Factors associated with prevalent abnormal anal cytology in a large cohort of HIV-infected adults in the United States

L. Conley; T. Bush; T. M. Darragh; J. M. Palefsky; E. R. Unger; P. Patel; E. M. Kojic; S. Cu-Uvin; H. Martin; E. T. Overton; J. Hammer; K. Henry; C. Vellozzi; K. Wood; J. T. Brooks

doi:10.1086/656775

Factors associated with prevalent abnormal anal cytology in a large cohort of HIV-infected adults in the United States

L. Conley, T. Bush, T. M. Darragh, J. M. Palefsky, E. R. Unger, P. Patel, E. M. Kojic, S. Cu-Uvin, H. Martin, E. T. Overton, J. Hammer, K. Henry, C. Vellozzi, K. Wood, J. T. Brooks

Medicine - Infectious Disease and International Medicine

Research output: Contribution to journal › Article › peer-review

62 Scopus citations

Abstract

Background. The prevalence of and risk factors for abnormal anal cytology among men and women with human immunodeficiency virus (HIV) infection have not been extensively investigated. Methods. The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN study) is a prospective cohort study of HIV-infected patients in 4 US cities. Baseline questionnaires were administered and anal samples for cytology and human papillomavirus (HPV) detection and genotyping were collected. Results. Among 471 men and 150 women (median age, 41 years), 78% of participants were receiving combination antiretroviral therapy, 41% had a CD4⁺ cell count of ≥500 cells/μL, and 71% had an HIV RNA viral load of <400 copies/mL. The anal cytology results were as follows: 336 participants (54%) had negative results, 96 participants (15%) had atypical squamous cells, 149 participants (24%) had low-grade squamous intraepithelial lesions, and 40 participants (6%) had high-grade squamous intraepithelial lesions. In a multivariate analysis, abnormal anal cytology was associated with number of high-risk and low-risk HPV types (adjusted odds ratio [AOR] for both, 1.28; P < .001), nadir CD4 ⁺ cell count of <50 cells/μL (AOR, 2.38; P = .001), baseline CD4⁺ cell count of <500 cells/μL (AOR, 1.75; P = .004), and ever having receptive anal intercourse (AOR, 2.51; P < .001). Conclusion. HIV-infected persons with multiple anal HPV types or a nadir CD4⁺ cell count of <50 cells/μL have an increased risk for abnormal anal cytology.

Original language	English (US)
Pages (from-to)	1567-1576
Number of pages	10
Journal	Journal of Infectious Diseases
Volume	202
Issue number	10
DOIs	https://doi.org/10.1086/656775
State	Published - Nov 15 2010

Bibliographical note

Funding Information:
Potential conflicts of interest: none reported. Presented in part: 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles, CA, 28 February 2007. Financial support: Centers for Disease Control and Prevention (contracts 200-2002-00610/00611/00612/00613 and 200-2007-3633/23634/23635/23636). The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. a Study group members are listed at the end of the text.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1086/656775

Find It

Find It at U of M Libraries

Cite this

Conley, L., Bush, T., Darragh, T. M., Palefsky, J. M., Unger, E. R., Patel, P., Kojic, E. M., Cu-Uvin, S., Martin, H., Overton, E. T., Hammer, J., Henry, K., Vellozzi, C., Wood, K., & Brooks, J. T. (2010). Factors associated with prevalent abnormal anal cytology in a large cohort of HIV-infected adults in the United States. Journal of Infectious Diseases, 202(10), 1567-1576. https://doi.org/10.1086/656775

Conley, L, Bush, T, Darragh, TM, Palefsky, JM, Unger, ER, Patel, P, Kojic, EM, Cu-Uvin, S, Martin, H, Overton, ET, Hammer, J, Henry, K, Vellozzi, C, Wood, K & Brooks, JT 2010, 'Factors associated with prevalent abnormal anal cytology in a large cohort of HIV-infected adults in the United States', Journal of Infectious Diseases, vol. 202, no. 10, pp. 1567-1576. https://doi.org/10.1086/656775

@article{dc71683c7b6540d989147873016d8752,

title = "Factors associated with prevalent abnormal anal cytology in a large cohort of HIV-infected adults in the United States",

abstract = "Background. The prevalence of and risk factors for abnormal anal cytology among men and women with human immunodeficiency virus (HIV) infection have not been extensively investigated. Methods. The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN study) is a prospective cohort study of HIV-infected patients in 4 US cities. Baseline questionnaires were administered and anal samples for cytology and human papillomavirus (HPV) detection and genotyping were collected. Results. Among 471 men and 150 women (median age, 41 years), 78% of participants were receiving combination antiretroviral therapy, 41% had a CD4+ cell count of ≥500 cells/μL, and 71% had an HIV RNA viral load of <400 copies/mL. The anal cytology results were as follows: 336 participants (54%) had negative results, 96 participants (15%) had atypical squamous cells, 149 participants (24%) had low-grade squamous intraepithelial lesions, and 40 participants (6%) had high-grade squamous intraepithelial lesions. In a multivariate analysis, abnormal anal cytology was associated with number of high-risk and low-risk HPV types (adjusted odds ratio [AOR] for both, 1.28; P < .001), nadir CD4 + cell count of <50 cells/μL (AOR, 2.38; P = .001), baseline CD4+ cell count of <500 cells/μL (AOR, 1.75; P = .004), and ever having receptive anal intercourse (AOR, 2.51; P < .001). Conclusion. HIV-infected persons with multiple anal HPV types or a nadir CD4+ cell count of <50 cells/μL have an increased risk for abnormal anal cytology.",

author = "L. Conley and T. Bush and Darragh, {T. M.} and Palefsky, {J. M.} and Unger, {E. R.} and P. Patel and Kojic, {E. M.} and S. Cu-Uvin and H. Martin and Overton, {E. T.} and J. Hammer and K. Henry and C. Vellozzi and K. Wood and Brooks, {J. T.}",

note = "Funding Information: Potential conflicts of interest: none reported. Presented in part: 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles, CA, 28 February 2007. Financial support: Centers for Disease Control and Prevention (contracts 200-2002-00610/00611/00612/00613 and 200-2007-3633/23634/23635/23636). The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. a Study group members are listed at the end of the text.",

year = "2010",

month = nov,

day = "15",

doi = "10.1086/656775",

language = "English (US)",

volume = "202",

pages = "1567--1576",

journal = "Journal of Infectious Diseases",

issn = "0022-1899",

publisher = "Oxford University Press",

number = "10",

}

TY - JOUR

T1 - Factors associated with prevalent abnormal anal cytology in a large cohort of HIV-infected adults in the United States

AU - Conley, L.

AU - Bush, T.

AU - Darragh, T. M.

AU - Palefsky, J. M.

AU - Unger, E. R.

AU - Patel, P.

AU - Kojic, E. M.

AU - Cu-Uvin, S.

AU - Martin, H.

AU - Overton, E. T.

AU - Hammer, J.

AU - Henry, K.

AU - Vellozzi, C.

AU - Wood, K.

AU - Brooks, J. T.

N1 - Funding Information: Potential conflicts of interest: none reported. Presented in part: 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles, CA, 28 February 2007. Financial support: Centers for Disease Control and Prevention (contracts 200-2002-00610/00611/00612/00613 and 200-2007-3633/23634/23635/23636). The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. a Study group members are listed at the end of the text.

PY - 2010/11/15

Y1 - 2010/11/15

N2 - Background. The prevalence of and risk factors for abnormal anal cytology among men and women with human immunodeficiency virus (HIV) infection have not been extensively investigated. Methods. The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN study) is a prospective cohort study of HIV-infected patients in 4 US cities. Baseline questionnaires were administered and anal samples for cytology and human papillomavirus (HPV) detection and genotyping were collected. Results. Among 471 men and 150 women (median age, 41 years), 78% of participants were receiving combination antiretroviral therapy, 41% had a CD4+ cell count of ≥500 cells/μL, and 71% had an HIV RNA viral load of <400 copies/mL. The anal cytology results were as follows: 336 participants (54%) had negative results, 96 participants (15%) had atypical squamous cells, 149 participants (24%) had low-grade squamous intraepithelial lesions, and 40 participants (6%) had high-grade squamous intraepithelial lesions. In a multivariate analysis, abnormal anal cytology was associated with number of high-risk and low-risk HPV types (adjusted odds ratio [AOR] for both, 1.28; P < .001), nadir CD4 + cell count of <50 cells/μL (AOR, 2.38; P = .001), baseline CD4+ cell count of <500 cells/μL (AOR, 1.75; P = .004), and ever having receptive anal intercourse (AOR, 2.51; P < .001). Conclusion. HIV-infected persons with multiple anal HPV types or a nadir CD4+ cell count of <50 cells/μL have an increased risk for abnormal anal cytology.

AB - Background. The prevalence of and risk factors for abnormal anal cytology among men and women with human immunodeficiency virus (HIV) infection have not been extensively investigated. Methods. The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN study) is a prospective cohort study of HIV-infected patients in 4 US cities. Baseline questionnaires were administered and anal samples for cytology and human papillomavirus (HPV) detection and genotyping were collected. Results. Among 471 men and 150 women (median age, 41 years), 78% of participants were receiving combination antiretroviral therapy, 41% had a CD4+ cell count of ≥500 cells/μL, and 71% had an HIV RNA viral load of <400 copies/mL. The anal cytology results were as follows: 336 participants (54%) had negative results, 96 participants (15%) had atypical squamous cells, 149 participants (24%) had low-grade squamous intraepithelial lesions, and 40 participants (6%) had high-grade squamous intraepithelial lesions. In a multivariate analysis, abnormal anal cytology was associated with number of high-risk and low-risk HPV types (adjusted odds ratio [AOR] for both, 1.28; P < .001), nadir CD4 + cell count of <50 cells/μL (AOR, 2.38; P = .001), baseline CD4+ cell count of <500 cells/μL (AOR, 1.75; P = .004), and ever having receptive anal intercourse (AOR, 2.51; P < .001). Conclusion. HIV-infected persons with multiple anal HPV types or a nadir CD4+ cell count of <50 cells/μL have an increased risk for abnormal anal cytology.

UR - http://www.scopus.com/inward/record.url?scp=78349253468&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78349253468&partnerID=8YFLogxK

U2 - 10.1086/656775

DO - 10.1086/656775

M3 - Article

C2 - 20925532

AN - SCOPUS:78349253468

SN - 0022-1899

VL - 202

SP - 1567

EP - 1576

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 10

ER -

Factors associated with prevalent abnormal anal cytology in a large cohort of HIV-infected adults in the United States

Abstract

Bibliographical note

UN SDGs

Publisher link

Find It

Other files and links

Fingerprint

Cite this