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Human papillomavirus genotypes in human immunodeficiency virus-positive patients with anal pathology in Madrid, Spain

Benjamín García-Espinosa1, Ernesto Moro-Rodríguez13* and Emilio Álvarez-Fernández2

Author Affiliations

1 Department of Histology and Anatomical Pathology, Rey Juan Carlos University, School of Medicine, Madrid, Spain

2 Department of Anatomical Pathology and Laboratories, Hospital General Universitario “Gregorio Marañón”, Madrid, Spain

3 Universidad Rey Juan Carlos, Av de Atenas s/n, E28922, Alcorcón, Madrid, Spain

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Diagnostic Pathology 2013, 8:204  doi:10.1186/1746-1596-8-204

Published: 10 December 2013

Abstract

Background

We studied anal specimens to determine the distribution of human papillomavirus (HPV) genotypes and co-infection occurrence. This information will contribute to the knowledge of HPV genotype distributions and provide an estimate of the prevalence of different oncogenic HPV genotypes found in patients in Madrid (Spain).

Methods

We studied a total of 82 anal biopsies from the Hospital General Universitario Gregorio Marañón of Madrid. These included 4 specimens with benign lesions, 52 specimens with low-grade anal squamous intraepithelial lesion, 24 specimens with high-grade anal squamous intraepithelial lesions and 2 specimens with invasive anal carcinoma. HPV genotyping was performed with PCR amplification and reverse dot blot hybridization.

Results

We detected 33 different HPV genotypes, including 16 HPVs associated with a high risk of carcinogenesis, 3 HPVs associated with a highly likely risk of carcinogenesis and 14 HPVs associated with a low-risk of carcinogenesis. In two specimens, an uncharacterized HPV genotype was detected. The most frequent HPV genotypes found were HPV-16 (10.3%; 95% CI: 6.6%-15.1%), HPV-52 (8.5%; 95% CI: 5.2%-13%) and HPV-43/44 (7.6%; 95% CI: 4.5%-11.9%). HPV-18 was only detected in 0.9% (95% CI: 0.1%-3.2%) of the total viruses detected in all lesions. HPV co-infections were found in 83.9% of all types of lesions. The majority of cases (90.2%) were concomitantly infected with the human immunodeficiency virus (HIV).

Conclusion

The prevalence of high-risk carcinogenic genotypes in anal pathological samples was remarkable. Therefore, further studies that include a greater number of samples, particularly invasive carcinoma cases are needed to evaluate the potential influence of these HPV genotypes in the appearance of anal carcinomas. Also, the influence of other accompanying infections should be evaluated clarify the appearance of this type of carcinoma.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2075238024106058 webcite.

Keywords:
Anal squamous intraepithelial lesions; Human papillomavirus; Polymerase chain reaction; Genotyping; HIV; Anus; Spain