TY - JOUR
T1 - Incidence, clearance, persistence and factors related with high-risk anal HPV persistence in South-East Asian MSM and transgender women
AU - Yunihastuti, Evy
AU - Teeratakulpisarn, Nipat
AU - Jeo, Wifanto Saditya
AU - Nilasari, Hanny
AU - Rachmadi, Lisnawati
AU - Somia, I. Ketut Agus
AU - Sukmawati, Made Dewi Dian
AU - Amijaya, Komang Agus Trisna
AU - Yee, Ilias A.
AU - Hairunisa, Nany
AU - Hongchookiat, Piranun
AU - Trachunthong, Deondara
AU - Pankam, Tippawan
AU - Nonenoy, Siriporn
AU - Ramautarsing, Reshmie
AU - Azwa, Iskandar
AU - Merati, Tuti P.
AU - Phanuphak, Praphan
AU - Phanuphak, Nittaya
AU - Palefsky, Joel M.
N1 - Funding Information:
This work was supported in part by subawards from amfAR (grant numbers 108520-52-IGTA and 108893-55-IPTA), The Foundation for AIDS Research with funds provided by Life Ball and Verein Aids Life (’AIDS LIFE’). The Asia Pacific HIV Research Collaboration is an initiative of TREAT Asia, a program of amfAR, The Foundation for AIDS Research, with support from the National Institute of Allergy and Infectious Diseases (NIAID) of the U.S. National Institutes of Health (NIH) as part of the International Epidemiologic Databases to Evaluate AIDS (IeDEA). These subgrants were supported with funds provided by NIH cooperative agreement #5U01AI0699007-07 and a supplement to NIH cooperative agreement #5U01AI0699007-08. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned above.
Publisher Copyright:
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - OBJECTIVES: Persistent anal high-risk human papillomavirus (HR-HPV) infection is a major risk factor for anal cancer among MSM and transgender women (TGW). We aimed to estimate incidence, clearance, and persistence of anal HR-HPV in HIV-positive and HIV-negative MSM and TGW, and to assess factors for HR-HPV persistence. DESIGN: Prospective cohort study. METHODS: MSM and TGW aged at least 18 years, were enrolled from Indonesia, Malaysia, and Thailand, then followed up 6-monthly for 12 months. Anal swabs were collected at every visit for HR-HPV genotypes to define anal HR-HPV incidence, clearance, and persistence. Logistic regression was used to evaluate factors associated with HR-HPV persistence. RESULTS: Three hundred and twenty-five MSM and TGW were included in this study, of whom 72.3% were HIV-positive. The incidence of anal HR-HPV persistence was higher in HIV-positive than HIV-negative MSM participants (28.4/1000 vs. 13.9/1000 person-months). HIV-positive participants had HR-HPV lower clearance rate than HIV-negative participants (OR 0.3; 95% CI 0.1-0.7). The overall persistence of HR-HPV was 39.9% in HIV-positive and 22.8% HIV-negative participants. HPV-16 was the most persistent HR-HPV in both HIV-positive and HIV-negative participants. HIV infection (aOR 2.87; 95% CI 1.47-5.61), living in Kuala Lumpur (aOR 4.99; 95% CI 2.22-11.19) and Bali (aOR 3.39; 95% CI 1.07-10.75), being employed/freelance (aOR 3.99; 95% CI 1.48-10.77), and not being circumcised (aOR 2.29; 95% CI 1.07-4.88) were independently associated with anal HR-HPV persistence. CONCLUSION: HIV-positive MSM and TGW had higher risk of persistent anal HR-HPV infection. Prevention program should be made available and prioritized for HIV-positive MSM and TGW where resources are limited.
AB - OBJECTIVES: Persistent anal high-risk human papillomavirus (HR-HPV) infection is a major risk factor for anal cancer among MSM and transgender women (TGW). We aimed to estimate incidence, clearance, and persistence of anal HR-HPV in HIV-positive and HIV-negative MSM and TGW, and to assess factors for HR-HPV persistence. DESIGN: Prospective cohort study. METHODS: MSM and TGW aged at least 18 years, were enrolled from Indonesia, Malaysia, and Thailand, then followed up 6-monthly for 12 months. Anal swabs were collected at every visit for HR-HPV genotypes to define anal HR-HPV incidence, clearance, and persistence. Logistic regression was used to evaluate factors associated with HR-HPV persistence. RESULTS: Three hundred and twenty-five MSM and TGW were included in this study, of whom 72.3% were HIV-positive. The incidence of anal HR-HPV persistence was higher in HIV-positive than HIV-negative MSM participants (28.4/1000 vs. 13.9/1000 person-months). HIV-positive participants had HR-HPV lower clearance rate than HIV-negative participants (OR 0.3; 95% CI 0.1-0.7). The overall persistence of HR-HPV was 39.9% in HIV-positive and 22.8% HIV-negative participants. HPV-16 was the most persistent HR-HPV in both HIV-positive and HIV-negative participants. HIV infection (aOR 2.87; 95% CI 1.47-5.61), living in Kuala Lumpur (aOR 4.99; 95% CI 2.22-11.19) and Bali (aOR 3.39; 95% CI 1.07-10.75), being employed/freelance (aOR 3.99; 95% CI 1.48-10.77), and not being circumcised (aOR 2.29; 95% CI 1.07-4.88) were independently associated with anal HR-HPV persistence. CONCLUSION: HIV-positive MSM and TGW had higher risk of persistent anal HR-HPV infection. Prevention program should be made available and prioritized for HIV-positive MSM and TGW where resources are limited.
UR - http://www.scopus.com/inward/record.url?scp=85092681744&partnerID=8YFLogxK
U2 - 10.1097/QAD.0000000000002654
DO - 10.1097/QAD.0000000000002654
M3 - Article
C2 - 32773478
AN - SCOPUS:85092681744
SN - 0269-9370
VL - 34
SP - 1933
EP - 1941
JO - AIDS (London, England)
JF - AIDS (London, England)
IS - 13
ER -
