MICROBIOLOGY

• Human papilloma virus (HPV) is a non-enveloped, double-stranded DNA virus that infects stratified squamous epithelium.
• Most infections are self-limited and cleared within 2 years. Oncogenic high-risk types may persist and cause HPV-infected cells to transform into cancer cells.[4][16]
• Oncogenicity is linked to HPV persistence and immunocompromised states, i.e., HIV infection and solid organ transplantation.[14]
  • Cervical cancer is an AIDS-defining malignancy. HPV is a necessary cause of anal, cervical, and vulvovaginal squamous cell cancer.[13][22]
  • Anal cancer incidence rate estimates are highest for men-who-have-sex-with-men (MSM) living with HIV at 85 cases/100,000PY.[7] In non-MSM men living with HIV, the incidence estimate is 32 cases/100,000PY. And in MSM without HIV, the incidence estimate is 19/100,000PY.
• Recent guideline updates include HPV testing of clinician-collected cervical samples, self-collected vaginal samples, and clinician collected anal samples.[2][12] HPV testing via BD Onclarity HPV assay with the Copan 522C.8- swab and the Roche cobas assay with the Evalyn brush or Copan 522C.80 swab are FDA-approved for self-collected vaginal specimens.[2] These recommendations apply to asymptomatic, average-risk individuals. Due to limited data, self-collected vaginal specimens are not a screening option for those living with HIV.[1]