ABSTRACT
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Subject(s)
Humans , Male , Adult , Immunocompromised Host/drug effects , Antibodies, Monoclonal, Humanized/adverse effects , Mycobacterium Infections, Nontuberculous/etiology , Tuberculosis, Miliary/etiology , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium scrofulaceum/isolation & purification , Antitubercular Agents/therapeutic use , Joint Diseases/drug therapyABSTRACT
Antecedentes y objetivos: los hombres VIH que tienen sexo con hombres (VIH-HSH) presentan la mayor incidencia de cáncer anal (CA). El estudio tiene como objetivo conocer la prevalencia de la infección anal por virus del papiloma humano de alto riesgo (VPH-AR) y de los hallazgos citológicos e histológicos, así como la implementación de un programa de cribado en el contexto de una ciudad media española, Vigo (España). Método: análisis prospectivo de una cohorte de 264 hombres (VIH-HSH). A los pacientes se les realizó una citología anal y genotipado de VPH-AR para el estudio de la prevalencia de alteraciones citológicas y de la infección VPH-AR. A 209 se les realizó una anoscopia de alta resolución (AAR). Los resultados se relacionaron con variables epidemiológicas, clínicas y analíticas. Resultados: de los 209 pacientes seleccionados, la prevalencia de VPH-AR, alteraciones citológicas e histológicas anales fue de 85,6%, 47,5% y 39,3% respectivamente. La sensibilidad y especificidad para la citología ≥ ASCUS (atipia de células escamosas de significado indeterminado) respecto a las alteraciones histológicas fue de 61% y 85% (OR: 8,7; IC95%: 4,4-17,2), respectivamente. La concordancia observada entre la citología HSIL (lesión escamosa intraepitelial de alto grado) e histología HSIL (AIN-2/3, neoplasia intraepitelial tipo 2 y 3) fue del 64%,(OR: 11,4; IC95%: 3,5-36,7). Un paciente con citología HSIL presentó cáncer escamoso anal prevalente. Conclusiones: la AAR resultó factible y con resultados similares a los de grupos relevantes. Gran prevalencia de la infección anal por VPH-AR y de alteraciones citológicas e histológicas (AU)
Background: Men who have sex with men (MSM) infected with human immunodeficiency virus (HIV) have the highest risk of developing anal cancer (AC). The objective of this study was to describe our screening implementation program in this population, and report the prevalence of human papillomavirus (HPV) anal infection, and cytological and histological findings in a Spanish medium-size community (Vigo, Spain). Method: Prospective cohort analysis of 240 HIV-infected MSM. Cellular anal sample and high risk HPV (HR-HPV)-tests were performed to study cytological changes and HPV genotyping. High resolution anoscopy (HRA) was performed in 209 patients. Results were analyzed with respect to epidemiological, clinical and analytical factors. Results: Of 209 patients selected for HRA, the prevalence of HR-HPV anal infection, cytological and histological alterations was 85.6%, 47.5%, and 39.8%, respectively. Sensitivity and specificity for ≥ ASCUS (atypia of squamous cells of undetermined significance) cytology in relation to histological alterations were 61% and 85%, (OR: 8.7; IC 95%: 4.4-17.2), respectively. Observed concordance between high-grade squamous intraepithelial lesion (HSIL) cytology and HSIL anal intraepithelial neoplasia types 2 and 3 (AIN-2/3) histology was 64% (OR: 11.4; IC 95%: 3.6-36.7). One patient with HSIL cytology presented a prevalent anal squamous carcinoma. Conclusions: HRA was feasible with similar results to relevant groups. There was a high prevalence of anal HR-HPV infection, and cytological and histological alterations (AU)
Subject(s)
Humans , Male , Adult , Anus Neoplasms/epidemiology , HIV Infections/epidemiology , Anal Canal/pathology , Papilloma/complications , Carcinoma in Situ/epidemiology , Sexually Transmitted Diseases/epidemiology , Mass Screening/methods , Homosexuality, Male/statistics & numerical data , Spain/epidemiology , Prospective Studies , Anal Canal , Cross-Sectional Studies/statistics & numerical data , Colposcopy , Cytological Techniques , Histological Techniques , Sensitivity and SpecificityABSTRACT
BACKGROUND: Men who have sex with men (MSM) infected with human immunodeficiency virus (HIV) have the highest risk of developing anal cancer (AC). The objective of this study was to describe our screening implementation program in this population, and report the prevalence of human papillomavirus (HPV) anal infection, and cytological and histological findings in a Spanish medium-size community (Vigo, Spain). METHOD: Prospective cohort analysis of 240 HIV-infected MSM. Cellular anal sample and high risk HPV (HR-HPV)-tests were performed to study cytological changes and HPV genotyping. High resolution anoscopy (HRA) was performed in 209 patients. Results were analyzed with respect to epidemiological, clinical and analytical factors. RESULTS: Of 209 patients selected for HRA, the prevalence of HR-HPV anal infection, cytological and histological alterations was 85.6%, 47.5%, and 39.8%, respectively. Sensitivity and specificity for ≥ ASCUS (atypia of squamous cells of undetermined significance) cytology in relation to histological alterations were 61% and 85%, (OR: 8.7; IC 95%: 4.4-17.2), respectively. Observed concordance between high-grade squamous intraepithelial lesion (HSIL) cytology and HSIL anal intraepithelial neoplasia types 2 and 3 (AIN-2/3) histology was 64% (OR: 11.4; IC 95%: 3.6-36.7). One patient with HSIL cytology presented a prevalent anal squamous carcinoma. CONCLUSIONS: HRA was feasible with similar results to relevant groups. There was a high prevalence of anal HR-HPV infection, and cytological and histological alterations.
Subject(s)
Anus Neoplasms/diagnosis , HIV Infections/complications , Papillomavirus Infections/diagnosis , Adult , Anus Neoplasms/epidemiology , Cohort Studies , Cross-Sectional Studies , HIV Infections/epidemiology , Homosexuality, Male , Humans , Male , Mass Screening , Middle Aged , Papillomavirus Infections/epidemiology , Precancerous Conditions/diagnosis , Prevalence , Prospective Studies , Risk Factors , Sexual BehaviorABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Pancreatitis/chemically induced , HIV Infections/drug therapy , Anti-Retroviral Agents/adverse effects , Recurrence , Pancreatitis/diagnosis , HIV Infections/complications , AIDS-Related Opportunistic Infections/chemically induced , Anti-Retroviral Agents/therapeutic useSubject(s)
Foreign Bodies/complications , Liver Abscess/etiology , Aged , Female , Humans , Middle AgedABSTRACT
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