Human papillomavirus 68 subtypes among people with human immunodeficiency virus and implications for anal screening
摘要
Human papillomavirus (HPV) infection is a key risk factor for anal cancer. While HPV16’s carcinogenic role is well established, the contribution of other high-prevalence genotypes in people with HIV (PWH), such as HPV68 is less defined. This study examines the prevalence of HPV68 subtypes, their oncogene expression, and association with histologically confirmed high-grade squamous intraepithelial lesions (HSIL).
MethodsTwo hundred PWH with abnormal anal cytology underwent HPV genotyping and mRNA analysis for the E6/E7 oncogenes of HPV16 and HPV68. Statistical analyses evaluated associations between HPV genotypes, oncogene expression, and HSIL.
ResultsThe cohort had a median age of 50 (IQR, 43-57) years, with 83% male participants and 93.9% virologically suppressed. HSIL was confirmed by histology in 25% of participants. HPV68 (28.5%) and HPV16 (24.5%) were the most prevalent genotypes, with HPV68a detected in 65.3% of HPV68-positive cases. Among HSIL cases, HPV16 (42%) and HPV68 (34%) were most common. HPV68a was significantly associated with HSIL in participants without HPV16. mRNA expression levels of E6 and E7 from HPV68a were significantly higher in the HSIL group (142.0 vs 12.9, p = 0.007 and 82.5 vs 9.1, p = 0.014, respectively). Differences remained significant after adjusting for the number of HPV genotypes and HPV16.
ConclusionsThese findings suggest that HPV68a drives anal HSIL and warrants inclusion in screening and vaccination for high-risk groups.