Kelly H, et al. - Researchers tried to find out the correlation of antiretroviral therapy (ART) and other HIV-related factors on anal HPV infection, anal intraepithelial neoplasia (AIN), and anal cancer among people living with HIV. Systematic review and meta-analysis were conducted to search MEDLINE and EMBASE for studies published between Jan 1, 1996, and Oct 30, 2019, that reported the relationship of HIV-related exposures (ART or highly active ART, HIV-RNA plasma viral load, and nadir or current CD4 cell count) with outcomes of anal high-risk HPV prevalence, incidence, and persistence; prevalence, incidence, progression, or regression of anal histological and cytological abnormalities; and anal cancer incidence. The Newcastle-Ottawa scale was applied to analyze the risk of bias of included studies and random-effects meta-analyses were performed to evaluate heterogeneity using the I 2 statistic. In this study, 6,777 studies were distinguished, of which 5,377 were excluded before full-text review. Anal high-risk HPV infection and anal cancer risk may be reduced by the effective ART use and early initiation at high nadir CD4 counts. This research gives comprehensive estimates of the impact of ART and HIV-related factors on the natural history of anal HPV-related disease in people living with HIV, while most studies were cross-sectional in design and few adjusted for potential confounders,