Prevalence and incidence of HPV infection in men having sex with men enrolled in a PrEP study: A sub-study of the ANRS IPERGAY trial.

BACKGROUND: HPV infection is more frequent in HIV-infected than in HIV-negative men having sex with men (MSM). There are currently no data regarding HPV infection in PrEP-using MSM. METHODS: HIV-negative MSM enrolled in ANRS Ipergay PrEP study were prospectively enrolled. Anal, penile and oral samples were collected at baseline and every 6 months for HPV detection and genotyping. Anal swabs for cytology were obtained at baseline and at 24 months. RESULTS: One hundred and sixty-two participants were enrolled. The prevalence of any-HPV at baseline was 92%, 32% and 12% at the anal, penile and oral sites respectively. High-risk (HR) HPV were observed in 84%, 25% and 10% of anal, penile and oral baseline samples respectively. Nonavalent HPV vaccine genotypes were observed in 77%, 22% and 6% of anal, penile and oral baseline samples, respectively. Multiple infections were observed in 76%, 17% and 3% of cases at the anal, penile and oral site respectively. The most frequent HR genotypes were HPV 53, 51 and 16 at anal site, HPV 33, 39 and 73 at penile site and HPV 66 at oral site. The incidence of any-HPV at anal site was 86.2/1000 person-months and the incidence of HR-HPV was 72.3/1000 person-months. Baseline cytology was normal in 32% of cases, and classified as ASC-US, LSIL, HSIL and ASC-H in respectively 23%, 40%, 5% and 1% of cases. CONCLUSIONS: PrEP users have a similar risk of HPV infection than HIV-infected MSM, much higher than previously reported in HIV-negative MSM.