Barcelona 2013
Menu
AIDSImpact.com
Conference Details
Authors
International Committee
Plenary Speakers
Presenting Speakers
Programme
Sessions
Scientific Committee
Acknowledgements
| Abstract #83 - Well Being and Life Expectancy | ||||
|
Session: 25.7: Well Being and Life Expectancy (Parallel) on Tuesday @ 11.00-13.00 in Raval Chaired by Xiaming Li, Carlos Mur Authors: Presenting Author: Dr. Rana Aslanov - Memorial nUniversity of Newfoundland, Canada |
||||
| Additional Authors: | ||||
| Aim: Human Papillomavirus (HPV) is the most common sexually transmitted infection. People with HIV or HIV-positive partners are at the higher risk of HPV-related pre-cancerous lesions and malignancy. We aimed to determine the prevalence of high risk (HR) HPV-types in HIV-positive adults in Atlantic Canada, to correlate their prevalence with underlying pre-malignant lesions and malignancy, and also to correlate these lesions with patients? demographics and risk factors. | ||||
| Method / Issue: This study was designed for a 3-year period subsequent to the baseline screening. HIV-positive adults treated through the participating ID (infectious disease) clinics were approached by physicians or nurses to request participation in the study. Consented participants were required to complete a confidential questionnaire. Oropharyngeal and anal swabs were obtained from all participants and cervical specimen from females. All specimens were tested for cytologic abnormalities, HPV DNA and genotyping. | ||||
| Results / Comments: The screening year analysis was based on 300 patients (91.7% males): Halifax, Nova Scotia?150; Moncton, New Brunswick?90; St. John?s, Newfoundland?44; and Saint John, New Brunswick?16 participants. The mean age was 46.9 years. Total 77.3% of participants tested positive for HPV infection, of them 54% with multiple genotypes. Total 46 HPV genotypes were detected, of which 39% were HR. The most frequently detected HR types were: 16-11.8%; 52-7.2%; 45-5.6%; 51-5.4% and 18/59- 4.6% each. HR types 16, 45, 51, 52, 53, 59 were strongly associated with anal precursor lesions: ASC-US in 12.3%; ASC-HSIL in 1%; LSIL in 11.7%; and HSIL in 1% of cases. The highest number of cytologic abnormalities was reported in anal specimens (26%). Cytologic changes were significantly associated with patients? high risk sexual behavior. The overall prevalence of the HR genotypes was 46.6% and of the cytologic abnormalities caused by them 27.3% during the screening year. Anal, oropharyngeal and cervical histopathology with biopsy confirmed the cytologic abnormalities except for the few discrepancies. One case with unsatisfactory for the cytology evaluation anal sample was investigated further based on the patient?s clinical presentation and showed rectal squamous cell carcinoma (SCC) in situ with HPV16/18 genotypes. One anal sample with ASC-US showed HSIL with HPV18/51. Three other anal specimens with LSIL each were diagnosed with HSIL and associated with HPV16. Throat cancer was diagnosed in male patient with negative for abnormality (NILM) oral cytology; this specimen was associated with oral HPV16 genotype. Finally, one cervical specimen with LSIL was confirmed as a mild cervical dysplasia with the followed-up hysterectomy. | ||||
| Discussion: All participants with precancerous lesions were referred to specialist for further investigation. Overall, 26% of participants had abnormal anal cytology confirmed by biopsy, including one case with rectal SCC. The analysis of the follow-up years will allow us to conduct a comparative analysis in order to determine Incidence Rate (IR), Prevalence Rate (PR) and Relative Risk (RR) in acquiring pre-cancerous lesions and malignancy in HIV-positive people in Atlantic Canada. The study findings might be helpful in promoting and implementing a provincial anal cancer screening program for the populations at the highest risk for HPV-caused cancers. | ||||
| Go Back | ||||