686. Molecular Markers for Human Papillomavirus (HPV) in HIV Infected Patients with and without Anal Dysplasia
Session: Abstracts: Virology
Friday, October 22, 2010

Human Papillomavirus (HPV) has been linked to anal dysplasia and carcinoma, which are commonly detected in HIV infected men.  HPV genotypes 16 & 18 are considered most highly oncogenic.   Episomal HPV in infected cells may linearize and integrate into the host genome. This integration results in loss of E2 expression and an increase in pro-oncogenic E6 and E7 transcription.  Chromosomal instability over time leads to progression to dysplasia and cancer.  The role of anal cytology screening for anal dysplasia/carcinoma is still under debate.  The purpose of this study is to determine whether HPV viral load and oncogene expression correlate with severity of anal dysplasia in HIV infected patients.


Anal swabs of HIV infected patients with and without anal dysplasia were processed for DNA and RNA extraction.  From each cellular sample, quantitative real-time PCR was performed to determine HPV 16  & 18 viral load and quantify transcription of HPV E2, E6, E7 genes.


Data is presented on a set of 30 HIV infected patients with cytological evidence of anal dysplasia and 10 HIV infected men with normal cytology.  Eleven patients were infected with HPV 16, seven with HPV 18, four were dually infected, and eight were uninfected with high risk HPV.  HPV viral loads and level of integration differed among the patients with anal dysplasia.  All ten patients with normal anal cytology did not have any evidence of HPV 16 or 18 infection.  Multiple host factors were identified and correlated with virologic data. 


High risk HPV was not detected among individuals with normal anal cytology. Although HPV burden differed in HIV infected patients, no correlation was seen between HPV viral load and grade of dysplasia. There was variation in frequency of integration of HPV 16 into host DNA.  A trend towards more frequent detection of HPV16 E6 transcription among individuals with high grade dysplasia than in patients with low grade dysplasia was noted although this did not meet statistical significance.  These findings suggest that multiple host and virologic factors might be involved with anal dysplasia progression.  Ongoing analysis with larger sample size might identify additional trends.

Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

Vidya Devarajan, MD , Infectious Diseases, University of Cincinnati Medical Center, Cincinnati, OH
Jaime Robertson, MD , Infectious Diseases, University of Cincinnati Medical Center, Cincinnati, OH
G.Alan Smulian, MD , Infectious Diseases, University of Cincinnati Medical Center, Cincinnati, OH


V. Devarajan, None

J. Robertson, None

G. A. Smulian, None

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