ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
HPV and anal cancer
Anal cancer is the most common non-AIDS cancer in HIV positive MSM.
Up to 100 times the risk compared with the general population.
90-92% show HPV types 16 (or 18), second only to cervical cancer in its association with this virus.
29% of positive MSM test positive for HPV type 16.
1 in 5 go on to Incident HPV16 (test positive at 12 months) - 4% in total.
Higher risk with anal STIs.
Clearance of most HPV types is common - 50% will clear per year.
HPV16 is twice as difficult to clear than the other HPV types (only happens in 20%).
Predictors of clearance - younger age, smaller lesions, low risk lesions.
30-50% of HIV positive men have HSIL (high-grade squamous intraepithelial lesions).
It is not standard of care to treat these (unproven effectiveness).