Cytological anal squamous intraepithelial lesions associated with anal high-risk human papillomavirus infections among men Who have sex with men in northern Thailand

© 2016 Ruanpeng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background: Anal cancer, one of human pap...

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Main Authors: Ruanpeng D., Chariyalertsak S., Kaewpoowat Q., Supindham T., Settakorn J., Sukpan K., Utaipat U., Miura T., Kosashunhanan N., Saokhieo P., Songsupa R., Wongthanee A.
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Published: 2017
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/41911
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spelling th-cmuir.6653943832-419112017-09-28T04:24:08Z Cytological anal squamous intraepithelial lesions associated with anal high-risk human papillomavirus infections among men Who have sex with men in northern Thailand Ruanpeng D. Chariyalertsak S. Kaewpoowat Q. Supindham T. Settakorn J. Sukpan K. Utaipat U. Miura T. Kosashunhanan N. Saokhieo P. Songsupa R. Wongthanee A. © 2016 Ruanpeng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background: Anal cancer, one of human papillomavirus (HPV) related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM) and HIV-infected (HIV+) persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL) using Papanicolau (Pap) screening among MSM in northern Thailand and its associated factors. Methods: Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification. Results: Mean age was 27.2 years (range 18-54). Overall, 86 (43.0%) had ASIL: 28 (14.2%) with atypical cells of undetermined significance (ASCUS), 1 (0.5%) with atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 56 (28.4%) with low-grade squamous intraepithelial lesion (LSIL), and 1 (0.5%) with high-grade squamous intraepithelial lesion (HSIL). ASIL was associated by univariate analysis (p ≤ 0.05) with older age, gender identity other than bisexual (i.e., gay men and transgender women), rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002) and HIV infection (p = 0.01). Conclusions: ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA), not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population. 2017-09-28T04:24:08Z 2017-09-28T04:24:08Z 2016-05-01 Journal 2-s2.0-84971472943 10.1371/journal.pone.0156280 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84971472943&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/41911
institution Chiang Mai University
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country Thailand
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description © 2016 Ruanpeng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background: Anal cancer, one of human papillomavirus (HPV) related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM) and HIV-infected (HIV+) persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL) using Papanicolau (Pap) screening among MSM in northern Thailand and its associated factors. Methods: Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification. Results: Mean age was 27.2 years (range 18-54). Overall, 86 (43.0%) had ASIL: 28 (14.2%) with atypical cells of undetermined significance (ASCUS), 1 (0.5%) with atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 56 (28.4%) with low-grade squamous intraepithelial lesion (LSIL), and 1 (0.5%) with high-grade squamous intraepithelial lesion (HSIL). ASIL was associated by univariate analysis (p ≤ 0.05) with older age, gender identity other than bisexual (i.e., gay men and transgender women), rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002) and HIV infection (p = 0.01). Conclusions: ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA), not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.
format Journal
author Ruanpeng D.
Chariyalertsak S.
Kaewpoowat Q.
Supindham T.
Settakorn J.
Sukpan K.
Utaipat U.
Miura T.
Kosashunhanan N.
Saokhieo P.
Songsupa R.
Wongthanee A.
spellingShingle Ruanpeng D.
Chariyalertsak S.
Kaewpoowat Q.
Supindham T.
Settakorn J.
Sukpan K.
Utaipat U.
Miura T.
Kosashunhanan N.
Saokhieo P.
Songsupa R.
Wongthanee A.
Cytological anal squamous intraepithelial lesions associated with anal high-risk human papillomavirus infections among men Who have sex with men in northern Thailand
author_facet Ruanpeng D.
Chariyalertsak S.
Kaewpoowat Q.
Supindham T.
Settakorn J.
Sukpan K.
Utaipat U.
Miura T.
Kosashunhanan N.
Saokhieo P.
Songsupa R.
Wongthanee A.
author_sort Ruanpeng D.
title Cytological anal squamous intraepithelial lesions associated with anal high-risk human papillomavirus infections among men Who have sex with men in northern Thailand
title_short Cytological anal squamous intraepithelial lesions associated with anal high-risk human papillomavirus infections among men Who have sex with men in northern Thailand
title_full Cytological anal squamous intraepithelial lesions associated with anal high-risk human papillomavirus infections among men Who have sex with men in northern Thailand
title_fullStr Cytological anal squamous intraepithelial lesions associated with anal high-risk human papillomavirus infections among men Who have sex with men in northern Thailand
title_full_unstemmed Cytological anal squamous intraepithelial lesions associated with anal high-risk human papillomavirus infections among men Who have sex with men in northern Thailand
title_sort cytological anal squamous intraepithelial lesions associated with anal high-risk human papillomavirus infections among men who have sex with men in northern thailand
publishDate 2017
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84971472943&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/41911
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