Prevention of human papillomavirus (HPV)-related tumors in people living with human immunodeficiency virus (HIV)

Abstract

In comparison to their HIV-negative counterparts, people living with HIV (PLWH) have a higher prevalence of human papillomavirus (HPV) infection in various anatomical sites coupled with increased HPV persistence, higher risk of HPV-related tumors, and faster disease progression. Areas covered: Gender-neutral prevention strategies for HPV-related cancers in PLWH discussed: ABC approach, HPV vaccination, antiretroviral treatment (ART), anal cancer screening, and smoking cessation. Gender specific strategies: cervical cancer screening reduces the incidence and mortality of cervical cancer and circumcision might reduce the risk of HPV infections in men. Expert commentary: HPV-related cancer incidence has not declined (e.g. cervical cancer) and has even increased (e.g. anal cancer) in the ART era, demanding an effective HPV prevention strategy. HPV vaccination should be introduced into national prevention programs worldwide immediately because current prophylactic vaccines are safe, tolerable, and immunogenic in PLWH. HPV vaccine efficacy trials in PLWH are essential to determine the most appropriate immunization schedule. The population most at risk of anal cancer is HIV-positive men who have sex with men, who are not protected by herd immunity if only the female population is vaccinated. Unvaccinated PLWH need enhanced surveillance for early detection of HPV-related cancers and their precursors.

The Role of Beta HPV Types and HPV-Associated Inflammatory Processes in Cutaneous Squamous Cell Carcinoma

“…Immunosuppression. The prevalence of HPV infection is higher in immunosuppressed individuals than in the general population, and they have an increased risk of developing HPV-associated tumours, characterized by an aggressive behavior and a rapid growth [77]. Increased levels of HPV DNA were detected in these individuals, leading to the hypothesis that HPV infection is an important cofactor in the occurrence of SCC in these patients [78].…”

Comorbidities associated with HPV infection among people living with HIV-1 in the southeastern US: a retrospective clinical cohort study

“…However, we are aware that crude incidence rates were used for trend analysis, because log transformed Joinpoint regression model was conducted. Although PLWH are at higher risks of HPV-related anogenital conditions compared to the general population [1], most of these HPVrelated HSIL and cancers were still not common among them. In order to normalize the distribution of the diagnosed cases over the study period, a log transformed rate model needs to be adopted.…”

“…Human papillomavirus (HPV) is a common sexually transmitted infection (STIs) in the general population and specifically among people living with HIV infection (PLWH) [1,2]. While the infection is treatable, it has chronic sequelae including development of cancer [3].…”

Comorbidities associated with HPV infection among people living with HIV-1 in the Southeastern US: a retrospective clinical cohort study

“…However, we are aware that crude incidence rates were used for trend analysis, because log transformed Joinpoint regression model was conducted. Although PLWH are at higher risks of HPVrelated anogenital conditions compared to the general population [1], most of these HPV-related HSIL and cancers were still not common among them. In order to normalize the distribution of the diagnosed cases over the study period, a log transformed rate model needs to be adopted.…”