{"doi":"10.1093/cid/ciac581","title":"Incidence and Clearance of Anal Human Papillomavirus Infection in 16 164 Individuals, According to Human Immunodeficiency Virus Status, Sex, and Male Sexuality: An International Pooled Analysis of 34 Longitudinal Studies","abstract":"BACKGROUND: Understanding the natural history of anal high-risk human papillomavirus (hrHPV) infection is key for designing anal cancer prevention programs but has not been systematically characterized. METHODS: We reanalyzed data from 34 studies including 16 164 individuals in 6 risk groups defined by human immunodeficiency virus (HIV) status, sex, and male sexuality: men who have sex with men (MSM) and people with HIV (MSMWH), HIV-negative MSM, women with HIV (WWH), HIV-negative women, men who have sex with women (MSW) with HIV (MSWWH), and HIV-negative MSW. We used Markov models to estimate incidence and clearance of 13 hrHPV types and their determinants. RESULTS: Human papillomavirus (HPV) 16 had the highest incidence-clearance ratio of the hrHPV types. MSMWH had the highest hrHPV incidence (eg, 15.5% newly HPV-16 infected within 2 years), followed by HIV-negative MSM (7.5%), WWH (6.6%), HIV-negative women (2.9%), MSWWH (1.7%), and HIV-negative MSW (0.7%). Determinants of HPV-16 incidence included HIV status and number of sexual partners for MSM, women, and MSW, and anal sex behavior for MSM only. HPV-16 clearance was lower for people with HIV (PWH) and lower for prevalent than incident infection. Among MSM, increasing age was associated with lower clearance of prevalent, but not incident, HPV-16 infection. CONCLUSIONS: This robust and unifying analysis of anal hrHPV natural history is essential to designing and predicting the impact of HPV vaccination and HPV-based screening programs on anal cancer prevention, particularly in MSM and PWH. Importantly, it demonstrates the higher carcinogenic potential of longstanding anal prevalent hrHPV infection than more recent incident infection.","journal":"Clinical Infectious Diseases","year":2022,"id":238532,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":54,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6504,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":33585,"name":"Marc T. Goodman","orcid":"0000-0002-4839-3021","position":1,"is_corresponding":false},{"id":345205,"name":"Ningshao Xia","orcid":"0000-0003-0179-5266","position":2,"is_corresponding":false},{"id":352530,"name":"Jun Zhang","orcid":"0000-0002-6601-9180","position":3,"is_corresponding":false},{"id":390461,"name":"Anna R. Giuliano","orcid":"0000-0002-5440-8859","position":4,"is_corresponding":false},{"id":315093,"name":"Gypsyamber DʼSouza","orcid":"0000-0002-0575-7948","position":5,"is_corresponding":false},{"id":382865,"name":"Nancy A. Hessol","orcid":"0000-0003-3374-8384","position":6,"is_corresponding":false},{"id":231951,"name":"Maarten F. Schim van der Loeff","orcid":"0000-0002-4903-7002","position":7,"is_corresponding":false},{"id":862853,"name":"Jianghong Dai","orcid":"0000-0002-5231-1009","position":8,"is_corresponding":false},{"id":862854,"name":"Karin Neukam","orcid":"0000-0003-3875-1013","position":9,"is_corresponding":false},{"id":862855,"name":"Alexandra de Pokomandy","orcid":"0000-0001-6809-1357","position":10,"is_corresponding":false},{"id":719582,"name":"I. Mary Poynten","orcid":"0000-0002-6113-3769","position":11,"is_corresponding":false},{"id":862856,"name":"Ronald B. 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