We enrolled MSM who were aged 50+ during 2018-2022 in San Francisco, CA.
One hundred twenty-nine MSMLWH and 109 MSM-not-LWH participated. All participants had anal HPV DNA testing (Atila Biosystems) and high-resolution anoscopy with a biopsy of visible lesions.
Among MSMLWH, 47% had anal HSIL, 19% had HPV-16, and 51% had other oncogenic anal HPV types (excluding HPV-16). Among MSM-not-LWH, 37% had anal HSIL, 22% had HPV-16, and 34% had other oncogenic anal HPV types. Increasing age was not statistically associated with prevalent HSIL, HPV-16, or other oncogenic HPV infections in MSMLWH or MSM-not-LWH. HPV-16 (odds ratio: 45.1, 95% confidence interval: 15.8-129); other oncogenic HPV types (odds ratio: 5.95, 95% confidence interval: 2.74-12.9) were associated with increased odds of anal HSIL, adjusted for age, income, education, and HIV status.
The prevalence of oncogenic anal HPV, anal HPV-16, and anal HSIL remains very high in older MSMLWH and MSM-not-LWH. With recent evidence showing that treating anal HSIL prevents anal cancer, MSM aged 50+ should be considered for anal cancer screening.
方法:我们在旧金山注册了2018-2022年年龄在50岁以上的MSM,CA.
方法:参加了112名MSMLWH和109名MSM-not-LWH。所有参与者都进行了肛门HPVDNA检测(AtilaBiosystems)和高分辨率肛门镜检查,并进行了可见病变的活检。
结果:在MSMLWH中,47%有肛交HSIL,19%患有HPV-16,51%患有其他致癌肛门HPV类型(不包括HPV-16)。在MSM-非LWH中,37%有肛交HSIL,22%有HPV-16,34%有其他致癌肛门HPV类型。年龄增长与流行的HSIL没有统计学关联,MSMLWH或MSM-not-LWH中的HPV-16或其他致癌HPV感染。HPV-16(优势比:45.1,95%置信区间:15.8-129);其他致癌HPV类型(优势比:5.95,95%置信区间:2.74-12.9)与肛门HSIL的几率增加有关,根据年龄调整,收入,教育,和艾滋病毒状况。
结论:致癌肛门HPV的患病率,肛门HPV-16和肛门HSIL在老年MSMLWH和MSM-not-LWH中仍然很高。最近的证据表明,治疗肛门HSIL可以预防肛门癌,50岁以上的MSM应考虑用于肛门癌筛查。