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High Prevalence of Anal High-Grade Squamous Intraepithelial Lesions, and Prevention Through Human Papillomavirus Vaccination, in Young Men Who Have Sex With Men Living With Human Immunodeficiency Virus.
- Source :
-
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2021 Oct 20; Vol. 73 (8), pp. 1388-1396. - Publication Year :
- 2021
-
Abstract
- Background: Men who have sex with men (MSM) are at high risk for human papillomavirus (HPV)-related anal cancer. Little is known about the prevalence of low-grade squamous intraepithelial lesions (LSILs) and the anal cancer precursor, high-grade squamous intraepithelial lesions (HSILs), among young MSM with HIV (MSMLWH). HPV vaccination is recommended in this group, but its safety, immunogenicity, and protection against vaccine-type HPV infection and associated LSILs/HSILs have not been studied.<br />Methods: Two hundred and sixty MSMLWH aged 18-26 years were screened at 17 US sites for a clinical trial of the quadrivalent (HPV6,11,16,18) HPV (qHPV) vaccine. Those without HSILs were vaccinated at 0, 2, and 6 months. Cytology, high-resolution anoscopy with biopsies of lesions, serology, and HPV testing of the mouth/penis/scrotum/anus/perianus were performed at screening/month 0 and months 7, 12, and 24.<br />Results: Among 260 MSMLWH screened, the most common reason for exclusion was detection of HSILs in 88/260 (34%). 144 MSMLWH were enrolled. 47% of enrollees were previously exposed to HPV16. No incident qHPV type-associated anal LSILs/HSILs were detected among men naive to that type, compared with 11.1, 2.2, 4.5, and 2.8 cases/100 person-years for HPV6,11,16,18-associated LSILs/HSILs, respectively, among those previously exposed to that type. qHPV was immunogenic and safe with no vaccine-associated serious adverse events.<br />Conclusions: 18-26-year-old MSMLWH naive to qHPV vaccine types were protected against incident qHPV type-associated LSILs/HSILs. Given their high prevalence of HSILs, there is an urgent need to vaccinate young MSMLWH before exposure to vaccine HPV types, before initiating sexual activity, and to perform catch-up vaccination.<br /> (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)
- Subjects :
- Adolescent
Adult
Anal Canal
HIV
Homosexuality, Male
Humans
Male
Papillomaviridae genetics
Prevalence
Sexual Behavior
Vaccination
Young Adult
Alphapapillomavirus
Anus Neoplasms epidemiology
Anus Neoplasms prevention & control
HIV Infections complications
HIV Infections prevention & control
Papillomavirus Infections complications
Papillomavirus Infections epidemiology
Papillomavirus Infections prevention & control
Papillomavirus Vaccines
Sexual and Gender Minorities
Squamous Intraepithelial Lesions
Subjects
Details
- Language :
- English
- ISSN :
- 1537-6591
- Volume :
- 73
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
- Publication Type :
- Academic Journal
- Accession number :
- 33991185
- Full Text :
- https://doi.org/10.1093/cid/ciab434