Human Papillomavirus typing in a cohort of HIV-1-infected men in Milan, Italy

Objective: Highly onchogenic 16 and 18-HPV genotypes are the major cause of cervical cancers in women. Anal intraepithelial neoplasia (AIN), increasingly reported in HIV infected patients, is less characterized than cervical disease. This study want to focus the spectrum of human papillomaviruses in a cohort of HIV+ men. Methods: HIV/HPV co-infected male patients were recruited. Anal Pap smear, Hybrid-capture-II HPV test and HPV genotyping were performed. Tissue biopsies were collected in case of acetic white lesions or warts on high resolution anoscopy, unsatisfactory, ASC-US or ASC-H cytology. Results: Among the 172 samples amplified by PCR primers MY09/11, Pap smear was negative in 11.62%, L-SIL in 70.34%, H-SIL in 11.62%, ASC-US in 1.74%, and inadequate in 5.81%. Hybrid-capture-test was negative in 4.07%, LR were found in 12.79%, HR in 19.77% and HR/LR in 59.3%. The association of cytology/hybrid capture identified 98.25% of the samples positive on PCR. Histology on 98 patients was neg in 22.45%, AIN-1 in 70.41% and AIN 2-3 in 6.12%. In 1 case invasive cancer was demonstrated. HPV type specific prevalence of the 30 different HPV genotypes identified was 31.97% for HPV-6, 30.8% for HPV-16, 28.49% for HPV-11, 8.14% for HPV-58 and HPV-30. HPV-18 was found in 6 patients (3.49%). Multiple HPV genotypes were identified in 81 patients. Discussion: HPV 16-18, reported as the cause of >75% of all cervical carcinoma world wide, are reported with variable rates in anal carcinoma of HIV infected patients. According to a recent meta-analysis on HPV types among HIV infected women we observed a broader range of HPV genotypes, a high proportion of other than 16 serotypes, and higher proportion of multiple infections in HIV infected men compared to the reported rates in general population. Coinfection with multiple types of human papillomavirus should be monitored in view of type specific cancer protection of anti HPV vaccines.