First clinical data on anal HPV and dysplasia in MSM living with HIV in Algeria; cross-sectional study (2024)

Introduction Anal cancer, though rare in the general population, is increasing among men who have sex with men (MSM), particularly those living with HIV. In Algeria, no clinical data on anal HPV or precancerous lesions were available until now. Objective To determine the prevalence of anal HPV infection, identify circulating high-risk genotypes, and estimate the frequency of anal dysplasia among MSM with HIV in Setif, Algeria. Methodology A cross-sectional study was conducted in 2024 among 57 MSM followed at the STI/HIV Reference Center in Setif. Anal HPV was detected by PCR (GeneXpert®), followed by high-resolution anoscopy with targeted biopsies. Histology was classified according to LAST (LSIL, HSIL). Results HPV infection was detected in 72% (41/57). HPV-16 and HPV-18 were the predominant genotypes, found in 42.1% and 35.1% of participants. Among the 41 biopsied patients, 85.4% had precancerous lesions, including 39% HSIL. Multiple HPV co-infections occurred in 24.3%. The main risk factors were condomless receptive anal intercourse, smoking, and chemsex. Conclusion This first Algerian study reveals a high prevalence of anal HPV infection and precancerous lesions among MSM with HIV. Findings support the urgent need for targeted screening, HPV vaccination, and strengthened prevention.