AI Article Synopsis
- Defective cell-mediated immunity in patients with inflammatory bowel disease (IBD) may increase the risk of anal dysplasia and cancer associated with human papillomavirus (HPV), prompting a study on HPV prevalence in this demographic.
- A total of 46 sexually active IBD patients (25 males, 21 females) underwent anal examinations and HPV testing, revealing a high prevalence of anal HPV (89.1%) and abnormal anal cytology in 45.7% of participants.
- The findings indicate that a significant portion of IBD patients have HPV infections and dysplasia, highlighting the need for regular screening and preventive measures in these individuals.
Article Abstract
Background: Defective cell-mediated immunity increases the risk of human papillomavirus-associated anal dysplasia and cancer. There is limited information on anal canal disease in patients with IBD.
Objective: The purpose of this study was to assess anal/vaginal human papillomavirus and anal dysplasia prevalence in patients with IBD.
Design: Patients had an anal examination before routine colonoscopy.
Settings: The study was conducted at a tertiary IBD referral center.
Patients: We studied a convenience sample of sexually active male and female patients with IBD who were not on biological therapy.
Intervention: Anal examination, anal and vaginal human papillomavirus testing, anal cytology, and high-resolution anoscopy/biopsy were carried out.
Main Outcome Measures: Anal and vaginal human papillomavirus types, anal cytology, and biopsy grade were measured.
Results: Twenty-five male and 21 female evaluable participants, 31 with Crohn's disease, 14 with ulcerative colitis, and 1 with indeterminate colitis, were predominantly white (91.3%), treatment experienced (76.1%), an average age of 38.1 years (range, 22.0-66.0 y), and had an average length of IBD diagnosis of 9.3 years (range, 1.0-33.0 y). Eighteen (39.1%) had an abnormal perianal examination and 3 (6.5%) had an abnormal digital examination. Forty-one (89.1%) had anal human papillomavirus, 16 with a single type and 25 with multiple types (range, 2-5 types). Human papillomavirus type 16 was most common (65.2%), followed by human papillomavirus types 11 and 45 (37.0% each). Nineteen of 21 (90.5%) women had vaginal human papillomavirus. Overall, 21 (45.7%) had abnormal anal cytology. Thirty three (71.7%) had ≥1 anal biopsy (9 had multiple), with dysplasia diagnosed in 28 (60.9%) and high-grade and low-grade squamous intraepithelial lesions diagnosed in 4 (8.7%) and 24 (43.5%).
Limitations: No control group was included, and no detailed sexual history was taken.
Conclusions: A high prevalence of anal and vaginal human papillomavirus and anal dysplasia was demonstrated in the study population outcomes. See Video Abstract at http://links.lww.com/DCR/A379.
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