8% vs. 75.7%) in HSIL screening, with similar positive (PPV) and negative predictive value (NPV) of 20.3 vs. 22.9 and 89.7 vs. 88.1, respectively. Combining both tests increased the sensitivity and NPV of HSIL diagnosis to 100%. Correlation of cytology vs. histology was, generally, very low and PCR of HR-HPV vs. histology was non-existent (<0.2) or low (<0.4). Area under the receiver operating characteristics (AUROC) curve analysis of cytology and PCR HR-HPV for the diagnosis of HSIL was poor (<0.6). Multivariate regression analysis showed protective factors against HSIL were: viral suppression (OR: 0.312; 95%CI: 0.099-0.984), and/or syphilis infection (OR: 0.193; 95%CI: 0.045-0.827). HSIL risk was associated with HPV-68 genotype (OR: 20.1; 95%CI: 2.04-197.82). CONCLUSIONS: When cytology and PCR HR-HPV findings are normal, the diagnosis of pre-malignant HSIL can be reliably ruled-out in HIV suppression with treatment protects against the appearance of HSIL [corrected].
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“Sensitivity and specificity of anal cytology to detect HSIL are limited (sensitivity 55%–89% and specificity 40%–67%) (1286–1291).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1291]
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Metadata
- Authors
- Hidalgo-Tenorio, C., Rivero-Rodriguez, M., Gil-Anguita, C., Esquivias, J., López-Castro, R., Ramírez-Taboada, J., de Hierro, M. L., López-Ruiz, M. A., Martínez, R. J., & Llaño, J. P.
- Affiliations
- Hospital Universitario Virgen de las Nieves (ES)
- Corresponding author
- Hidalgo-Tenorio, Carmen
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-04-07
- Volume
- 10
- Issue
- 4
- Pages
- e0123590
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4425629
- OpenAlex
- W2094700350
- Cited by
- 25
- References
- 42
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2021: 4 · 2020: 4 · 2019: 1 · 2018: 5 · 2017: 6 · 2015: 1
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Update notices
- correction (2015-05-08)
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Surgery › Colorectal and Anal Carcinomas
- Health Sciences › Medicine › Surgery › Genital Health and Disease
- Keywords
- high-risk HPV, anal squamous intraepithelial lesions, high-grade squamous intraepithelial lesion, HIV-positive men who have sex with men, anal cancer screening, HPV genotyping, HPV68, anal cytology, HPV testing, viral suppression, syphilis, sensitivity and specificity
- MeSH terms
- Adult, Anal Canal, Anus Neoplasms, Cross-Sectional Studies, Cytodiagnosis, DNA, Viral, Female, HIV Seropositivity, Humans, Male, Mucous Membrane, Prospective Studies, Spain, HIV Infections, Polymerase Chain Reaction, Homosexuality, Male, Papillomaviridae, Papillomavirus Infections, Squamous Intraepithelial Lesions of the Cervix
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