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Kahn JA, Belzer M, Chi X, Lee J, Gaur AH, Mayer K, Martinez J, Futterman DC, Stier EA, Paul ME, Chiao EY, Reirden D, Goldstone SE, Ortiz Martinez AP, Cachay ER, Barroso LF, Da Costa M, Wilson CM, Palefsky JM. Pre-vaccination prevalence of anogenital and oral human papillomavirus in young HIV-infected men who have sex with men. Papillomavirus Res 2019; 7:52-61. [PMID: 30658128 PMCID: PMC6356116 DOI: 10.1016/j.pvr.2019.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/06/2018] [Accepted: 01/10/2019] [Indexed: 11/23/2022]
Abstract
The aims of this study were to: 1) determine prevalence of anogenital and oral HPV, 2) determine concordance between HPV at anal, perianal, scrotal/penile, and oral sites; and 3) describe factors associated with anogenital HPV types targeted by the 9-valent vaccine. Data were collected from 2012 to 2015 among men who have sex with men 18-26 years of age enrolled in a vaccine trial (N = 145). Penile/scrotal, perianal, anal, and oral samples were tested for 61 HPV types. Logistic regression was used to identify factors associated with types in the 9-valent vaccine. Participants' mean age was 23.0 years, 55.2% were African-American, and 26.2% were Hispanic; 93% had anal, 40% penile, and 6% oral HPV. Among those with anogenital infection, 18% had HPV16. Concordance was low between anogenital and oral sites. Factors independently associated with a 9-valent vaccine-type HPV were: race (African-American vs. White, OR=2.67, 95% CI=1.11-6.42), current smoking (yes vs. no, OR=2.37, 95% CI=1.03-5.48), and number of recent receptive anal sex partners (2+ vs. 0, OR=3.47, 95% CI=1.16-10.4). Most MSM were not infected with HPV16 or HPV18, suggesting that they may still benefit from HPV vaccination, but anogenital HPV was very common, highlighting the importance of vaccinating men before sexual initiation. CLINICAL TRIAL NUMBER: NCT01209325.
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Affiliation(s)
- Jessica A Kahn
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Marvin Belzer
- Department of Pediatrics, University of Southern California, Los Angeles, CA, USA.
| | - Xiaofei Chi
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Jeannette Lee
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Aditya H Gaur
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Kenneth Mayer
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Jaime Martinez
- John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
| | | | | | - Mary E Paul
- Baylor College of Medicine, Houston, TX, USA.
| | | | - Daniel Reirden
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
| | | | - Ana P Ortiz Martinez
- Cancer Control and Population Sciences Program, University of Puerto Rico, San Juan, PR, USA.
| | - Edward R Cachay
- Department of Medicine, Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA.
| | - Luis F Barroso
- Department of Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA.
| | - Maria Da Costa
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Craig M Wilson
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Joel M Palefsky
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
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Ellsworth GB, Lensing SY, Ogilvie CB, Lee JY, Goldstone SE, Berry-Lawhorn JM, Jay N, Stier EA, Logan JS, Einstein MH, Saah A, Mitsuyasu RT, Aboulafia D, Palefsky JM, Wilkin TJ. A delayed dose of quadrivalent human papillomavirus vaccine demonstrates immune memory in HIV-1-infected men. Papillomavirus Res 2018; 6:11-14. [PMID: 29807211 PMCID: PMC6121157 DOI: 10.1016/j.pvr.2018.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/20/2018] [Accepted: 05/23/2018] [Indexed: 12/20/2022]
MESH Headings
- Adult
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- HIV Infections/complications
- HIV Infections/immunology
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/administration & dosage
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/immunology
- Humans
- Immunologic Memory
- Male
- Middle Aged
- Papillomavirus Infections/immunology
- Papillomavirus Infections/prevention & control
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Affiliation(s)
- G B Ellsworth
- Division of Infectious Diseases, Weill Cornell Medical College, 53W 23rd St, 6th Fl, New York, NY 10023, USA
| | - S Y Lensing
- University of Arkansas for Medical Sciences, Little Rock, USA
| | - C B Ogilvie
- Weill Cornell Medical College, New York City, USA
| | - J Y Lee
- University of Arkansas for Medical Sciences, Little Rock, USA
| | | | | | - N Jay
- University of California at San Francisco, USA
| | - E A Stier
- Boston University Medical Center, Boston, MA, USA
| | | | - M H Einstein
- Albert Einstein College of Medicine, USA; Albert Einstein Cancer Center, Montefiore Medical Center, New York City, USA
| | - A Saah
- Merck Laboratories, Whitehouse Station, NJ, USA
| | | | - D Aboulafia
- Virginia Mason Medical Center, Seattle, WA, USA; Division of Hematology, University of Washington, USA
| | | | - T J Wilkin
- Division of Infectious Diseases, Weill Cornell Medical College, 53W 23rd St, 6th Fl, New York, NY 10023, USA.
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Truesdale MD, Goldstone SE. The fear factor: drivers and barriers to follow-up screening for human papillomavirus-related anal cancer in men who have sex with men. Int J STD AIDS 2010; 21:482-8. [DOI: 10.1258/ijsa.2010.010070] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Human papillomavirus (HPV)-related anal cancer incidence is rising in men who have sex with men (MSM). Effective screening strategies exist, but many patients are lost to follow-up (LTF). We studied factors impacting screening compliance to recommended annual screening visits. Retrospective chart review identified MSM with anal dysplasia. MSM were grouped as regular screeners (regular to follow-up [RF]) (≥1 visit/year), lost to follow-up (LTF) (>1 year since previous screening) and LTF who then returned for screening (lost came back [LCB]). From June 2007 to March 2008, subjects completed a questionnaire in-person at the time of screening or via telephone (LTF). Questionnaires were completed after anal dysplasia diagnosis. One hundred and ninety-five MSM were enrolled (96 RF, 50 LTF and 49 LCB). RF were compliant for 4.8 years; LTF were lost for 2.3 years. LCB were previously lost for 5.6 years before returning. Mean knowledge score of screening procedures was larger in RF versus LTF ( P < 0.001). MSM with more sexual partners in the past six months were more likely to be LCB versus LTF ( P = 0.05). RF were more likely to describe their HPV diagnosis as ‘upsetting’ ( P = 0.003). RF were more likely driven by physical symptoms versus LTF ( P = 0.002). MSM with high-grade intraepithelial lesions (HSIL) were more likely to be RF versus those with low-grade intraepithelial lesions (P = 0.001. Positive predictors for screening compliance include an upsetting experience during the HPV diagnosis, physical symptoms driving the initial visit and HSIL. Engaging patients in a firm, salient approach may facilitate follow-up compliance.
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Affiliation(s)
- M D Truesdale
- Department of Urology, Columbia University Medical Center, Herbert Irving Pavilion, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032
| | - S E Goldstone
- Department of Surgery, Mount Sinai School of Medicine, 420 West 23rd Street, New York, NY 10011, USA
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Goldstone SE, Winkler B, Ufford LJ, Alt E, Palefsky JM. High prevalence of anal squamous intraepithelial lesions and squamous-cell carcinoma in men who have sex with men as seen in a surgical practice. Dis Colon Rectum 2001; 44:690-8. [PMID: 11357031 DOI: 10.1007/bf02234568] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Anal high-grade squamous intraepithelial lesions are probable invasive anal squamous-cell cancer precursors, and although unproved, treatment of high-grade squamous intraepithelial lesions may prevent progression to anal squamous-cell cancer. Men who have sex with men are often treated for benign anorectal disorders without consideration given to the possibility of concurrent high-grade squamous intraepithelial lesions or anal squamous-cell cancer. We determined the prevalence of anal high-grade squamous intraepithelial lesions and anal squamous-cell cancer in an urban surgical practice of men who have sex with men referred for treatment of anal condyloma and other benign noncondylomatous anal disorders. METHODS One hundred thirty-one HIV-positive and 69 HIV-negative men who have sex with men referred for surgical treatment of presumed benign anorectal disease were evaluated by anal cytology, high-resolution anoscopy, and biopsy. Anal cytology and histology were reported with a modified Bethesda classification. RESULTS One hundred fifty-seven patients (79 percent) were referred for condyloma, 4 (2 percent) for anal squamous intraepithelial lesions (anal high-grade squamous intraepithelial lesions) diagnosed by primary care providers, and 39 (19 percent) for other benign anorectal disorders. One hundred forty-three patients (93 percent) had abnormal anal cytology, with 107 (54 percent) having high-grade squamous intraepithelial lesions on cytology. Biopsy results revealed 120 patients (60.0 percent) with high-grade squamous intraepithelial lesions and 5 patients (3 percent) with invasive squamous-cell carcinoma. Four of five men with anal squamous-cell cancer were HIV positive. Fourteen men (36 percent) who have sex with men referred for noncondylomatous benign anal disorders had high-grade squamous intraepithelial lesions, and three (8 percent) had anal squamous-cell cancer. High-grade squamous intraepithelial lesions and anal squamous-cell cancer were seen most often at the squamocolumnar junction. CONCLUSIONS Men who have sex with men referred for treatment of either condyloma or noncondylomatous benign anorectal disease had a high prevalence of anal high-grade squamous intraepithelial lesions and anal squamous-cell cancer. All men who have sex with men referred for treatment of benign anorectal disease should have high-resolution anoscopy and aggressive biopsy of all abnormal areas. Treatment of external lesions alone could miss high-grade squamous intraepithelial lesions or anal squamous-cell cancer.
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Affiliation(s)
- S E Goldstone
- Department of Surgery, Mount Sinai School of Medicine, New York, NY, USA
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Abstract
A case report is presented of a large retroperitoneal hibernoma along with the clinical, radiographic, and pathologic findings. Despite the unusual size and location of this hibernoma, the case illustrates the salient features of these rare tumors of brown fat origin. Pitfalls in preoperative diagnosis are discussed. To date, there has been no convincing evidence of malignant potential of this tumor, and total excision remains the treatment of choice.
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Abstract
A case report is presented of a large retroperitoneal hibernoma along with the clinical, radiographic, and pathologic findings. Despite the unusual size and location of this hibernoma, the case illustrates the salient features of these rare tumors of brown fat origin. Pitfalls in preoperative diagnosis are discussed. To date, there has been no convincing evidence of malignant potential of this tumor, and total excision remains the treatment of choice.
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Abstract
An assay for colony-forming cells of breast epithelia derived from normal and malignant surgical specimens is described using an IMR 90 fibroblast feeder layer. Their radiosensitivity (DO: 120-172) is consistent with the proliferative origin of the colonies. Distilled water inhibits proliferation of a proportion of the colony-forming cells after a 1-minute exposure. Continued detection of colonies after 10 minutes of exposure indicates that it is an inefficient way of completely eradicating proliferating epithelial cells of normal and malignant origin.
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