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Abstract no. WEPDB0103

Abstract no. WEPDB0103. Prevalence of anal Human Papillomavirus (HPV) infection and anal squamous intraepithelial lesions (SIL) in a Cohort of Brazilian HIV-infected women.

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Abstract no. WEPDB0103

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  1. Abstract no.WEPDB0103 Prevalence of anal Human Papillomavirus (HPV) infection and anal squamous intraepithelial lesions (SIL) in a Cohort of Brazilian HIV-infected women Beatriz Grinsztejn1, Ruth Khalili Friedman1, Valdilea Veloso1, Monica Derrico1, Cynthia B. Cunha1, Carina Barillo1, Brenda Hoagland1, Sandra Wagner1, AngelaC.V. de Andrade1, Andrea Cytryn1, José Eduardo Levi2, Thais Heinke3, Janice Mery C. de Oliveira Coelho1, Paula Mendes Luz1, Jose Ricardo Coutinho1 1 Fundação Oswaldo Cruz – Instituto de Pesquisa Clínica Evandro Chagas/IPEC, Rio de Janeiro, Stateof Rio de Janeiro, Brazil. 2 Laboratório de Virologia - Instituto de Medicina Tropical, Universidade de São Paulo, Stateof São Paulo, Brazil. 3SalomãoZoppiDiagnósticos

  2. Background • Anal cancer in specific populations, such as people living with HIV/AIDS, has been increasing at alarming rates. • The incidence of anal carcinoma (AC) has been increasing despite the implementation of ART, which has not been shown to consistently alter the course of HPV-associated anogenitaldisease

  3. Methods • Study Design and Population: Cross-sectional study conducted in the IPEC-FiocruzHIV+ women cohort in active follow-up between January 2011 and December 2012. Women aged ≥18 years without a history of anal cancer were accessed. • Data Collection: Structured interviews were performed to access sociodemographic characteristics and risk behaviors; data on HIV-related parameters and medical conditions were captured from the medical charts. • All procedures were performed after obtaining IRB approval and written informed consent from study participants.

  4. Methods Anal Liquid-based Cytology: Samples collected in ThinPrep™ solution. Results reported according to Bethesda criteria; HPV Testing using PapilloCheck: HR-HPV: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 26, 53, 66, 70, 73, 82 LR-HPV: 6, 11, 40, 42, 43, 44/55 Anal examination and High Resolution Anoscopy (HRA): Performed for women with an abnormal cytology result and/or visible hypercromic lesions on anal margin. Biopsies were performed as clinically required.

  5. Methods • Statistical Analysis: • Anal HPV testing results, cytology results and the frequency of histological AIN and anal cancer (margin and/or canal) were calculated as simple proportions. • Women who had normal cytology and no visible lesions were considered as negative for AIN. Histological results were considered for the final diagnostic. • If multiple biopsies were obtained, the highest grade was used to denote the lesion status at that visit. • The STATA/SE 10.1 software package was used in the analysis.

  6. Results Characteristics of participants in the IPEC/FIOCRUZ Women`s Cohort (N=816)

  7. Results Characteristics of participants in the IPEC/FIOCRUZ Women`s Cohort (N=816) < 200 45.8%

  8. Results • Anal cytology was abnormal in 245/816 (30%) women: • Of these, 204 (83.3%) were submitted to HRA.

  9. Results Prevalence of anal histological HPV-related lesions. a 41 women were not considered as they presented abnormal cytology results and did not come to HRA. Among all women with histological AIN2+, 7.3%, 70.9% and 21,8% had lesions only in the anal margin, only in the anal canal and in both sites, respectively.

  10. Prevalence of High risk HPV genotypes in all women (N=717)* * Total of women with available HPV genotyping results

  11. Prevalence of Low Risk HPV genotypes in all women (N=717)* * Total of women with available HPV genotyping results

  12. Conclusions The prevalence of abnormal anal cytology was high. Prevalence of histological AIN2+ may be underestimated as women with normal cytology were not referred to HRA. Systematic screening for HPV-related anal lesions among women is warranted and may impact the increasing incidence of anal cancer, although a screening algorithm is not yet defined. HIV+ women may benefit from the HPV vaccines already available. However, further studies are needed to investigate the role of other HPV types involved in high grade HPV-related lesions among HIV-infected women in developing countries.

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