Human papillomavirus infection in the oral cavity of HIV patients is not reduced by initiating antiretroviral therapy.

TitleHuman papillomavirus infection in the oral cavity of HIV patients is not reduced by initiating antiretroviral therapy.
Publication TypeJournal Article
Year of Publication2016
AuthorsShiboski CH, Lee A, Chen H, Webster-Cyriaque J, Seaman T, Landovitz RJ, John M, Reilly N, Naini L, Palefsky J, Jacobson MA
JournalAIDS
Volume30
Issue10
Pagination1573-82
Date Published2016 Jun 19
ISSN1473-5571
Abstract

OBJECTIVE: The incidence of human papillomavirus (HPV)-related oral malignancies is increasing among HIV-infected populations, and the prevalence of oral warts has reportedly increased among HIV patients receiving antiretroviral therapy (ART). We explored whether ART initiation among treatment-naive HIV-positive adults is followed by a change in oral HPV infection or the occurrence of oral warts.

DESIGN: Prospective, observational study.

METHODS: HIV-1 infected, ART-naive adults initiating ART in a clinical trial were enrolled. End points included detection of HPV DNA in throat-washes, changes in CD4 T-cell count and HIV RNA, and oral wart diagnosis.

RESULTS: Among 388 participants, 18% had at least one HPV genotype present before initiating ART, and 24% had at least one genotype present after 12-24 weeks of ART. Among those with undetectable oral HPV DNA before ART, median change in CD4 count from study entry to 4 weeks after ART initiation was larger for those with detectable HPV DNA during follow-up than those without (P =  0.003). Both prevalence and incidence of oral warts were low (3% of participants having oral warts at study entry; 2.5% acquiring oral warts during 48 weeks of follow-up).

CONCLUSION: These results suggest: effective immune control of HPV in the oral cavity of HIV-infected patients is not reconstituted by 24 weeks of ART; whereas ART initiation was not followed by an increase in oral warts, we observed an increase in oral HPV DNA detection after 12-24 weeks. The prevalence of HPV-associated oral malignancies may continue to increase in the modern ART era.

DOI10.1097/QAD.0000000000001072
Alternate JournalAIDS
PubMed ID26919735
PubMed Central IDPMC4900420
Grant ListU01 AI068634 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
UM1 AI068634 / AI / NIAID NIH HHS / United States
UM1 AI068636 / AI / NIAID NIH HHS / United States