High-risk HPV L1 and E6/E7 seropositivity is prospectively associated with anal cancer. We studied L1, E1, E2, E6, E7 seropositivity of high-risk (hr) HPV types as potential predictors of anal high-grade squamous intraepithelial lesions (HSIL) among HIV-positive men who have sex with men (MSM).
HIV-positive participants of the longitudinal HIV&HPV in MSM (H2M) study who had at least two visits and a high-resolution anoscopy (HRA) after the last H2M visit were included in this analysis. Sera were collected in 2010-2013. Serum antibodies to E6, E7, and L1 proteins of 7 hr-HPV types (16, 18, 31, 33, 45, 52, 58), and serum antibodies to E1 and E2 of HPV16 and HPV18 were analyzed by multiplex serology. Seropositivity was defined as 3 out of 4 positive among E1/E2/E6/E7 for HPV16 and HPV18; and both E6 and E7 positive for each non-HPV16/18-type. Univariable and multivariable logistic regression was used to assess whether hr-HPV seropositivity was predictive of HSIL.
Among 193 MSM (median age 50 years [IQR]:45-56) 60 (31%) were diagnosed with histologically proven anal HSIL: 25 (13%) AIN2 and 35 (18%) AIN3. The median nadir CD4+ was 235 cells/µl (IQR: 150-315 cells/µl), and 94% had an undetectable HIV viral load at time of HRA. Seropositivity for E1, E2, E6, E7 of HPV16 was 7%, 4%, 4%, and 5%, respectively. In total, 0 (0%) were HPV16 three out of four positive for E1/E2/E6/E7, and 0 (0%) HPV18 three out of four positive for E1/E2/E6/E7. E6 and E7 seropositivity for each of the non-HPV16/18 hr-HPV types was 0% (n=0). Type-specific seropositivity as defined above was not associated with HSIL diagnoses.
No association between type-specific hr-HPV seropositivity and anal HSIL was found among HIV-positive MSM. Our analysis shows that (type-specific) hr-HPV seropositivity cannot be used as predictor of HSIL in HIV-positive MSM.