Risk factors of high-grade anal intraepithelial neoplasia recurrence in HIV-infected MSM

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Joaquin Burgos1, Adria Curran, Stefania Landolfi

  • 1aInfectious Diseases Department bAnatomical Pathology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR) cInternal Medicine Department, Hospital Universitari del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.

AIDS (London, England)
|March 3, 2017
PubMed
Abstract

Insights

High-grade anal intraepithelial neoplasia (HGAIN) frequently recurs in HIV-infected men who have sex with men (MSM). Regular high-resolution anoscopy (HRA) follow-up is crucial for early detection and management.

Area of Science:

  • Oncology
  • Infectious Diseases
  • Public Health

Background:

  • High-grade anal intraepithelial neoplasia (HGAIN) is a precursor to anal cancer.
  • HIV-infected men who have sex with men (MSM) have a significantly higher risk of HGAIN and its recurrence.
  • Understanding recurrence risk factors is vital for effective patient management.

Purpose of the Study:

  • To identify risk factors associated with HGAIN recurrence in HIV-infected MSM.
  • To evaluate the effectiveness of different diagnostic methods for detecting HGAIN recurrence.
  • To inform follow-up strategies for this high-risk population.

Main Methods:

  • A cohort of 100 HIV-infected MSM with treated HGAIN was followed for a mean of 17.6 months.
  • Participants underwent regular anal cytology, human papillomavirus (HPV) testing, and high-resolution anoscopy (HRA).
  • Kaplan-Meier analysis and Cox proportional hazards regression were used to assess recurrence and risk factors.

Main Results:

  • HGAIN recurred in 39% of patients within 24 months.
  • Risk factors for recurrence included hepatitis C antibodies, low nadir CD4 count (<200 cells/μl), extensive HGAIN lesions, and infection with multiple oncogenic HPV strains.
  • HRA demonstrated 100% sensitivity for detecting recurrence.

Conclusions:

  • The risk of HGAIN recurrence is substantial in HIV-infected MSM.
  • Post-treatment surveillance is essential for this population.
  • Direct high-resolution anoscopy (HRA) is the most sensitive method for detecting HGAIN recurrence.

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