{"doi":"10.1093/cid/ciad614","title":"Two-Year Incidence and Cumulative Risk and Predictors of Anal High-Grade Squamous Intraepithelial Lesions (Anal Precancer) Among Women With Human Immunodeficiency Virus","abstract":"BACKGROUND: Detection and treatment of anal histologic high-grade squamous intraepithelial lesions (hHSIL) prevents anal cancer. However, anal hHSIL incidence among women with human immunodeficiency virus (HIV, WHIV) remains unknown. Performance of anal high-risk human papillomavirus ([hr]HPV), anal cytology (anal-cyt), and both for hHSIL detection longitudinally over 2 years also remains undetermined. METHODS: We determined 2-year incidence and cumulative risk estimates (2-y-CR) of anal hHSIL among WHIV using prevalence and incidence (per 100 person-years [py]) observations stratified by baseline hrHPV and/or anal-cyt results. RESULTS: In total, 229 WHIV with complete baseline data were included in the analysis; 114 women without prevalent anal hHSIL were followed with 2 annual evaluations. Median age was 51, 63% were Black, and 23% were Hispanic. Anal hrHPV or abnormal anal-cyt was associated with an increased risk of incident anal hHSIL at 2 years (18.9/100py [95% confidence interval {CI} 11.4-31.3] and 13.4/100py [95% CI 8.0-22.7], respectively) compared with no detection of anal HPV or negative cytology (2.8/100py [95% CI 1.1-7.4] and 4.2 [95% CI, 1.8-10.2]) The presence of anal hrHPV with abnormal cytology was associated with 2-y-CR of anal hHSIL of 65.6% (95% CI 55.4%-75%); negative hrHPV with negative cytology was associated with 2-y-CR of anal hHSIL of 9.2% (95% CI 7.0-16.0). CONCLUSIONS: Detection of anal hrHPV or abnormal anal cytology are comparable predictors for 2-y-CR of anal hHSIL. The absence of anal hrHPV combined with negative cytology was predictive of a lower (but measurable) risk of developing anal hHSIL. These findings provide important data to inform anal cancer screening guidelines for WHIV.","journal":"Clinical Infectious Diseases","year":2023,"id":356722,"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":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9653,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":885079,"name":"Mayuri Jain","orcid":null,"position":1,"is_corresponding":false},{"id":369652,"name":"Himanshu Joshi","orcid":"0000-0003-0272-0733","position":2,"is_corresponding":false},{"id":265754,"name":"Teresa M. Darragh","orcid":"0000-0002-4382-9949","position":3,"is_corresponding":false},{"id":307925,"name":"Ashish A. Deshmukh","orcid":"0000-0001-8936-8108","position":4,"is_corresponding":false},{"id":308659,"name":"Jeannette Y. Lee","orcid":"0000-0003-3536-2442","position":5,"is_corresponding":false},{"id":304399,"name":"Mark H. Einstein","orcid":"0000-0001-7422-0338","position":6,"is_corresponding":false},{"id":894977,"name":"Naomi Jay","orcid":"0000-0002-3574-4144","position":7,"is_corresponding":false},{"id":895526,"name":"J. Michael Berry-Lawhorn","orcid":null,"position":8,"is_corresponding":false},{"id":265771,"name":"Joel M. Palefsky","orcid":"0000-0002-5097-3818","position":9,"is_corresponding":false},{"id":366697,"name":"Timothy Wilkin","orcid":"0000-0001-9386-9335","position":10,"is_corresponding":false},{"id":308258,"name":"Grant Ellsworth","orcid":"0000-0002-7096-5153","position":11,"is_corresponding":false},{"id":301950,"name":"Audrey L. French","orcid":"0000-0002-9776-8934","position":12,"is_corresponding":false},{"id":1105785,"name":"Luis F. Barroso","orcid":"0009-0008-9665-9008","position":13,"is_corresponding":false},{"id":794741,"name":"Rebecca Levine","orcid":null,"position":14,"is_corresponding":false},{"id":759713,"name":"Humberto M. Guiot","orcid":"0000-0001-5177-977X","position":15,"is_corresponding":false},{"id":722853,"name":"M. Katayoon Rezaei","orcid":"0000-0002-2919-1715","position":16,"is_corresponding":false},{"id":292068,"name":"Elizabeth Y. Chiao","orcid":"0000-0001-5752-2916","position":17,"is_corresponding":false},{"id":307929,"name":"Elizabeth A. Stier","orcid":"0000-0003-3526-0032","position":0,"is_corresponding":true}],"reference_count":15,"raw_metadata":null,"created_at":"2026-07-19T01:13:30.556819Z","pmid":"37805952","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}