Concordance of Oral and Anal Human Papillomavirus in Men Who Have Sex With Men Living With Human Immunodeficiency Virus

Background

To detect human papillomavirus (HPV) at oral and anal sites and assess genotype concordance among men who have sex with men (MSM) living with human immunodeficiency virus (HIV) in Taiwan.

Methods

HIV-positive men aged 20 years or older attending outpatient clinics at Taoyuan General Hospital, Taiwan, were enrolled. Oral gargle and anal swab samples were collected for HPV genotyping using linear array testing. Multivariate logistic regression identified factors associated with oral-HPV and oral-anal genotype concordance. Significance was set at p < 0.05.

Results

Of 196 eligible participants, the mean age was 32.2 years and over 95% were MSM. The mean CD4+ T cell count was 588 cells/μL (95% confidence interval [CI]: 551–626), and 73% (n = 143) had suppressed viral loads. Anal-HPV was detected in 184 participants (93.8%, 95% CI: 90.5%–97.2%), with 82.7% (n = 162) having oncogenic genotypes. Oral HPV was found in 20 participants (10.2%, 95% CI: 5.9%–14.4%), with 30% (n = 6) having oncogenic genotypes. Among those with oral HPV, 55% (n = 11) showed genotype concordance with anal sites. Only 30% reported condom use during oral sex. Concordance was significantly associated with the number of anal-HPV genotypes (adjusted odds ratio: 1.58, 95% CI: 1.08–2.32, p = 0.015), adjusting for drug use, internet-based partners, recent sexually transmitted infections, and anal oncogenic HPV count.

Conclusions

Oral HPV was common, and over half of the infections matched genotypes found anally. These results support targeted HPV vaccination promotion among MSM living with HIV in Taiwan.