Journal article
Anal Cancer Precursor Lesions in HIV-Infected Persons: Tissue Human Papillomavirus Type Distribution and Impact on Treatment Response
Diseases of the colon & rectum, Vol.62(5), pp.579-585
05/01/2019
DOI: 10.1097/DCR.0000000000001307
PMID: 30570548
Abstract
BACKGROUND: Data on tissue distribution of human papillomavirus types in anal high-grade squamous intraepithelial lesions are limited and the impact on treatment outcomes poorly understood.
OBJECTIVE: We aimed to investigate potential predictors of treatment failure after electrocautery ablation, including human papillomavirus type(s) isolated from index lesions.
DESIGN: This was a retrospective cohort study.
SETTINGS: The study was conducted at a tertiary academic referral center in New York City.
PATIENTS: Seventy-nine HIV-infected patients with a diagnosis of anal high-grade squamous intraepithelial lesions between January 2009 and December 2012 were included, and genomic DNA was extracted from biopsy tissue.
MAIN OUTCOME MEASURES: The prevalence of human papillomavirus types in index lesions and surveillance biopsies after electrocautery ablation were analyzed to evaluate treatment response.
RESULTS: Of 79 anal high-grade squamous intraepithelial lesions, 71 (90%) tested positive for >= 1 human papillomavirus type; 8 (10%) had no human papillomavirus detected. The most common type was 16 (39%), followed by 33 (15%). Human papillomavirus type 18 was seen in 3%. Sixty-one patients (77%) underwent electrocautery ablation and had subsequent surveillance biopsies. Surveillance biopsies yielded benign findings or low-grade squamous intraepithelial lesions in 31 (51%) of 61 and recurrent high-grade squamous intraepithelial lesions in 30 (49%) of 61 patients (mean follow-up: 35 mo). Ablation response did not differ significantly based on baseline demographics, smoking history, history of anogenital warts, mean CD4(+) T-cell count, antiretroviral-therapy use, and HIV viral load (<50 copies/mL). The recurrence of high-grade lesions was not significantly associated with high-risk human papillomavirus types detected in index lesions.
LIMITATIONS: Human papillomavirus genotyping in surveillance biopsies was not performed.
CONCLUSIONS: Anal high-grade squamous intraepithelial lesions in HIV-infected patients contain a wide range of human papillomavirus types, and individual lesions commonly harbor multiple types concomitantly. Recurrence of anal high-grade squamous intraepithelial lesions after electrocautery ablation occurs frequently and is not affected by high-risk human papillomavirus types. See Video Abstract at http://links.lww.com/DCR/A833.
Details
- Title: Subtitle
- Anal Cancer Precursor Lesions in HIV-Infected Persons: Tissue Human Papillomavirus Type Distribution and Impact on Treatment Response
- Creators
- Takaaki Kobayashi - Mount Sinai Beth IsraelKeith Sigel - Icahn School of Medicine at Mount SinaiTamara Kalir - Icahn School of Medicine at Mount SinaiIain J. MacLeod - Harvard UniversityYuxin Liu - Icahn School of Medicine at Mount SinaiMichael Gaisa - Icahn School of Medicine at Mount Sinai
- Resource Type
- Journal article
- Publication Details
- Diseases of the colon & rectum, Vol.62(5), pp.579-585
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/DCR.0000000000001307
- PMID
- 30570548
- ISSN
- 0012-3706
- eISSN
- 1530-0358
- Number of pages
- 7
- Grant note
- K07CA180782 / National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Language
- English
- Date published
- 05/01/2019
- Academic Unit
- Infectious Diseases; Internal Medicine
- Record Identifier
- 9984362677002771
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