1702. Detection of Biomarkers for Anal Cancer in HIV+ Individuals
Session: Poster Abstract Session: HIV: HIV, HPV, and other STDs
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • IDSA 2015 POSTER.pdf (673.4 kB)
  • Background: The rates of anal cancer have increased over the past 30 years.  HIV+ men (36%) and women (26%) have high rates of anal dysplasia coupled with high rates of anal HPV detection (50-90%). Anal cancer prevention involves Pap smear detection of abnormal cells followed by biopsy and treatment which leads to >50% of HIV+ individuals potentially requiring biopsies.  Our objective is to discover potential biomarkers of anal dysplasia that could better triage individuals with abnormal anal Pap smears.

    Methods: HIV+ men and women were enrolled from outpatient clinics at Ochsner Helath System (OHS) and the HIV Outpatient Program (HOP).  After informed consent, a sexual history questionnaire was obtained and anal swabs were collected for analysis of cytology, viral infection (HPV, EBV) and local cytokines.

    Results: Thirty-four men from OMC (58% Caucasian) and 47 men and women from HOP (80% African-American) were enrolled.  For the entire cohort, the mean age was 47, the mean CD4 cell count was 498 and median HIV VL was 39.  An abnormal Pap smear was seen in 69%, dysplasia in 39% with 80% being positive for high-risk HPV.  Women, being African-Americans, lower CD4 cell counts and higher HIV viral loads were seen in individuals with either an abnormal anal Pap smear or dysplasia.   HPV and EBV were detected in 87% of those with dysplasia as compared to 61% of those without (p=.05).  Higher amounts of IL-4 were seen those with an abnormal anal Pap smear or dysplasia (p=0.001).

    Conclusion: HIV+ patients who are female, African American with lower CD4 cell counts and higher HIV viral load, having HPV and EBV detected in anal samples and higher amounts of IL-4 may be markers of current or future anal disease.  Additional subjects at both ILH and OHS are currently being enrolled to further explore these potential markers.

    Julia Garcia-Diaz, MD, FIDSA1, Atif Ghaffar, MPH2, Susan Muery, BS3, Nia Nelson, BS4, Susan Scariano, LPN3, Jennifer Cameron, PhD4 and Michael Hagensee, MD5, (1)Ochsner Clinic Foundation, New Orleans, LA, (2)LSU, New Orleans, LA, (3)Ochsner Medical Center, New Orleans, LA, (4)LSU Medical Center, New Orleans, LA, (5)Louisiana State University, New Orleans, LA

    Disclosures:

    J. Garcia-Diaz, None

    A. Ghaffar, None

    S. Muery, None

    N. Nelson, None

    S. Scariano, None

    J. Cameron, None

    M. Hagensee, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.