{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:41:36Z","timestamp":1765960896223},"reference-count":15,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,10,4]],"date-time":"2016-10-04T00:00:00Z","timestamp":1475539200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Anal screening is recommended in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive patients, especially men who have sex with men (<jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content>), due to an increased incidence of anal cancer. The optimal screening methods are not generally agreed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Screening for anal lesions by anorectal examination, including anoscopy, was offered to <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive outpatients in a tertiary care university hospital regardless of gender or sexual orientation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 1206 screened patients (701 <jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content>, 247 heterosexual men, 258 women), 311 (26%) had histologically proven lesions related to human papilloma virus (<jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>) (34% <jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content>, 14% heterosexual men, 14% women); 123 (10%) had low\u2010grade dysplasia and 70 (6%) high\u2010grade dysplasia. Seven anal cancers were also diagnosed. Determinants of any lesion were age &lt; 45\u00a0years [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> = 1.56 (95% CI, 1.16\u20132.11)], a <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 count of &lt; 200\/mm<jats:sup>3<\/jats:sup> [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> = 2.54 (1.71\u20133.78)], receptive anal intercourse [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> =3.03 (2.06\u20134.47)], sub\u2010Saharan African origin [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> = 0.53 (0.33\u20130.85)], and history of <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\u2010related lesion [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> = 1.84 (1.35\u20132.51)]. These determinants were similar for all different grades of dysplasia. In patient subgroup analysis, receptive anal intercourse, the <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 cell count and a history of <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> lesions were determinants of <jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>\u2010positivity in all patients, whereas age was only a determinant in men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Anoscopy is an alternative method for anal screening in an <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive population. This screening has to be compared with other tools in populations at high risk of anal cancer.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13304","type":"journal-article","created":{"date-parts":[[2016,2,20]],"date-time":"2016-02-20T21:07:03Z","timestamp":1456002423000},"page":"997-1004","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Determinants of macroscopic anal cancer and precancerous lesions in 1206 <scp>HIV<\/scp>\u2010infected screened patients"],"prefix":"10.1111","volume":"18","author":[{"given":"L.","family":"Abramowitz","sequence":"first","affiliation":[{"name":"AP\u2010HP Department of Gastroenterology and Proctology Bichat University Hospital Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Benabderrahmane","sequence":"additional","affiliation":[{"name":"AP\u2010HP Department of Gastroenterology and Proctology Bichat University Hospital Paris 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