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Title: Clinical and molecular aspects of anal human papillomavirus, human papillomavirus associated anal squamous intraepithelial lesions, and anal cancer
Author: Cranston, Ross Douglas
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2008
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In a population of men who have sex with men (MSM), anal HPV is common with 61% of HIV-negative and 93% of HIV-positive men testing positive for the virus using the polymerase chain reaction (PCR) technique. MSM also have high rates of anal dysplasia, the putative precursor of anal cancer. The goal of this thesis is to describe clinical and molecular aspects of anal human papillomavirus, and its associated anal lesions, and has four main aims. Identification of risk factors for the development of anal cancer: high-grade anal dysplasia may be a risk factor or marker for the subsequent development of anal cancer and in the context of long-standing HIV infection, anal cancer may be diagnosed at an earlier age than in the general population. Investigation of the efficacy of self-taken and cytology swabs: a population of MSM with previous experience of anal cytology testing and anal biopsy with only written instructions are capable of self-collecting samples with sensitivity comparable to experienced clinicians. In addition the sensitivity of anal cytology collected by clinicians and subjects to detect AIN 2 or 3 on biopsy was comparable. Thus self-collected anal cytology may allow high-risk populations to be screened outside of a medical setting. Investigation of the feasibility of cytokine detection by reverse transcription PCR: likely due to the nature of the samples, RNA purity was low with resulting multiplicity of bands with PCR production was run on agarose gel. Likely causes for experimental failure include faecal contamination of specimens, and low quantities of investigational cytokines in cytology specimens. Investigation of the prevalence of age-related anal HPV and anal cytological abnormality in a cohort of HIV-negative MSM: This study illustrated for the first time the epidemiology of anal HPV infection and anal cytological diagnoses in a population of HIV-negative MSM recruited from a wide age-range.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available