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.
S. Muery, None
N. Nelson, None
S. Scariano, None
J. Cameron, None
M. Hagensee, None