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HPV and HIV: A Terrible Tango
Slide 1.
HPV and HIV: A Terrible Tango
Slide 1.
Disclosures
Slide 2.
Outline
Slide 3.
Infectious Virus Particle of HPV
Slide 4.
Oncogenic HPV types
Slide 5.
Non-oncogenic HPV types
Slide 6.
HPV Infection and Productive Life Cycle
Slide 7.
Spectrum of HPV disease
Slide 8.
Rates per 100,000 Women
Slide 9.
Age-standardized cervical cancer incidence rate across the globe
Slide 10.
Anal anatomy
Slide 11.
Age-adjusted incidence rate of anal cancer by gender and year of diagnosis
Slide 12.
Estimated number of cases of anal cancer in the U.S. 2010-2013
Slide 13.
Anal and cervical cancer incidence in men who have sex with men
Slide 14.
Recent reports of incidence in anal cancer since introduction of HAART
Slide 15.
Anal cancer rates in North American AIDS Cohort Collaboration on Research and Design) (NA-ACCORD) 1996-2007
Slide 16.
Anal cancer rates in North American AIDS Cohort Collaboration on Research and Design) (NA-ACCORD) 1996-2007
Slide 17.
Anal HPV infection by age group in sexually active HIV-negative MSM
Slide 18.
Anal and cervical HPV infection in HIV-positive women and HIV-negative women at high risk of HIV infection
Slide 19.
Prevalence of AIN among MSM Population-based data
Slide 20.
AIN in HIV-positive and HIV-negative women in the Womens Interagency HIV Study
Slide 21.
AIN in women with CIN/VIN/VAIN
Slide 22.
AIN 2/3 is the precursor to anal cancer
Slide 	23.
Superficially invasive anal cancer arising from AIN 2/3
Slide 24.
Role of primary care provider in screening
Slide 25.
Role of primary care provider in screening
Slide 26.
Anal cytology screening for AIN
Slide 27.
Who should be screened?
Slide 28.
Treatment of HGAIN
Slide 29.
Anal Neoplasia Clinic
Slide 30.
Anal Neoplasia Clinic
Slide 31.
Treatment of AIN 2/3
Slide 32.
Choice of treatment
Slide 33.
85% trichloroacetic acid
Slide 34.
Treatment with infrared coagulation
Slide 36.
IRC and electrocautery ablation in HIV+ MSM
Slide 36.
5-fluorouracil 5% cream
Slide 37.
Cartoon: Two Chocolate Rabbits in Conversation
Slide 38.
When we refer patients to the surgeon
Slide 39.
Primary prevention of anal HPV infection and anal cancer
Slide 40.
HPV Vaccine against Anal HPV Infection and Anal Intraepithelial Neoplasia
Slide 41.
Quadrivalent vaccine in males: efficacy against HPV 6/11/16/18-related AIN and anal cancer in MSM
Slide 42.
Efficacy against HPV 6/11/16/18-related AIN and anal cancer
Slide 43.
HPV vaccination of boys and men
Slide 44.
Vaccination of HIV-positive men and women
Slide 45.
Geometric mean titers to HPV 6, 11, 16 and 18 one month after completion of the standard vaccine regimen
Slide 46.
Percentage of participants sero- and HPV DNA-negative to HPV 6/11/16/18
Slide 47.
Summary
Slide 48.
Resources
Slide 49.