Heightened HIV Replication in Anal High-Grade Squamous Intraepithelial Lesions

Human papillomavirus (HPV) infection of the anal canal and associated diseases such as squamous cell carcinoma are common among men who have sex with men (MSM), and anal HPV infection is associated with HIV acquisition. In addition, HIV-infected MSM are less likely to clear anal HPV infection, and antiretroviral therapy (ART) has not significantly reduced the rates of HPV-associated diseases in such patients. Might HPV affect the HIV-1 burden in the anal mucosa?

To explore this question, investigators in Europe studied three HIV-infected individuals who were on ART, had undetectable plasma HIV viral loads, and had recently received a diagnosis of anal high-grade squamous intraepithelial lesions (HSILs). All three had CD4-count nadirs of <350…