Incidence and Predictors of Abnormal Anal Cytology Findings Among HIV-Infected Adults Receiving Contemporary Antiretroviral Therapy
| Autor: | Kathleen C. Wood, John T. Brooks, Susan Cu-Uvin, Lois Conley, Keith Henry, Teresa M. Darragh, E. Milu Kojic, John Hammer, Elizabeth R. Unger, Martin Steinau, Harold L. Martin, Joel M. Palefsky, Pragna Patel, Timothy J. Bush, E. Turner Overton |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Anti-HIV Agents Anal Canal HIV Infections Article Men who have sex with men 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Risk Factors Cytology medicine Humans Immunology and Allergy 030212 general & internal medicine Homosexuality Male Prospective cohort study Gynecology business.industry Obstetrics Incidence Incidence (epidemiology) Hazard ratio Middle Aged Anal canal medicine.disease Natural history Infectious Diseases medicine.anatomical_structure 030220 oncology & carcinogenesis Female business |
| Zdroj: | Journal of Infectious Diseases. 213:351-360 |
| ISSN: | 1537-6613 0022-1899 |
| DOI: | 10.1093/infdis/jiv408 |
| Popis: | Author(s): Conley, Lois J; Bush, Timothy J; Darragh, Teresa M; Palefsky, Joel M; Unger, Elizabeth R; Patel, Pragna; Steinau, Martin; Kojic, E Milu; Martin, Harold; Overton, E Turner; Cu-Uvin, Susan; Hammer, John; Henry, Keith; Wood, Kathleen; Brooks, John T; SUN Study Group | Abstract: BackgroundAnal cancer rates are higher for human immunodeficiency virus (HIV)-infected adults than for uninfected adults. Limited published data exist characterizing the incidence of precursor lesions detected by anal cytology.MethodsThe Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy was a prospective cohort of 700 HIV-infected participants in 4 US cities. At baseline and annually thereafter, each participant completed a behavioral questionnaire, and healthcare professionals collected anorectal swabs for cytologic examination and human papillomavirus (HPV) detection and genotyping.ResultsAmong 243 participants with negative baseline results of anal cytology, 37% developed abnormal cytology findings (incidence rate, 13.9 cases/100 person-years of follow-up; 95% confidence interval [CI], 11.3-16.9) over a median follow-up duration of 2.1 years. Rates among men having sex with men, among women, and among men having sex with women were 17.9 cases/person-years of follow-up (95% CI, 13.9-22.7), 9.4 cases/person-years of follow-up (95% CI, 5.6-14.9), and 8.9 cases/person-years of follow-up (95% CI, 4.8-15.6), respectively. In multivariable analysis, the number of persistent high-risk HPV types (adjusted hazard ratio [aHR], 1.17; 95% CI, 1.01-1.36), persistent high-risk HPV types except 16 or 18 (aHR, 2.46; 95% CI, 1.31-4.60), and persistent types 16 or 18 (aHR, 3.90; 95% CI, 1.78-8.54) remained associated with incident abnormalities.ConclusionsThe incidence of abnormal anal cytology findings was high and more likely to develop among persons with persistent high-risk HPV. |
| Databáze: | OpenAIRE |
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