HUMAN PAPILLOMAVIRUS-ASSOCIATED LESIONS I N MEN WITH OR WITHOUT HIV-INFECTION - COMPARISON OF COLPOSCOPIC, HISTOPATHOLOGICAL AND VIROLOGICAL RESULTS

Anal and genital lesions caused by human papilloma virus (HPV) may be associated with severe dysplasia and cancer, chiefly in cases of << hi gh risk >> HPV types 16, 18, 31, 35, 51. The frequency of HPV infectio ns and the severity of genital cancers seem to b increased in patients with human immunodeficiency virus (HIV) infection. Patients and metho d. The distribution of different HPV types was compared with the anato mical and clinical features of the lesions in two populations, one HIV + (n = 40) and the other HIV- (n = 48), who had anal and genital lesio ns. The HPV DNA was determined by molecular hybridization in situ, usi ng biotinylated probes which recognized HPV types 6/11, 16/8 and 31/35 /51 on 99 lesions. Results. HIV+ subjects differed from HIV - subjects in that a higher proportion of them had anal lesions (50 p. 100 vs 10 p. 100) and condyloma latum (80 p. 100 vs 50 p. 100). Koilocytosis wi thout dysplasia was more often found in HIV- subjects (12.5 p. 100 vs 55 p. 100). Conversely, dysplasia was more frequent amont the lesions of HIV+ subjects: grade I 39.5 p. 100 vs 17.5 p. 100; grade II 25 p. 1 00 vs 4 p. 100; grade III 12.5 p. 100 vs 0 p. 100. Koilocytosis was pr eferentially associated with condyloma acuminatum. In HIV+ subjects th e DNA of HPV, detected in 73 p. 100 of the lesions, was << high risk > > HPV DNA in 86 p. 100 of the cases, whereas in HIV- subjects 51 p. 10 0 of the samples were positive in hybridization, and 61.5 p. 100 had < < low risk >> HPV DNA. In subjects of all groups << high risk >>HPV wa s found in dysplastic lesions. Conclusion. HIV seropositive subjects s how an imbalanced distribution of HPV with predominance of << high ris k >> HPV. This suggests that immunodepression encourages infection by this oncogenic virus, thereby contributing to the frequency of cancer in HIV+ subjects.