Epidemiology of anal human papillomavirus infection and high-grade squamous intraepithelial lesions in 29 900 men according to HIV status, sexuality, and age: a collaborative pooled analysis of 64 studies

A new collaborative pooled analysis led by researchers from the International Agency for Research on Cancer (IARC) provides evidence of the high prevalence of anal human papillomavirus (HPV) infection in HIV-positive and HIV-negative men who have sex with men (MSM). The study was published in The Lancet HIV.

The researchers produced a comprehensive picture of anal HPV infection in 29 900 men from 64 studies before HPV vaccination, by evaluating the age-specific prevalence of anal HPV infection, high-grade squamous intraepithelial lesions (HSIL), and their combination, stratified by HIV status and sexuality. They found a rapid increase in the prevalence of anal HPV16 infection with age in both HIV-positive and HIV-negative MSM between the ages of 15 and 24 years; the HPV16 prevalence was consistently high at older ages. HIV infection and HIV-related immunosuppression had an amplifying effect on anal HPV16 infection in both MSM and men who have sex with women. HIV infection and degree of HIV immunosuppression were also significant predictors of the prevalence of anal HSIL and HPV16-positive anal HSIL in MSM.

These findings highlight the benefits of gender-neutral HPV vaccination before sexual debut over catch-up HPV vaccination, and pinpoint HIV-positive MSM as a priority for anal cancer screening research and initiatives.

Wei F, Gaisa MM, D’Souza G, Xia N, Giuliano AR, Hawes SE, et al.
Epidemiology of anal human papillomavirus infection and high-grade squamous intraepithelial lesions in 29 900 men according to HIV status, sexuality, and age: a collaborative pooled analysis of 64 studies.
Lancet HIV, Published online 30 July 2021;
https://doi.org/10.1016/S2352-3018(21)00108-9

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