Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria
Background: Anal precancers and cancers can be detected during screening with high-resolution anoscopy (HRA). The sensitivity of HRA depends on the burden and duration of human papillomavirus (HPV) among those screened as well as anoscopist proficiency, which is highly correlated with prior screenin...
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Format: | Article |
Language: | English |
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Elsevier
2020-12-01
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Series: | Papillomavirus Research |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2405852120300094 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rebecca G. Nowak Lisa M. Schumaker Nicholas P. Ambulos Nicaise Ndembi Wuese Dauda Chinedu H. Nnaji Andrew Mitchell Trevor J. Mathias Paul Jibrin Teresa M. Darragh Oluwole Olaomi Trevor A. Crowell Stefan D. Baral Manhattan E. Charurat Søren M. Bentzen Joel M. Palefsky Kevin J. Cullen Manhattan Charurat Julie Ake Aka Abayomi Sylvia Adebajo Stefan Baral Trevor Crowell Charlotte Gaydos Sosthenes Ketende Afoke Kokogho Jennifer Malia Olumide Makanjuola Nelson Michael Nicaise Ndemb Rebecca Nowak Oluwasolape Olawore Zahra Parker Sheila Peel Habib Ramadhani Merlin Robb Cristina Rodriguez-Hart Eric Sanders-Buell Elizabeth Shoyemi Sodsai Tovanabutra Sandhya Vasan |
spellingShingle |
Rebecca G. Nowak Lisa M. Schumaker Nicholas P. Ambulos Nicaise Ndembi Wuese Dauda Chinedu H. Nnaji Andrew Mitchell Trevor J. Mathias Paul Jibrin Teresa M. Darragh Oluwole Olaomi Trevor A. Crowell Stefan D. Baral Manhattan E. Charurat Søren M. Bentzen Joel M. Palefsky Kevin J. Cullen Manhattan Charurat Julie Ake Aka Abayomi Sylvia Adebajo Stefan Baral Trevor Crowell Charlotte Gaydos Sosthenes Ketende Afoke Kokogho Jennifer Malia Olumide Makanjuola Nelson Michael Nicaise Ndemb Rebecca Nowak Oluwasolape Olawore Zahra Parker Sheila Peel Habib Ramadhani Merlin Robb Cristina Rodriguez-Hart Eric Sanders-Buell Elizabeth Shoyemi Sodsai Tovanabutra Sandhya Vasan Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria Papillomavirus Research HPV in MSM Anal cancer screening Sub-Saharan Africa Next-generation sequencing |
author_facet |
Rebecca G. Nowak Lisa M. Schumaker Nicholas P. Ambulos Nicaise Ndembi Wuese Dauda Chinedu H. Nnaji Andrew Mitchell Trevor J. Mathias Paul Jibrin Teresa M. Darragh Oluwole Olaomi Trevor A. Crowell Stefan D. Baral Manhattan E. Charurat Søren M. Bentzen Joel M. Palefsky Kevin J. Cullen Manhattan Charurat Julie Ake Aka Abayomi Sylvia Adebajo Stefan Baral Trevor Crowell Charlotte Gaydos Sosthenes Ketende Afoke Kokogho Jennifer Malia Olumide Makanjuola Nelson Michael Nicaise Ndemb Rebecca Nowak Oluwasolape Olawore Zahra Parker Sheila Peel Habib Ramadhani Merlin Robb Cristina Rodriguez-Hart Eric Sanders-Buell Elizabeth Shoyemi Sodsai Tovanabutra Sandhya Vasan |
author_sort |
Rebecca G. Nowak |
title |
Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria |
title_short |
Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria |
title_full |
Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria |
title_fullStr |
Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria |
title_full_unstemmed |
Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, Nigeria |
title_sort |
multiple hpv infections among men who have sex with men engaged in anal cancer screening in abuja, nigeria |
publisher |
Elsevier |
series |
Papillomavirus Research |
issn |
2405-8521 |
publishDate |
2020-12-01 |
description |
Background: Anal precancers and cancers can be detected during screening with high-resolution anoscopy (HRA). The sensitivity of HRA depends on the burden and duration of human papillomavirus (HPV) among those screened as well as anoscopist proficiency, which is highly correlated with prior screening experience. Our objective was to compare the identification and type of HPV and the likelihood of HRA-detected precancer for men who have sex with men (MSM) undergoing their first HRA-screening in Nigeria. Methods: MSM were recruited from an HIV test-and-treat cohort, TRUST/RV368, into a new anal cancer screening program. Anal swabs obtained during screening underwent Ion Torrent next-generation sequencing using barcoded HPV PCR broad-spectrum primers 5+/6+ to detect up to 161 HPVs. All high-risk (HR) HPVs and the most abundant low-risk (LR)-HPVs were evaluated as type-specific infections with some categorized as belonging to a multiple infection. HRA screening results included benign, low-grade squamous intraepithelial lesions (LSIL), or HSIL as detected by cytology or histology. Multivariable logistic regression was used to assess the association of HPV and other cofactors with any SIL. Results: Among 342 MSM, 60% were HIV-infected, 89% were under 35 years of age, and 51% had 8 or more years since anal coital debut. Of those with SIL, 89% had LSIL and only 11% had HSIL. Prevalence of any HPV and high-risk (HR)-HPV was 92% and 74%, respectively. The most prevalent genotypes in rank order were HPV6 (31%), HPV16 (23%), HPV42 (20%), HPV11 (18%), HPV45 (18%), and HPV51 (17%). For multiple HR-HPVs, 31% had a single HR-HPV, 32% had 2-3, and 10% had 4 or more. Low-risk HPVs, type 6 and/or 11, were common (42%) and were significantly associated with SIL (adjusted odds ratio [aOR]:1.8, 95% confidence interval [CI]: 1.1–3.1) together with perianal warts (aOR:6.7, 95% CI: 3.3–13.5). In contrast, HR-HPV and multiple HR-HPVs were not significantly associated with SIL (all p > 0.05). Conclusions: Detection of HSIL was low. Although HR-HPV was abundant, HSIL development also depends on the duration of HR-HPV infections and the anoscopist's level of experience. As our cohort ages and the anoscopist becomes more skilled, detection of HSIL will likely improve. |
topic |
HPV in MSM Anal cancer screening Sub-Saharan Africa Next-generation sequencing |
url |
http://www.sciencedirect.com/science/article/pii/S2405852120300094 |
work_keys_str_mv |
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doaj-2028881ccea8440d8cc4fb7e474e3bf32020-12-17T04:50:29ZengElsevierPapillomavirus Research2405-85212020-12-0110100200Multiple HPV infections among men who have sex with men engaged in anal cancer screening in Abuja, NigeriaRebecca G. Nowak0Lisa M. Schumaker1Nicholas P. Ambulos2Nicaise Ndembi3Wuese Dauda4Chinedu H. Nnaji5Andrew Mitchell6Trevor J. Mathias7Paul Jibrin8Teresa M. Darragh9Oluwole Olaomi10Trevor A. Crowell11Stefan D. Baral12Manhattan E. Charurat13Søren M. Bentzen14Joel M. Palefsky15Kevin J. Cullen16Manhattan Charurat17Julie Ake18Aka Abayomi19Sylvia Adebajo20Stefan Baral21Trevor Crowell22Charlotte Gaydos23Sosthenes Ketende24Afoke Kokogho25Jennifer Malia26Olumide Makanjuola27Nelson Michael28Nicaise Ndemb29Rebecca Nowak30Oluwasolape Olawore31Zahra Parker32Sheila Peel33Habib Ramadhani34Merlin Robb35Cristina Rodriguez-Hart36Eric Sanders-Buell37Elizabeth Shoyemi38Sodsai Tovanabutra39Sandhya Vasan40Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA; Corresponding author. Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, 725 W. Lombard Street, Baltimore, MD, 21201, USA.University of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USAUniversity of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USAInstitute of Human Virology Nigeria, Abuja, NigeriaInstitute of Human Virology Nigeria, Abuja, NigeriaInstitute of Human Virology Nigeria, Abuja, NigeriaInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USAUniversity of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USANational Hospital, Abuja, NigeriaDepartment of Pathology, University of California, San Francisco, CA, USANational Hospital, Abuja, NigeriaU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USAJohns Hopkins School of Public Health, Baltimore, MD, USAInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USAUniversity of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USADepartment of Medicine, University of California, San Francisco, CA, USAUniversity of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USAUniversity of Maryland, Baltimore, USAU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USAInternational Centre for Advocacy for the Right to Health, Abuja, NigeriaMaryland Global Initiatives Corporation, Abuja, NigeriaJohns Hopkins University, Baltimore, USAU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USAJohns Hopkins University, Baltimore, USAJohns Hopkins University, Baltimore, USAU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; HJF Medical Research International, Abuja, NigeriaDepartment of Laboratory Diagnostics and Monitoring, Walter Reed Army Institute of Research, Silver Spring, USAThe Initiative for Equal Rights, Lagos, NigeriaCenter for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, USAInstitute of Human Virology Nigeria, Abuja, NigeriaUniversity of Maryland, Baltimore, USAJohns Hopkins University, Baltimore, USAU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USADepartment of Laboratory Diagnostics and Monitoring, Walter Reed Army Institute of Research, Silver Spring, USAUniversity of Maryland, Baltimore, USAHenry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USANew York City Department of Health and Mental Hygiene, Long Island City, USAU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USAPopulation Council Nigeria, Lagos, NigeriaU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USAU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USABackground: Anal precancers and cancers can be detected during screening with high-resolution anoscopy (HRA). The sensitivity of HRA depends on the burden and duration of human papillomavirus (HPV) among those screened as well as anoscopist proficiency, which is highly correlated with prior screening experience. Our objective was to compare the identification and type of HPV and the likelihood of HRA-detected precancer for men who have sex with men (MSM) undergoing their first HRA-screening in Nigeria. Methods: MSM were recruited from an HIV test-and-treat cohort, TRUST/RV368, into a new anal cancer screening program. Anal swabs obtained during screening underwent Ion Torrent next-generation sequencing using barcoded HPV PCR broad-spectrum primers 5+/6+ to detect up to 161 HPVs. All high-risk (HR) HPVs and the most abundant low-risk (LR)-HPVs were evaluated as type-specific infections with some categorized as belonging to a multiple infection. HRA screening results included benign, low-grade squamous intraepithelial lesions (LSIL), or HSIL as detected by cytology or histology. Multivariable logistic regression was used to assess the association of HPV and other cofactors with any SIL. Results: Among 342 MSM, 60% were HIV-infected, 89% were under 35 years of age, and 51% had 8 or more years since anal coital debut. Of those with SIL, 89% had LSIL and only 11% had HSIL. Prevalence of any HPV and high-risk (HR)-HPV was 92% and 74%, respectively. The most prevalent genotypes in rank order were HPV6 (31%), HPV16 (23%), HPV42 (20%), HPV11 (18%), HPV45 (18%), and HPV51 (17%). For multiple HR-HPVs, 31% had a single HR-HPV, 32% had 2-3, and 10% had 4 or more. Low-risk HPVs, type 6 and/or 11, were common (42%) and were significantly associated with SIL (adjusted odds ratio [aOR]:1.8, 95% confidence interval [CI]: 1.1–3.1) together with perianal warts (aOR:6.7, 95% CI: 3.3–13.5). In contrast, HR-HPV and multiple HR-HPVs were not significantly associated with SIL (all p > 0.05). Conclusions: Detection of HSIL was low. Although HR-HPV was abundant, HSIL development also depends on the duration of HR-HPV infections and the anoscopist's level of experience. As our cohort ages and the anoscopist becomes more skilled, detection of HSIL will likely improve.http://www.sciencedirect.com/science/article/pii/S2405852120300094HPV in MSMAnal cancer screeningSub-Saharan AfricaNext-generation sequencing |