Document 0323
 DOCN  M9650323
 TI    Prospective study of high grade anal squamous intraepithelial neoplasia
       in a cohort of homosexual men: influence of HIV infection,
       immunosuppression and human papillomavirus infection.
 DT    9605
 AU    Critchlow CW; Surawicz CM; Holmes KK; Kuypers J; Daling JR; Hawes SE;
       Goldbaum GM; Sayer J; Hurt C; Dunphy C; et al; Department of
       Epidemiology, School of Public Health and Community; Medicine,
       University of Washington, Seattle 98195, USA.
 SO    AIDS. 1995 Nov;9(11):1255-62. Unique Identifier : AIDSLINE MED/96126180
 AB    OBJECTIVE: To determine the risk of developing high grade anal squamous
       intraepithelial neoplasia (HG-AIN) in relation to HIV infection and
       immunosuppression, after controlling for the effects of human
       papillomavirus (HPV) infection. DESIGN: Prospective cohort study of 158
       HIV-seropositive and 147 HIV-seronegative homosexual men presenting to a
       community-based clinic with initially negative anal cytologic and
       colposcopic findings. METHODS: Subjects completed self-administered
       questionnaires, underwent cytologic screening, and standardized unaided
       and colposcopic examination of the proximal anal canal for presence of
       abnormalities suggestive of AIN. Anal specimens were screened for HPV
       DNA. RESULTS: HG-AIN developed in eight (5.4%) and 24 (15.2%)
       HIV-seronegative and -seropositive men, respectively. Risk of HG-AIN
       among HIV-seronegative men was associated with detection of anal HPV
       types 16 or 18 by Southern transfer hybridization (STH), detection of
       HPV 16 or 18 at the lower levels by polymerase chain reaction but not by
       STH, and with number of positive HPV tests; HG-AIN risk among
       HIV-seropositive men was associated with detection of HPV 16 or 18 only
       by STH, detection of HPV types other than 16 or 18, CD4 count < or = 500
       x 10(6)/l, and number of positive HPV tests. HIV-induced
       immunosuppression remained an independent predictor of HG-AIN after
       adjusting for type and level of detection of HPV; HIV infection
       predicted HG-AIN risk after adjustment for number of positive HPV tests.
       CONCLUSIONS: The association of HG-AIN with HIV, independent of HPV
       type, level of HPV detection and number of positive HPV tests, suggests
       that this increased risk cannot be entirely explained by an effect of
       HIV on HPV detection. Future studies focusing on factors more specific
       to the local microenvironment in the anal canal should help clarify
       these issues.
 DE    Adult  Anus Neoplasms/*ETIOLOGY  Cohort Studies  Homosexuality, Male
       Human  HIV Infections/*COMPLICATIONS  Immunosuppression/*ADVERSE EFFECTS
       Male  Neoplasms, Squamous Cell/*ETIOLOGY  *Papillomavirus, Human
       Papovaviridae Infections/*COMPLICATIONS  Prospective Studies  Risk
       Factors  Support, U.S. Gov't, P.H.S.  Tumor Virus
       Infections/*COMPLICATIONS  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).