P16.30 Epidemiology of anal infection in hiv infected patients attending a sexually transmitted infection clinic in brazil

Abstract

Introduction Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. The objective of this study was determinating the prevalence, genotype distribution and risk factors associated with anal HPV infection among persons of both sexes with HIV attending a STI clinic in Espirito Santo, Brazil. Methods Cross sectional study assessing HIV-infected persons. A comprehensive survey was administered that included a demographic and behavioural assessment. Anal specimens were collected for cytology and HPV screening using Polymerase Chain Reaction. Results A total of 169 patients completed the study, 122 female and 47 male, mean age was 40.3 years, 81.4% lived in Vitoria, the average education was 8.6 years, 48.8% were married, 42.1% had between 5 and 20 sexual partners, 25.4% initiated sexual activity before age 15. 72% reported anal sexual activity, 58.3% had a history of STI, the most frequent being condyloma acuminata (25.4%) followed by syphilis (9%). 31.6% knew to be HIV positive for more than 10 years, 65.1% had an undetectable viral load, only 3.5% had CD4 below 200 cells and 82.9% were taking HAART. Anal cytology in both sexes had a 13.2% prevalence changes. The prevalence of HPV infection of any type was 71%, and high-risk HPV types were 52.4%. The HPV types most frequent high-risk types were: 16, 51 and 53. 37.3% had multiple HPV types. Conclusions Anal HPV is common among HIV-infected persons attending this STI clinic, repeated annual cytology screening for HIV-infected, particularly for those with increased immunosuppression, anal HPV, history of the other STIs, or abnormal cervical cytology will increase the likelihood of detecting AIN 2-3.