May 5, 2011
A recent study in a Veteran's Affairs HIV clinic in Miami reveals that more than half of HIV-positive men have abnormal surface anal cells, caused by the virus called HPV. People living with HIV generally have a higher rate of these abnormal cells than the general population. This study provides more information to help prevent this pre-cancerous condition.
HPV is the most common sexual infection in the U.S. However, it's more common in HIV-positive people (including those who haven't had anal sex), and high-risk types can lead to the pre-cancerous condition called dysplasia. Over time, high-risk HPV can eventually lead to anal cancer in certain individuals.
In 2006, researchers collected and examined anal Pap smears from 98 men. No one had had one done before then. CD4 counts averaged 400, and more than 3 out of 4 were on HIV meds. The average age was 49 and 52% were black, 14% Latino/Hispanic and 33% white. More than half (55%) stated they had never had anal sex.
The results showed that 52 of the 98 men had abnormal Pap results, with varying degrees of low-risk (37%), high-risk (5%) and unknown-risk cells (58%). Of these 52 men, anoscopies were done in 33 of them, or looking at anal tissue through a special microscope. Two cases of cancer were found, 18 men had high-grade dysplasia and the other 13 showed inflammation but no dysplasia. Lower CD4 count was associated with higher-risk results.
This study continues to show the concern for detecting anal dysplasia before it becomes cancerous. Since routine anal screening has not yet become standard of care for people with HIV, it may be up to individuals to request this regular screening from their doctors.
Rosa-Cunha, I, et al. Description of a pilot anal Pap smear screening program among individuals attending a Veteran's Affairs HIV clinic. March 31, 2011 issue of AIDS Patient Care and STDs.