HPV oral lesions in HIV-infected patients: the impact of long-term HAART
Article first published online: 20 DEC 2012
© 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Journal of Oral Pathology & Medicine
Volume 42, Issue 6, pages 443–449, July 2013
How to Cite
J Oral Pathol Med (2013) 42: 443−449
- Issue published online: 3 JUL 2013
- Article first published online: 20 DEC 2012
- Manuscript Accepted: 13 NOV 2012
- Area of Basic Sciences
- Teacher Improvement Program (PROMEP) of the Public Education Secretariat . Grant Numbers: PROMEP/103.5/09/4255 , PROMEP/103.5/11/3456
- HAART ;
- human papillomavirus;
- oral warts
Since the introduction of highly active antiretroviral therapy (HAART), an increase in the frequency of human papillomavirus-associated oral lesions (HPV-OL) has been observed. Thus, the aim of this study was to determine the prevalence and factors associated with HPV-OL in Mexican HIV-infected patients, as well as its genotyping, in the HAART era.
In a cross-sectional study developed at an HIV/AIDS referral center in Mexico City, HIV-infected patients were consecutively included from 2004 to 2011. An oral exam was performed; lymphocyte CD4+ count, HIV-viral load, CDC-stage, and HAART use were recorded. HPV-OL samples were taken for routine histopathological analysis (H-E) and HPV-DNA amplification/sequencing. Logistic regression models were performed and the interactions tested using the STATA software.
Among 787 HIV patients, 55 (6.9%) showed HPV-OL. HPV-OLs were independently associated with age (≥40 years) and with a longer time of HAART use (≥12 months). The most frequent lesion was squamous cell papilloma in 22 (40%) cases, followed by multifocal epithelial hyperplasia in 15 (27.3%) cases. Labial mucosa was the most common site involved (56.4%). Of the sequences obtained, 65.4% corresponded to low risk and 11.5% to high risk. Mixed high- and low-risk infection were identified in 7.7% of the cases.
Human papillomavirus-associated oral lesions were associated with older age and longer HAART use. All lesions were benign in nature and most of the HPV sequences corresponded to low-risk types. The rise of HPV-OLs in HIV patients on HAART may be related with the longer life expectancy of individuals with an impaired immune system rather than a direct effect of HAART.