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We assessed factors associated with anal precancer in HIV+ and at-risk HIV-negative women from the Atlanta Women\u2019s Interagency HIV Study cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All participants underwent high-resolution anoscopy and anal cytology and had anal and cervical samples collected. Specimens were tested for 37 human papillomavirus (HPV) types and for FAM19A4 and microRNA124-2 promoter methylation. Binary logistic regression and multivariate analysis were conducted with histologic anal high-grade squamous intraepithelial lesion (A-HSIL) as the dependent variable.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seventy-five women were enrolled: 52 (69%) were HIV+ with three-fourths having undetectable viral load; 64 (86%) were black; mean age was 49 \u00b1 8 years. Forty-nine (65%) anal cytology samples were abnormal, and 38 (51%) of anal samples were positive for at least 1 of 13 high-risk HPV (hrHPV) types. Thirteen (18%) anal biopsies identified A-HSIL. Hypermethylation of FAM19A4 and\/or microRNA124-2 was found in 69 (95%) anal samples and 19 (26%) cervical samples. In multivariate analyses, the odds of having A-HSIL were &amp;gt;6 times higher in women with anal hrHPV (adjusted odds ratio [aOR], 6.08 [95% confidence interval {CI}, 1.27\u201329.18], P = .02) and with positive cervical methylation (aOR, 6.49 [95% CI, 1.66\u201325.35], P = .007), but not significantly higher in women with positive anal methylation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Anal hrHPV and promoter hypermethylation in the cervix show promise as biomarkers for anal cancer screening in HIV+ and at-risk HIV-negative women. Greater understanding of gene silencing by promoter hypermethylation in anal carcinogenesis is needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz336","type":"journal-article","created":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T19:17:08Z","timestamp":1556911028000},"page":"1121-1128","source":"Crossref","is-referenced-by-count":13,"title":["Pilot Study of Markers for High-grade Anal Dysplasia in a Southern Cohort From the Women\u2019s Interagency Human Immunodeficiency Virus Study"],"prefix":"10.1093","volume":"70","author":[{"given":"Cecile D","family":"Lahiri","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Georgia"},{"name":"Atlanta Women\u2019s Interagency HIV Study, Rollins School of Public Health, Emory University, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh 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