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2030-01-01
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PREVALENCE AND RISK FACTORS ASSOCIATED WITH ANAL INTRAEPITHELIAL NEOPLASIA AMONG HIV-POSITIVE MEN IN BRAZIL
Comportamento sexual
Neoplasias do Ânus
Neoplasia Intraepitelial anal
Homens
Author
Affilliation
Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Obstetrícia e Ginecologia. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Medicina Social e Preventiva. Belo Horizonte, MG, Brasil.
Universidade Federal de São João Del Rey. Divinópolis, MG, Brasil.
Departamento de Serviços de Saúde. Belo Horizonte,. MG, Brasil.
Departamento de Serviços de Saúde. Belo Horizonte,. MG, Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS.Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ. Brasil / Hospital Geral de Nova Iguaçu. Nova Iguaçu, RJ, Brasil.
Universidade da California. CA, USA.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Medicina Social e Preventiva. Belo Horizonte, MG, Brasil.
Universidade Federal de São João Del Rey. Divinópolis, MG, Brasil.
Departamento de Serviços de Saúde. Belo Horizonte,. MG, Brasil.
Departamento de Serviços de Saúde. Belo Horizonte,. MG, Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS.Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ. Brasil / Hospital Geral de Nova Iguaçu. Nova Iguaçu, RJ, Brasil.
Universidade da California. CA, USA.
Abstract
Objective. This study aimed to assess the prevalence of,
and associated factors with, anal intraepithelial neoplasia
(AIN) among HIV-positive men evaluated at public health
services in Brazil.
Materials and Methods. This is a multicenter crosssectional
study of HIV-positive male patients attending 6
public AIDS referral clinics in urban Brazil. Participants were
interviewed for sociodemographic and behavioral characteristics.
Anal swab specimens were collected for anal cytology
and HPV DNA testing using L1 polymerase chain
reaction. Univariate and multivariate analyses were performed
to evaluate risk factors associated with the presence
of low-grade squamous intraepithelial lesion (LSIL)
and/or high-grade squamous intraepithelial lesion (HSIL).
Results. Anal swabs were collected from 343 participants.
Prevalence of LSIL/HSIL was 24.8%. The majority
(60.1%) reported sexual intercourse with both men and
women in their lifetime. At least 36.7% had 1 or more
oncogenic HPV types. Four variables were independently
associated with the presence of LSIL/HSIL in multivariate
analysis: history of sex with both men and women (odds
ratio [OR] = 4.8) or men only (OR = 6.2) compared with
those having sex with women only; current cigarette
smoking (OR = 2.2); current CD4+ level between 200 and
500 cells/mm3 (OR = 2.9) or below 200 cells/mm3 (OR = 3.8)
compared with CD4+ level above 500 cells/mm3; and presence
of oncogenic anal HPV infection (OR = 9.6).
Conclusions. We found a high prevalence of AIN among
HIV-positive men in Brazil. This population may serve as
an important bridge population to women with implications
for anogenital HPV infection in both men and women. Our findings confirm the need to assess screening
programs for AIN among high-risk groups, similar to those
used to prevent cervical cancer.
Keywords in Portuguese
Infecções por HIVComportamento sexual
Neoplasias do Ânus
Neoplasia Intraepitelial anal
Homens
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