Abstract：
Anal cancer is caused by human papillomavirus (HPV), particularly HPV-16, and is preceded by anal high-grade squamous intraepithelial lesions (HSILs). The incidence of anal cancer is highest among men who have sex with men (MSM) living with HIV (MSMLWH) and increases with age. However, most previous studies of anal HPV infection and anal HSIL were performed on men under 50 years old, and relatively little is known about HSIL among older MSMLWH or MSM not living with HIV (MSM-Not-LWH).
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.
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.
摘要：
背景：肛门癌是由人乳头瘤病毒（HPV）引起的，尤其是HPV-16，并且在肛门高度鳞状上皮内病变（HSIL）之前。在男男性行为者（MSM）感染HIV（MSMLWH）的男性中，肛门癌的发病率最高，并且随着年龄的增长而增加。然而,以前大多数关于肛门HPV感染和肛门HSIL的研究都是在50岁以下的男性身上进行的，在老年MSMLWH或未感染HIV的MSM（MSM-Not-LWH）中，对HSIL的了解相对较少。
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。
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。
