TY - JOUR
T1 - Anal squamous intraepithelial lesions (SILs) in human immunodeficiency virus-positive men who have sex with men
T2 - Incidence and risk factors of SIL and of progression and clearance of low-grade SILs
AU - Jongen, Vita W
AU - Richel, O
AU - Marra, E
AU - Siegenbeek van Heukelom, M L
AU - van Eeden, A
AU - de Vries, H J C
AU - Cairo, I
AU - Prins, J M
AU - Schim van der Loeff, Maarten F
N1 - Funding Information: Financial support. This study was supported by Aidsfonds (grant 2014029; file P11119) and the DDL Diagnostic Laboratory. Funding Information: from Medicine, outside the scope of the current work. J. M. P. received research funding from the Netherlands Organisation for Health Research and Development for human papillomavirus (HPV) vaccine studies, outside the scope of the current work. The institution of M. F. S. v. d. L. received study funding from Sanofi Pasteur MSD, research funding from Janssen Infectious Diseases and Vaccines, and an in-kind contribution for an HPV study from Stichting Pathologie Onderzoek en Ontwikkeling. M. F. S. v. d. L. was a coinvestigator in a Merck-funded, investigator-initiated study and an investigator on a Sanofi Pasteur MSD–sponsored trial, and he served on a vaccine advisory board for GSK. Publisher Copyright: © 2020 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/6/16
Y1 - 2020/6/16
N2 - Background. Human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) are at risk of anal squamous cell carcinoma. Data are limited on the natural history of the precursor to this carcinoma, anal squamous intraepithelial lesions (SILs). Methods. HIV-positive MSM were screened for histopathological SILs by means of high-resolution anoscopy (HRA). For participants without SILs at baseline, we estimated the cumulative incidence and risk factors for SILs. For those with low-grade SILs (LSILs) at baseline, the risk of progression to high-grade SILs (HSILs) and the clearance rate were estimated at the lesion level. Results. Of 807 men without SILs at baseline, 107 underwent follow-up HRA between 1 to 4.5 years later. At the second visit 18 men (16.8%) showed LSIL, and 25 (23.4%) HSIL. Age was associated with incident LSILs (adjusted odds ratio [aOR], 2.10 per 10-year increase in age; P =.01). Of 393 men with LSILs at baseline, 114 underwent follow-up HRA 0.5 to 2.5 years later. Of the 177 LSILs found at baseline, 87 (49.2%) had cleared at the second visit, and 29 (16.4%) had progressed to HSILs. Conclusion. Incident LSILs and HSILs were common during follow-up among HIV-positive MSM without dysplasia at baseline. Among men with LSILs at baseline, nearly half of these lesions cleared, and a small portion progressed.
AB - Background. Human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) are at risk of anal squamous cell carcinoma. Data are limited on the natural history of the precursor to this carcinoma, anal squamous intraepithelial lesions (SILs). Methods. HIV-positive MSM were screened for histopathological SILs by means of high-resolution anoscopy (HRA). For participants without SILs at baseline, we estimated the cumulative incidence and risk factors for SILs. For those with low-grade SILs (LSILs) at baseline, the risk of progression to high-grade SILs (HSILs) and the clearance rate were estimated at the lesion level. Results. Of 807 men without SILs at baseline, 107 underwent follow-up HRA between 1 to 4.5 years later. At the second visit 18 men (16.8%) showed LSIL, and 25 (23.4%) HSIL. Age was associated with incident LSILs (adjusted odds ratio [aOR], 2.10 per 10-year increase in age; P =.01). Of 393 men with LSILs at baseline, 114 underwent follow-up HRA 0.5 to 2.5 years later. Of the 177 LSILs found at baseline, 87 (49.2%) had cleared at the second visit, and 29 (16.4%) had progressed to HSILs. Conclusion. Incident LSILs and HSILs were common during follow-up among HIV-positive MSM without dysplasia at baseline. Among men with LSILs at baseline, nearly half of these lesions cleared, and a small portion progressed.
KW - AIN
KW - Anal intraepithelial neoplasia
KW - Anal neoplasms
KW - HIV
KW - MSM
KW - Men who have sex with men
KW - Squamous intraepithelial lesions
UR - http://www.scopus.com/inward/record.url?scp=85079732444&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/infdis/jiz614
DO - https://doi.org/10.1093/infdis/jiz614
M3 - Article
C2 - 31755920
SN - 0022-1899
VL - 222
SP - 62
EP - 73
JO - Journal of infectious diseases
JF - Journal of infectious diseases
IS - 1
ER -