Grant: Travel Awards - Institute Community Support

Human Papillomavirus (HPV) is the most common sexually transmitted infection worldwide. There are low risk or benign HPV genotypes that may cause oral and/or genital warts, and high-risk HPV types (HR) which may lead to cancer. People with HIV or HIV-positive partners are at the higher risk of HPV-caused cancer. We hypothesized that early diagnosis and treatment of precancerous lesions will reduce the burden of disease in people living with HIV/AIDS. We aimed to examine the distribution of high risk (HR) HPV-types in HIV-positive adults in Atlantic Canada. We also investigate an association of those HPV types with detected precancerous lesions and cancer, and with patients' demographics and risk factors such as unprotected sex, number of sexual partners, smoking and others. This study was designed for a 3-year period subsequent to the baseline screening. Consented HIV-positive participants were required to complete a confidential questionnaire. Oral and anal swabs were obtained from all participants and cervical specimen from females. All specimens were tested for abnormalities at cell level and presence of HPV infection. The screening year analysis was based on 300 patients (92% males) from four Atlantic Provinces. The average age was 47 years. Total 77% of participants tested positive for HPV infection, of them 54% with multiple HPV types in one swab. Total 46 different HPV genotypes were detected, of which 39% were high-risk. The most often detected HR types were: 16, 52, 45, 51-and 18. The highest number of cytologic abnormalities was reported in anal specimens (26%). These changes were strongly associated with patients' high risk sexual behavior. The overall prevalence of high-risk genotypes during the screening year was 47%. All participants with abnormal changes were further investigated to confirm them. The histology analysis with the biopsy from abnormal area were performed. Some of the results demonstrated more severe changes and even cancer.