An anal cancer screening program for MSM in Italy: Prevalence of multiple HPV types and vaccine-targeted infections

Research output: Contribution to journalArticle

Abstract

Background: Elevated HPV infection rates have been described in HIV-positive males, placing these subjects at high risk of anal neoplasia. Bivalent, quadrivalent, and nonavalent vaccines to prevent HPV infection have been developed, and recently proposed for gender-neutral immunization programs. Objectives: In order to estimate the benefit that could be obtained by vaccination of HIV-positive men who have sex with men (MSM), we aimed at describing the frequency of multiple and vaccine-targeted HPV infections in MSM enrolled in an anal cancer screening program. Study design: The anal cancer screening program was conducted between July 2009 and October 2012. Mucosal anal samples were tested for HPV DNA using MY09/MY11 PCR primers and, if positive, genotyped using the CLART2HPV Clinical Array (35HPV types). Results: A total of 220 MSM were screened and 88.6% were positive for HPV DNA: in 86.5% at least one high-risk (HR) type was found and in 13% only low-risk (LR) HPV were found. Multiple infections accounted for 84.5% of HPV DNA-positive cases and overall 160 different HPV genotype combinations were recognized (only three combinations were detected in more than one patient each). Based on strain coverage, at least one vaccine-targeted HPV type was found in 38.9%, 64%, and 78.4% of cases when considering bivalent, quadrivalent and nonavalent vaccines, respectively. At least one HR vaccine-targeted strain was found in 39% of MSM for bivalent and quadrivalent vaccines, and in 64% of cases for nonavalent prevention. Conclusions: Anal HPV infections in unvaccinated mostly HIV-infected MSM are highly prevalent. The majority of this population has multiple infections with an extremely heterogeneous number of genotype combinations. The nonavalent vaccine could theoretically have prevented a minimum of one HR HPV type in two thirds of subjects.

Original languageEnglish
Pages (from-to)49-54
Number of pages6
JournalJournal of Clinical Virology
Volume72
DOIs
Publication statusPublished - Nov 1 2015

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Anus Neoplasms
Papillomavirus Vaccines
Early Detection of Cancer
Italy
Vaccines
Infection
HIV
DNA
Genotype
Immunization Programs
Vaccination
Polymerase Chain Reaction
Population
Neoplasms

Keywords

  • HIV
  • Human papillomavirus
  • MSM
  • Multiple infections
  • Vaccine-targeted infection
  • Vaccines

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

@article{178689aa09fd4f698f5487dda725381f,
title = "An anal cancer screening program for MSM in Italy: Prevalence of multiple HPV types and vaccine-targeted infections",
abstract = "Background: Elevated HPV infection rates have been described in HIV-positive males, placing these subjects at high risk of anal neoplasia. Bivalent, quadrivalent, and nonavalent vaccines to prevent HPV infection have been developed, and recently proposed for gender-neutral immunization programs. Objectives: In order to estimate the benefit that could be obtained by vaccination of HIV-positive men who have sex with men (MSM), we aimed at describing the frequency of multiple and vaccine-targeted HPV infections in MSM enrolled in an anal cancer screening program. Study design: The anal cancer screening program was conducted between July 2009 and October 2012. Mucosal anal samples were tested for HPV DNA using MY09/MY11 PCR primers and, if positive, genotyped using the CLART2HPV Clinical Array (35HPV types). Results: A total of 220 MSM were screened and 88.6{\%} were positive for HPV DNA: in 86.5{\%} at least one high-risk (HR) type was found and in 13{\%} only low-risk (LR) HPV were found. Multiple infections accounted for 84.5{\%} of HPV DNA-positive cases and overall 160 different HPV genotype combinations were recognized (only three combinations were detected in more than one patient each). Based on strain coverage, at least one vaccine-targeted HPV type was found in 38.9{\%}, 64{\%}, and 78.4{\%} of cases when considering bivalent, quadrivalent and nonavalent vaccines, respectively. At least one HR vaccine-targeted strain was found in 39{\%} of MSM for bivalent and quadrivalent vaccines, and in 64{\%} of cases for nonavalent prevention. Conclusions: Anal HPV infections in unvaccinated mostly HIV-infected MSM are highly prevalent. The majority of this population has multiple infections with an extremely heterogeneous number of genotype combinations. The nonavalent vaccine could theoretically have prevented a minimum of one HR HPV type in two thirds of subjects.",
keywords = "HIV, Human papillomavirus, MSM, Multiple infections, Vaccine-targeted infection, Vaccines",
author = "Garbuglia, {Anna Rosa} and Marco Gentile and Nonno, {Franca Del} and Patrizia Lorenzini and Daniele Lapa and Federico Lupi and Carmela Pinnetti and Andrea Baiocchini and Raffaella Libertone and Stefania Cicalini and Capobianchi, {Maria Rosaria} and Adriana Ammassari",
year = "2015",
month = "11",
day = "1",
doi = "10.1016/j.jcv.2015.09.001",
language = "English",
volume = "72",
pages = "49--54",
journal = "Journal of Clinical Virology",
issn = "1386-6532",
publisher = "Elsevier",

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TY - JOUR

T1 - An anal cancer screening program for MSM in Italy

T2 - Prevalence of multiple HPV types and vaccine-targeted infections

AU - Garbuglia, Anna Rosa

AU - Gentile, Marco

AU - Nonno, Franca Del

AU - Lorenzini, Patrizia

AU - Lapa, Daniele

AU - Lupi, Federico

AU - Pinnetti, Carmela

AU - Baiocchini, Andrea

AU - Libertone, Raffaella

AU - Cicalini, Stefania

AU - Capobianchi, Maria Rosaria

AU - Ammassari, Adriana

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background: Elevated HPV infection rates have been described in HIV-positive males, placing these subjects at high risk of anal neoplasia. Bivalent, quadrivalent, and nonavalent vaccines to prevent HPV infection have been developed, and recently proposed for gender-neutral immunization programs. Objectives: In order to estimate the benefit that could be obtained by vaccination of HIV-positive men who have sex with men (MSM), we aimed at describing the frequency of multiple and vaccine-targeted HPV infections in MSM enrolled in an anal cancer screening program. Study design: The anal cancer screening program was conducted between July 2009 and October 2012. Mucosal anal samples were tested for HPV DNA using MY09/MY11 PCR primers and, if positive, genotyped using the CLART2HPV Clinical Array (35HPV types). Results: A total of 220 MSM were screened and 88.6% were positive for HPV DNA: in 86.5% at least one high-risk (HR) type was found and in 13% only low-risk (LR) HPV were found. Multiple infections accounted for 84.5% of HPV DNA-positive cases and overall 160 different HPV genotype combinations were recognized (only three combinations were detected in more than one patient each). Based on strain coverage, at least one vaccine-targeted HPV type was found in 38.9%, 64%, and 78.4% of cases when considering bivalent, quadrivalent and nonavalent vaccines, respectively. At least one HR vaccine-targeted strain was found in 39% of MSM for bivalent and quadrivalent vaccines, and in 64% of cases for nonavalent prevention. Conclusions: Anal HPV infections in unvaccinated mostly HIV-infected MSM are highly prevalent. The majority of this population has multiple infections with an extremely heterogeneous number of genotype combinations. The nonavalent vaccine could theoretically have prevented a minimum of one HR HPV type in two thirds of subjects.

AB - Background: Elevated HPV infection rates have been described in HIV-positive males, placing these subjects at high risk of anal neoplasia. Bivalent, quadrivalent, and nonavalent vaccines to prevent HPV infection have been developed, and recently proposed for gender-neutral immunization programs. Objectives: In order to estimate the benefit that could be obtained by vaccination of HIV-positive men who have sex with men (MSM), we aimed at describing the frequency of multiple and vaccine-targeted HPV infections in MSM enrolled in an anal cancer screening program. Study design: The anal cancer screening program was conducted between July 2009 and October 2012. Mucosal anal samples were tested for HPV DNA using MY09/MY11 PCR primers and, if positive, genotyped using the CLART2HPV Clinical Array (35HPV types). Results: A total of 220 MSM were screened and 88.6% were positive for HPV DNA: in 86.5% at least one high-risk (HR) type was found and in 13% only low-risk (LR) HPV were found. Multiple infections accounted for 84.5% of HPV DNA-positive cases and overall 160 different HPV genotype combinations were recognized (only three combinations were detected in more than one patient each). Based on strain coverage, at least one vaccine-targeted HPV type was found in 38.9%, 64%, and 78.4% of cases when considering bivalent, quadrivalent and nonavalent vaccines, respectively. At least one HR vaccine-targeted strain was found in 39% of MSM for bivalent and quadrivalent vaccines, and in 64% of cases for nonavalent prevention. Conclusions: Anal HPV infections in unvaccinated mostly HIV-infected MSM are highly prevalent. The majority of this population has multiple infections with an extremely heterogeneous number of genotype combinations. The nonavalent vaccine could theoretically have prevented a minimum of one HR HPV type in two thirds of subjects.

KW - HIV

KW - Human papillomavirus

KW - MSM

KW - Multiple infections

KW - Vaccine-targeted infection

KW - Vaccines

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