Prevalence of high‐risk human papillomavirus DNA and mRNA and its association with abnormal anal cytology in the Czech male anal cancer screening cohort

Background Anal cancer (AC) screening is justified in high‐risk populations, particularly HIV‐positive men having sex with men (MSM). HR‐HPV testing could improve the efficiency of cytologically based screening of AC, as in the screening of biologically analogical cervical cancer. The specificity of HR‐HPV testing is influenced by the prevalence of HR‐HPV infection in the screened population. Reported anal HR‐HPV DNA prevalence in MSM is high, but HR‐HPV mRNA reflects rather long‐term infections and is more specific for high‐grade lesions. However, no data were published about HR‐HPV DNA and mRNA prevalence in the Czech AC screening population. Method Results of liquid‐based anal cytology of 203 predominantly HIV‐positive MSM from the Czech AC screening cohort were correlated with results of DNA and E6/E7 mRNA testing of 14 HR‐HPV types, and HPV16 genotyping. Eighty‐one MSM underwent a standard anoscopy. Results A total of 109 (53.7%) samples had abnormal cytology, with 12 (5.9%) ASC‐H/HSIL, 67 (33.0%) samples cytologically negative, and 27 (13.3%) unsatisfactory. HR‐HPV DNA was detected in 134 (66.0%) and HR‐HPV RNA in 72 (35.5%) anal smears. HR‐HPV mRNA and HPV16 mRNA positivity were associated with abnormal cytology (p = .0037, p = .0021). No significant association was found between HR‐HPV DNA or HPV16 DNA positivity and abnormal cytology. No high‐grade lesions were revealed by anoscopy. Conclusion Prevalence of anal HR‐HPV DNA among Czech MSM is high, however, the prevalence of HR‐HPV mRNA is half and associated with abnormal cytology. Our results indicate an increased efficiency of cytological screening when combined with HR‐HPV mRNA testing.