HIV-Positive Women More Likely to Have Precancerous Anal Lesions/I told you so!!

[Guest guest]

HIV-Positive Women More Likely to Have Precancerous Anal Lesions

HIV-positive women were more than twice as likely to have

precancerous anal lesions as their HIV-negative counterparts,

according to a study published in the January 2 issue of AIDS.

Recent studies have suggested that anal cancer may be more common in

people with HIV. As with cervical cancer, infection with the human

papillomavirus (HPV) is believed to be the primary driver behind the

development of anal cancer. A number of studies have compared the

rates of cervical cancer and precancerous cervical lesions between

HIV-positive and HIV-negative women, and have found an increased risk

for HIV-positive women. Few studies, however, have explored the

comparative risk for precancerous anal lesions—called anal

intraepithelial neoplasias (AIN)—in HIV-positive women.

To examine the rates of precancerous anal lesions in women,

Hessol, MSPH, from the University of California in San Francisco, and

her colleagues from the Women's Interagency HIV Study (WIHS) examined

470 HIV-positive and 185 HIV-negative women, most between 31 and 50

years of age.

Just over half were smokers and just under 50 percent had ever

engaged in anal sex—both being risk factors for anal lesions. It is

important to note, however, that women who've never engaged in anal

sex can get anal lesions and anal cancer, especially if they've had

HPV infection of the vagina or cervix.

Hessol's team found significant differences between the HIV-positive

and HIV-negative women. Eighty percent of the HIV-positive women had

evidence of anal HPV infection, compared with 50 percent of HIV-

negative women. They also reported that HIV-positive women were 40

percent more likely to have low-grade AIN and three times as likely

to have high-grade AIN as HIV-negative women. Overall, 16 percent of

HIV-positive women had either low- or high-grade AIN.

Contrary to some studies of cervical cancer, a woman's smoking

history did not appear to influence the development of AIN. The

factor most strongly associated with high-grade AIN was infection

with strains of HPV that are associated with cancer. The factor

associated with low-grade AIN was infection with any strain of HPV,

both those linked to cancer and those that are not. Though the

authors do not make recommendations about screening for anal lesions—

such as anal Pap smears and anoscopy—HIV-positive women may wish to

discuss this study and these procedures with their health care

providers.

Search: human papillomavirus, HPV, anal intraepithelial neoplasia

(AIN), anal cancer, cervical cancer, Hessol, UCSF

regards,

lily