Conley et al identified factors associated with anal dysplasia associated with HPV infection in HIV-infected adults in the United States. The authors are from the Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN Study).
Patient selection: HIV-positive adult
The assay for HPV strains identified 37 strains, with 22 high risk and 15 low risk. Many HPV strains are not included in the assays.
Risk factors for anal dysplasia:
(1) multiple HPV types infecting the anus (both low and high risk types)
(2) nadir CD4-positive cell count < 50 per µL
The authors felt that all HIV-positive patients should have anal cytology screening, not just men who have sex with men.
Limitations:
• There is a need to identify all of the types of HPV that are present. Positive results for both high and low risk strains may a more readily accessible endpoint.
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