High prevalence of multiple high-risk HPV infections in young HIV positive gay men

Gareth Hardy, HIV i-Base

Corinna Sadlier from Trinity College Dublin, investigated whether the baseline epidemiology of HPV infection in young HIV positive MSM may help guide primary and secondary prevention strategies.

The study recruited 50 HIV positive 18-26 year old MSM and conducted oropharyngeal, anal and penile swabs and tested serum for anti-HPV 16/18 antibodies.

HPV DNA was detected in 68% of study participants. High-risk HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) were found in anal swabs from 46% of participants, in penile swabs from 4% of participants and were not found at all in oropharyngeal swabs. Antibodies to HPV-16 were found in serum from 44% of participants while antibodies to another high-risk type, HPV-18, were found in serum from 26% of participants. Antibodies to both types were found in serum from 16% of participants. A detectable HIV viral load was associated with high-risk HPV detection (p=0.04).

Importantly, DNA from high-risk HPV types 51, 56 and 59, were frequently found in swabs, and these HPV types are not included in either the 4- or 9-valent vaccines. This demonstrates a need for improved primary and secondary prevention interventions in HIV positive MSM.

The four-valent HPV vaccine Gardisil confers protection against HPV types 6, 11, 16 and 18.

Merck’s 9-valent vaccine for HPV, Gardisil-9, which incudes HPV types 31, 33, 45, 52, and 58 as well as 6, 11, 16 and 18 was approved in the US in December 2014 and in the EU in June 2015. Vaccination can greatly reduce the burden of HPV disease, especially as HPV-16 is highly associated with anal cancer.

Reference:

Sadlier C et al. Prevalence, type and factors associated with HPV infection at multiple sites in young HIV positive MSM. 22nd Annual BHIVA Conference, 19-22 April 2016, Manchester. Oral abstract O9.
http://www.bhiva.org/documents/Conferences/2016Manchester/Presentations/160421/CorinnaSadlier.pdf (PDF slides)
http://www.bhiva.org/160421CorinnaSadlier.aspx (webcast)

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