19% in those without anal condylomata). Having anal condylomata was associated with higher prevalences of cytological abnormalities (83% vs. 32% in those without anal condylomata; OR 6.9; 95% CI 3.8–12.7) and high-grade squamous intraepithelial lesions (HSILs) (9% vs. 3% in those without
anal condylomata; OR 9.0; 95% CI 2.9–28.4) in the anal canal. HIV-infected men with anal condylomata were at risk of presenting HSILs and harbouring multiple HR HPV infections in the anal canal. Although MSM presented the highest prevalence of anal condylomata, heterosexual men also had a clinically important prevalence. Our findings emphasize the importance of screening and follow-up for condylomata in the anal canal in HIV-infected men. Human papillomavirus (HPV) types that infect the ano-genital tract can be divided into low-risk (LR) HPV types, RAD001 solubility dmso which are associated with Selleck FK866 the development of ano-genital condylomata,
and high-risk (HR) HPV types, which are implicated in the evolution of anal squamous cell cancer and its putative precursor, high-grade anal intraepithelial neoplasia (AIN) [1-3]. The association between genital warts and the presence of HPV infection has been widely described [4, 5]. Genital condylomata are benign lesions usually resulting from infection by HPV-6 or HPV-11. In contrast, HPV-16, HPV-18 and HPV-31 are associated with the development of high-grade dysplasia or carcinoma [5-7]. Cervical cytology is the most appropriate means of screening for precancerous lesions
and cervical HPV-related cancer . Currently, anal cytology is used as a screening tool for anal squamous lesions to detect AIN or anal cancer at an earlier stage [9, 10]. It is known 3-mercaptopyruvate sulfurtransferase that HIV-associated immunosuppression may increase the likelihood of development of both low-grade and high-grade HPV-related lesions. In addition, the longer life expectancies of the HIV-positive population as a result of highly active antiretroviral therapy may permit established high-risk HPV infections to progress to anal cancer . The transmission of HPV depends on sexual behaviour, and HPV infection is strongly related to the lifetime number of sexual partners as well as to the practice of receptive anal intercourse (RAI) in men having sex with men (MSM) . The HIV-positive population, and in particular MSM, have a high risk of developing anal condylomata and precancerous lesions or ano-genital neoplasia . Most condylomata lesions will spontaneously resolve in the immunocompetent population, but immune-compromised patients with condylomata (especially HIV-infected patients) generally require therapy that is painful and expensive, and also have a high risk of recurrence [14-16].