Journal article
Incidence and clearance of anal human papillomavirus infection in 16164 individuals, according to human immunodeficiency virus status, sex, and male sexuality: an international pooled analysis of 34 longitudinal studies
- Abstract:
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Background
Understanding the natural history of anal high-risk human papillomavirus (hrHPV) infection is key for designing anal cancer prevention programs but has not been systematically characterized.
Methods
We reanalyzed data from 34 studies including 16164 individuals in 6 risk groups defined by human immunodeficiency virus (HIV) status, sex, and male sexuality: men who have sex with men (MSM) and people with HIV (MSMWH), HIV-negative MSM, women with HIV (WWH), HIV-negative women, men who have sex with women (MSW) with HIV (MSWWH), and HIV-negative MSW. We used Markov models to estimate incidence and clearance of 13 hrHPV types and their determinants.
Results
Human papillomavirus (HPV) 16 had the highest incidence-clearance ratio of the hrHPV types. MSMWH had the highest hrHPV incidence (eg, 15.5% newly HPV-16 infected within 2 years), followed by HIV-negative MSM (7.5%), WWH (6.6%), HIV-negative women (2.9%), MSWWH (1.7%), and HIV-negative MSW (0.7%). Determinants of HPV-16 incidence included HIV status and number of sexual partners for MSM, women, and MSW, and anal sex behavior for MSM only. HPV-16 clearance was lower for people with HIV (PWH) and lower for prevalent than incident infection. Among MSM, increasing age was associated with lower clearance of prevalent, but not incident, HPV-16 infection.
Conclusions
This robust and unifying analysis of anal hrHPV natural history is essential to designing and predicting the impact of HPV vaccination and HPV-based screening programs on anal cancer prevention, particularly in MSM and PWH. Importantly, it demonstrates the higher carcinogenic potential of longstanding anal prevalent hrHPV infection than more recent incident infection.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Accepted manuscript, pdf, 713.6KB, Terms of use)
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- Publisher copy:
- 10.1093/cid/ciac581
Authors
+ National Institutes of Health
More from this funder
- Funder identifier:
- https://ror.org/01cwqze88
- Grant:
- 5UM1AI035043-23
+ National Cancer Institute
More from this funder
- Funder identifier:
- https://ror.org/040gcmg81
- Grant:
- R01CA169508-01A1
- Grant:
- K07CA225403
+ American Foundation for AIDS Research
More from this funder
- Funder identifier:
- https://ror.org/02jesmk44
- Grant:
- 108520-52-IGTA
- Grant:
- 108893-55-IPTA
+ National Institute of Allergy and Infectious Diseases
More from this funder
- Funder identifier:
- https://ror.org/043z4tv69
- Grant:
- 5U01AI0699007-07
- Grant:
- 5U01AI0699007-08
- Publisher:
- Oxford University Press
- Journal:
- Clinical Infectious Diseases More from this journal
- Volume:
- 76
- Issue:
- 3
- Pages:
- e692-e701
- Place of publication:
- United States
- Publication date:
- 2022-07-23
- Acceptance date:
- 2022-06-29
- DOI:
- EISSN:
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1537-6591
- ISSN:
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1058-4838
- Pmid:
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35869839
Terms of use
- Copyright holder:
- Wei et al.
- Copyright date:
- 2022
- Rights statement:
- © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved.
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from Oxford University Press at https://dx.doi.org/10.1093/cid/ciac581
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