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Grant Details

Grant Number: 5R01CA088739-05 Interpret this number
Primary Investigator: Palefsky, Joel
Organization: University Of California, San Francisco
Project Title: Anal HPV Infection and Asil in Hiv+ and HIV Women
Fiscal Year: 2005


Abstract

DESCRIPTION: The incidence of anal cancer is rising in the U.S. in both women and men. Anal cancer is more common in the general population in women than in men but is most common in HIV+ men who have sex with men (MSM). Recent data also show that anal cancer is more common in HIV+ women than HIV- women. Like cervical cancer, anal cancer is associated with human papillomavirus (HPV) and may be preceded by high-grade squamous intraepithelial lesions (HSIL). Little is known about anal HPV infection and HSIL in HIV+/- or high-risk HIV- women. In a pilot prospective study conducted in the Women's Interagency HIV Study (WIHS) in San Francisco among both HIV+ and HIV- women, anal HPV infection was more common than cervical infection. The 30-month incidence of anal HSIL among HIV+ women (20 percent) was similar to that observed in our earlier studies of FHV+/- MSM in San Francisco. This prospective study is designed to include the larger sample size of the entire WIHS cohort and has four specific aims: 1) to study the natural history of anal HPV infection among HIV+ and high-risk HIV- women in the highly active antiretroviral therapy (HAART) era; 2) study the development and progression of anal squamous intraepithelial lesions (ASIL) among HIV+ and high-risk HIV- women in the HAART era; 3) compare the natural history and risk factors for anal HPV infection and cytologic abnormalities to those of cervical HPV infection and cytologic abnormalities among HIV+ and high-risk HIV- women. Strain variants of HPV 16, 18 and 31 will be compared in the anus and cervix; and 4) analyze genetic changes in ASIL in women and compare these to cervical SIL in the same subjects. 1000 HIV+ and 300 high-risk HIV- women at the 6 national WIHS sites will be studied every 6 months with anal HPV testing, anal cytology, high resolution endoscopies and anal biopsy. Participants will be interviewed regarding behavioral and other risk factors for ASIL. These data will be analyzed in conjunction with the data already being collected at the routine WIHS visit, including cervical HPV testing, cervical cytology, CD4 levels and HIV viral load. Quantitative microsatellite analysis and array-based comparative genomic hybridization will be used to study genetic changes in ASIL. Screening for ASIL is projected to be cost-effective for anal cancer prevention in MSM. Therefore this study will have important public health implications if the data support implementation of screening for ASIL in HIV+ and high-risk HIV- women. Knowledge of genes involved in ASIL pathogenesis may provide new approaches to therapy of both anal and cervical HSIL as well as markers for disease progression.



Publications

Human Immunodeficiency Virus/aids, Human Papillomavirus, And Anal Cancer
Authors: Wang C.J. , Sparano J. , Palefsky J.M. .
Source: Surgical Oncology Clinics Of North America, 2017 Jan; 26(1), p. 17-31.
PMID: 27889034
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Concomitant anal and cervical human papillomavirusV infections and intraepithelial neoplasia in HIV-infected and uninfected women.
Authors: Hessol N.A. , Holly E.A. , Efird J.T. , Minkoff H. , Weber K.M. , Darragh T.M. , Burk R.D. , Strickler H.D. , Greenblatt R.M. , Palefsky J.M. .
Source: Aids (london, England), 2013-07-17 00:00:00.0; 27(11), p. 1743-51.
PMID: 23803793
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Updating the natural history of human papillomavirus and anogenital cancers.
Authors: Moscicki A.B. , Schiffman M. , Burchell A. , Albero G. , Giuliano A.R. , Goodman M.T. , Kjaer S.K. , Palefsky J. .
Source: Vaccine, 2012-11-20 00:00:00.0; 30 Suppl 5, p. F24-33.
PMID: 23199964
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Human papillomavirus-related disease in men: not just a women's issue.
Authors: Palefsky J.M. .
Source: The Journal Of Adolescent Health : Official Publication Of The Society For Adolescent Medicine, 2010 Apr; 46(4 Suppl), p. S12-9.
PMID: 20307839
Related Citations

Anal cancer prevention in HIV-positive men and women.
Authors: Palefsky J.M. .
Source: Current Opinion In Oncology, 2009 Sep; 21(5), p. 433-8.
PMID: 19587592
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Anal human papillomavirus infection is associated with HIV acquisition in men who have sex with men.
Authors: Chin-Hong P.V. , Husnik M. , Cranston R.D. , Colfax G. , Buchbinder S. , Da Costa M. , Darragh T. , Jones D. , Judson F. , Koblin B. , et al. .
Source: Aids (london, England), 2009-06-01 00:00:00.0; 23(9), p. 1135-42.
PMID: 19390418
Related Citations

The epidemiology of anal human papillomavirus and related neoplasia.
Authors: Palefsky J.M. , Rubin M. .
Source: Obstetrics And Gynecology Clinics Of North America, 2009 Mar; 36(1), p. 187-200.
PMID: 19344856
Related Citations

Performance characteristics of anal cytology and human papillomavirus testing in patients with high-resolution anoscopy-guided biopsy of high-grade anal intraepithelial neoplasia.
Authors: Berry J.M. , Palefsky J.M. , Jay N. , Cheng S.C. , Darragh T.M. , Chin-Hong P.V. .
Source: Diseases Of The Colon And Rectum, 2009 Feb; 52(2), p. 239-47.
PMID: 19279418
Related Citations

Anal intraepithelial neoplasia in a multisite study of HIV-infected and high-risk HIV-uninfected women.
Authors: Hessol N.A. , Holly E.A. , Efird J.T. , Minkoff H. , Schowalter K. , Darragh T.M. , Burk R.D. , Strickler H.D. , Greenblatt R.M. , Palefsky J.M. .
Source: Aids (london, England), 2009-01-02 00:00:00.0; 23(1), p. 59-70.
PMID: 19050387
Related Citations

Human papillomavirus-related disease in people with HIV.
Authors: Palefsky J. .
Source: Current Opinion In Hiv And Aids, 2009 Jan; 4(1), p. 52-6.
PMID: 19339939
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Comparison of patient- and clinician-collected anal cytology samples to screen for human papillomavirus-associated anal intraepithelial neoplasia in men who have sex with men.
Authors: Chin-Hong P.V. , Berry J.M. , Cheng S.C. , Catania J.A. , Da Costa M. , Darragh T.M. , Fishman F. , Jay N. , Pollack L.M. , Palefsky J.M. .
Source: Annals Of Internal Medicine, 2008-09-02 00:00:00.0; 149(5), p. 300-6.
PMID: 18765699
Related Citations

Human papillomavirus-related tumors in HIV.
Authors: Palefsky J. .
Source: Current Opinion In Oncology, 2006 Sep; 18(5), p. 463-8.
PMID: 16894294
Related Citations

Molecular cytogenetic characterization of human papillomavirus16-transformed foreskin keratinocyte cell line 16-MT.
Authors: McGhee E.M. , Cotter P.D. , Weier J.F. , Berline J.W. , Turner M.A. , Gormley M. , Palefsky J.M. .
Source: Cancer Genetics And Cytogenetics, 2006-07-01 00:00:00.0; 168(1), p. 36-43.
PMID: 16772119
Related Citations

Age-related prevalence of anal cancer precursors in homosexual men: the EXPLORE study.
Authors: Chin-Hong P.V. , Vittinghoff E. , Cranston R.D. , Browne L. , Buchbinder S. , Colfax G. , Da Costa M. , Darragh T. , Benet D.J. , Judson F. , et al. .
Source: Journal Of The National Cancer Institute, 2005-06-15 00:00:00.0; 97(12), p. 896-905.
PMID: 15956651
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Human papillomavirus anogenital disease in HIV-infected individuals.
Authors: Chin-Hong P.V. , Palefsky J.M. .
Source: Dermatologic Therapy, 2005 Jan-Feb; 18(1), p. 67-76.
PMID: 15842614
Related Citations

Age-Specific prevalence of anal human papillomavirus infection in HIV-negative sexually active men who have sex with men: the EXPLORE study.
Authors: Chin-Hong P.V. , Vittinghoff E. , Cranston R.D. , Buchbinder S. , Cohen D. , Colfax G. , Da Costa M. , Darragh T. , Hess E. , Judson F. , et al. .
Source: The Journal Of Infectious Diseases, 2004-12-15 00:00:00.0; 190(12), p. 2070-6.
EPub date: 2004-12-15 00:00:00.0.
PMID: 15551204
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Cervical human papillomavirus infection and cervical intraepithelial neoplasia in women positive for human immunodeficiency virus in the era of highly active antiretroviral therapy.
Authors: Palefsky J.M. .
Source: Current Opinion In Oncology, 2003 Sep; 15(5), p. 382-8.
PMID: 12960521
Related Citations

Incidence of anal cancer in California: increased incidence among men in San Francisco, 1973-1999.
Authors: Cress R.D. , Holly E.A. .
Source: Preventive Medicine, 2003 May; 36(5), p. 555-60.
PMID: 12689800
Related Citations

Chapter 6: Immunosuppression and co-infection with HIV.
Authors: Palefsky J.M. , Holly E.A. .
Source: Journal Of The National Cancer Institute. Monographs, 2003; (31), p. 41-6.
PMID: 12807944
Related Citations

Natural history and clinical management of anal human papillomavirus disease in men and women infected with human immunodeficiency virus.
Authors: Chin-Hong P.V. , Palefsky J.M. .
Source: Clinical Infectious Diseases : An Official Publication Of The Infectious Diseases Society Of America, 2002-11-01 00:00:00.0; 35(9), p. 1127-34.
EPub date: 2002-11-01 00:00:00.0.
PMID: 12384848
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Cervical and anal HPV infections in HIV positive women and men.
Authors: de Sanjosé S. , Palefsky J. .
Source: Virus Research, 2002 Nov; 89(2), p. 201-11.
PMID: 12445660
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