Statistically Significant Associations Between HPV33, HPV35, and HPV56 With Anal HSIL in a Population of MSMLWH.

The aim of the study is to determine the prevalence of high-risk human papillomavirus (hrHPV) genotypes in men who have sex with other men and are living with HIV and the factors associated with anal high-grade squamous intraepithelial lesions (HSIL). Anal swabs were collected for hrHPV genotyping from a cross-sectional group (N = 163) of eligible men who have sex with other men and are living with HIV attending a high-resolution anoscopy clinic. Persistent hrHPV infections were studied in a longitudinal subset (n = 37). Association of anal HSIL with specific hrHPV genotype(s) and with HIV-1 suppression was assessed. Pearson's χ2 test with continuity correction or Fisher's exact test was used to determine statistical significance (alpha = 0.05). Overall prevalence of hrHPV anal infections was 93.3% (152/163). Higher numbers of hrHPV genotypes were detected per sample in the HSIL group compared with less than or Low-grade squamous intraepithelial lesion (≤LSIL) group (p < .001). Proportion of participants infected with HPV33 was higher in the HSIL group (66.7%) than in ≤LSIL group (33.3%, p < .001), as was HPV35 (61.1% vs. 38.9%, p = .001) and HPV56 (56.7% vs. 43.3%, p = .022). HPV33 persistence was highly associated with HSIL (100%; 8/8) compared with ≤LSIL (0%; 0/8) (p < .001). Proportion of HIV-1 suppression (<200 cp/mL) was significantly lower among the HSIL group (80%; 48/60) compared with ≤LSIL group (95.1%; 97/102) (p = .006). Statistically significant associations existed between anal HSIL and HPV33, HPV35, and HPV56 infections, with HPV33 persistence, and with the lack of HIV-1 suppression. These findings emphasize the critical need for genotyping assays that differentiate more than just HPV16, HPV18 and a pool of "other" hrHPV genotypes and that have an intended use with anal specimens. Globally, this highest-risk population would benefit from the 9-valent vaccine to prevent infections and reduce anal cancer risk.

被引量：- 发表：1970

Diagnostic Accuracy of the ICD-10 Code for Lichen Sclerosus in Black Women.

The prevalence of vulvar lichen sclerosus in Black women is unknown. There is a lack of validity using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code L90.0 to identify women with vulvar lichen sclerosus overall, with less accuracy in Black women.

被引量：- 发表：1970

Severe Vulvovaginal Candidiasis Associated With Sodium-Glucose Cotransporter 2 Inhibitors Use in Postmenopausal Women.

We present a case series of severe vulvovaginal candidiasis in postmenopausal women using sodium-glucose cotransporter-2 inhibitor (SGLT2i) medications for the management of their diabetes mellitus. Twenty-four cases from a private vulvovaginal specialist clinic are described. All 24 patients were referred with severe and persistent vulvar pruritus, pain, and erythema. Examination findings varied between patients and included erythema, edema, erosions, adherent white discharge, and fissuring, which were extensive and often involved the mons pubis, labia majora, and extended to the perineum and perianal region, mimicking psoriasis and/or irritant dermatitis. The clinical presentation in this postmenopausal group hindered a timely diagnosis, resulting in a delay in appropriate management. Fortunately, all patients improved on oral antifungal treatment, and in those that ceased their SGLT2i medication, there was resolution of the condition. While candidiasis is reported to occur with SGLT2i, severe genital mycotic infections are not yet a well-recognized adverse effect and may be missed. The presentation in these cases was persistent and severe. Clinicians should have a high index of suspicion in postmenopausal women presenting with vulvar pain, pruritus, and extensive erythema that mimics psoriasis or irritant dermatitis, if they are on SGLT2i therapy.

被引量：- 发表：1970

Cervical Cancer Prevention in Individuals With Criminal Legal System Involvement.

被引量：- 发表：1970

Mycoplasma genitalium's Antibiotic Resistance in Sexually Transmitted Infections Clinics in Israel.

To determine the prevalence of antibiotic resistance rate in Mycoplasma genitalium, and distribution of mutations associated with this resistance, among patients that attended sexually transmitted infections (STI) investigation clinics. This cross-sectional study included M. genitalium-positive samples (urine, vaginal, rectal, and pharyngeal swabs) collected from 170 patients attending two STI investigation clinics, which were subjected to macrolide and quinolone resistance mutations analyses. Data regarding patient age, sex, and material/anatomical site of testing were collected. Macrolide-resistance mutations were identified in 48.8% of samples and were more common among males (p < .0001) and in rectal samples (p < .05). A2059C was the most prevalent macrolide-resistance mutation (18.2%). Quinolone resistance was detected in 23% of the samples, with S83I being the most common (17.1%) mutation. Rate of co-resistance to macrolides and quinolones was 21.2%. The high rate of antibiotic resistance found in the current study, especially to macrolides, underscores the importance of antibiotic resistance monitoring in M. genitalium isolates in cases of persistent or recurrent urethritis/cervicitis, in cases of treatment failure and among specific populations. Such surveillance will improve treatment regimens and cure rates.

被引量：- 发表：1970