Hindawi Publishing Corporation Journal of Sexually Transmitted Diseases Volume 2013, Article ID 915169, 8 pages http://dx.doi.org/10.1155/2013/915169 Clinical Study HPV Infection in a Cohort of HIV-Positive Men and Women: Prevalence of Oncogenic Genotypes and Predictors of Mucosal Damage at Genital and Oral Sites Giulia Marchetti, 1 Laura Comi, 1 Teresa Bini, 1 Marco Rovati, 2 Francesca Bai, 1 Barbara Cassani, 3 Marina Ravizza, 4 Marco Tarozzi, 5 Alessandro Pandolfo, 1 Serena Dalzero, 4 Enrico Opocher, 2 Solange Romagnoli, 3 Antonio Carrassi, 5 Silvano Bosari, 6 and Antonella d’Arminio Monforte 1 1 Department of Health Sciences, Institute of Infectious and Tropical Diseases, San Paolo Hospital, University of Milan, Via A Di Rudin` ı 8, 20142 Milan, Italy 2 Surgery Chair, Department of Health Sciences, San Paolo Hospital, University of Milan, 20142 Milan, Italy 3 Pathology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, 20142 Milan, Italy 4 Department of Health Sciences, Institute of Obstetrics and Gynecology, San Paolo Hospital, University of Milan, 20142 Milan, Italy 5 Dentistry Chair, Department of Health Sciences, San Paolo Hospital, University of Milan, 20142 Milan, Italy 6 Pathology Unit, Department of Medicine, Surgery and Dentistry, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20142 Milan, Italy Correspondence should be addressed to Giulia Marchetti; giulia.marchetti@unimi.it Received 11 December 2012; Revised 1 February 2013; Accepted 1 February 2013 Academic Editor: Jose L. (Toti) Sanchez Copyright © 2013 Giulia Marchetti et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Te aim of this study was to assess the prevalence of HPV infection and determinants of abnormal cytology in HIV-positive patients. In a cross-sectional study, patients of both sexes, asymptomatic for HPV, underwent anorectal (men)/cervical (women) and oral swabs. Cytology and HPV-PCR detection/genotyping (high- and low-risk genotypes, HR-LR/HPV) were performed. A total of 20% of the 277 enrolled patients showed oral HPV, with no atypical cytology; in men, anal HPV prevalence was 81% with 64% HR genotypes. In women, cervical HPV prevalence was 58% with 37% HR-HPV. Te most frequent genotypes were HPV-16 and HPV- 18; 37% of men and 20% of women harbored multiple genotypes. Also, 47% of men showed anal squamous intraepithelial lesions (SILs); 6% had high- and 35% low-grade SILs (HSILs/LSILs); 5% had atypical squamous cells of undetermined signifcance (ASC- US). HR-HPV was independently associated with anal-SIL in men ( = 0.039). Moreover, 37% of women showed cervical SIL: 14 ASC-US, 15 LSILs, 4 HSILs, and 1 in situ cancer. Te presence of both LR and HR-HPV in women was independently associated with SIL ( = 0.003 and  = 0.0001). HR-HPV and atypical cytology were frequently identifed in our cohort. HPV screening should be mandatory in HIV-infected subjects, and vaccine programs for HPV-negative patients should be implemented. 1. Introduction Human papillomavirus (HPV) is one of the most common sexually transmitted pathogens, responsible of several difer- ent diseases ranging from benign common warts to invasive carcinoma at a variety of anatomical sites, including the cervix, vulva, vagina, penis, anus, and oropharynx [1]. While the immune system eliminates over time most HPV infections in immunocompetents individuals, HPV infections tend to persist in immunodefcient ones, such as HIV-positive subjects, probably due to the inability to control the expression and replication of HPV by HIV-compromised immune system [2]. Persistent infections with oncogenic HPV genotypes are causally related to the development of high-grade intraepithelial lesions and invasive carcinoma. Many studies have shown a higher incidence of HPV- related cervical cancer [3] in HIV-positive women compared to general population, and in 1993, cervical cancer was