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Background We sought to summarize human papillomavirus (HPV) vaccine efficacy/effectiveness (VE) against anal HPV infection and anal intraepithelial neoplasia (AIN). Methods We performed literature review and meta-analysis to estimate VE, stratified by age and analytic population (per-protocol efficacy [PPE] or intention-to-treat [ITT] population in clinical trials, or all participants in real-world studies). Results We identified 6 clinical trials and 8 real-world studies. In participants vaccinated at age ≤26 years (mainly human immunodeficiency virus [HIV]–negative individuals), significant VE against incident/prevalent anal HPV infection was reported in clinical trials, with a higher estimate in PPE (2 studies with 2390 participants; VE, 84% [95% confidence interval (CI), 77%–90%]; I 2 = 0%) than ITT (2 studies with 4885 participants; 55%, 39%–67%; I 2 = 46%) populations or in real-world studies (4 studies with 2375 participants; 77%, 40%–91%; I 2 = 81%). HPV vaccination at age ≤26 years was associated with significant VE in preventing persistent anal HPV infection and AIN. No significant VE against anal HPV infection or AIN was found in persons vaccinated at age >26 years (mainly people living with HIV). Conclusions There is strong evidence for high VE against anal HPV infection and AIN in HIV-negative individuals vaccinated at age ≤26 years. However, the lower impact in ITT than in PPE populations and the lack of significant effect in people living with HIV aged >26 years indicates that vaccines have the higher impact in populations with less sexual exposure to anal HPV. [ABSTRACT FROM AUTHOR]

Background Age-specific data on anal, and corresponding cervical, human papillomavirus (HPV) infection are needed to inform female anal cancer prevention. Methods We centrally reanalyzed individual-level data from 26 studies reporting HPV prevalence in paired anal and cervical samples by human immunodeficiency virus (HIV) status and age. For women with HIV (WWH) with anal high-grade squamous intraepithelial lesions or worse (HSIL+), we also investigated concurrent cervical cytopathology. Results In HIV-negative women, HPV16 prevalence decreased significantly with age, both at anus (4.3% at 15–24 years to 1.0% at ≥55 years; ptrend = 0.0026) and cervix (7.4% to 1.7%; ptrend < 0.0001). In WWH, HPV16 prevalence decreased with age at cervix (18.3% to 7.2%; ptrend = 0.0035) but not anus (11.5% to 13.9%; ptrend = 0.5412). Given anal HPV16 positivity, concurrent cervical HPV16 positivity also decreased with age, both in HIV-negative women (ptrend = 0.0005) and WWH (ptrend = 0.0166). Among 48 WWH with HPV16-positive anal HSIL+, 27 (56%) were cervical high-risk HPV-positive, including 8 with cervical HPV16, and 5 were cervical HSIL+. Conclusions Age-specific shifts in HPV16 prevalence from cervix to anus suggest that HPV infections in the anus persist longer, or occur later in life, than in the cervix, particularly in WWH. This is an important consideration when assessing the utility of cervical screening results to stratify anal cancer risk. [ABSTRACT FROM AUTHOR]

This result appears to be somewhat inconsistent with another important finding of Liu et al [[3]] (and of previous analyses [[5]]), namely that cervical HPV infection is a strong predictor of anal HPV infection and aHSIL. So, if not cervical screening results, then could perhaps routinely available HIV-related immune suppression be used to triage WLH (as well as other PLH) for anal cancer screening? In this respect, anal HPV16 infection was by far the strongest predictor of histological aHSIL, of which approximately one-third were diagnosed among WLH with HPV16-positive anal swabs in the report by Liu et al [[3]]. [Extracted from the article]

Background: Knowledge of human papillomavirus (HPV) transmission dynamics, which have important public health implications for designing HPV vaccination strategies, is scarce in undeveloped areas.Methods: From May to July 2014, 390 couples were enrolled from the general population in Liuzhou, China. Exfoliated cells from male penis shaft/glans penis/coronary sulcus (PGC) and perianal/anal canal (PA) sites and from female vaginal, vulvar, and PA sites were collected biannually for 1 year.Results: The HPV type-specific concordance rate between couples was 15.5% (95% confidence interval [CI], 8.5%-25.0%). For anogenital HPV transmission, the male-to-female transmission rate (11.5 [95% CI, 4.3-30.7] per 1000 person-months) was similar to the female-to-male transmission rate (11.3 [95% CI, 5.9-21.7] per 1000 person-months). The concordance rates between male PGC site and female vaginal, vulvar, and PA sites were 20.0%, 21.8%, and 14.9%, respectively, which were significantly higher than expected by chance. Infections transmitted from males to females seemed mainly originated from male genital sites, whereas for female-to-male transmission, the vaginal, vulvar, and PA sites might be all involved.Conclusions: Among the heterosexual couples with relatively conservative sexual behavior, the anogenital HPV transmission rate for females to males is similar to that of males to females. In addition to the vagina and vulva, the female PA site is also an important reservoir for HPV transmission. [ABSTRACT FROM AUTHOR]

Background: Cytomegalovirus (CMV) establishes a lifelong latent infection after primary infection and may reactivate periodically, with the shedding of infectious virus in body fluids. To better understand the prevalence and shedding model of CMV in immunocompetent seropositive women of childbearing age, a 6-month longitudinal study was conducted in healthy female college students., Methods: A total of 102 nonpregnant female college students aged 18-30 years were enrolled and followed up every 2 weeks for 6 months. Saliva and urine samples were collected at each visit. Serum samples were collected at the first and last visits., Results: All participants were positive for anti-CMV immunoglobulin G (IgG) at entry. During the 6-month period, 29.4% of participants (30 of 102) shed CMV intermittently in saliva or urine. At each visit, the CMV shedding prevalence varied from 2.0% to 10.4% and presented only in 1 bodily fluid. The viral load was low and did not induce marked antibody increases. The baseline anti-CMV IgG level was not found to be associated with viral shedding., Conclusions: CMV shedding in saliva and urine is common and intermittent and does not stimulate an anamnestic antibody response in seropositive immunocompetent women of childbearing age with a low risk of exposure to exogenous infectious sources.