HPV oral lesions in HIV‐infected patients: the impact of long‐term HAART

Abstract

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.

Recalcitrant oral squamous cell papilloma lesions in two HIV-infected patients successfully treated with topical imiquimod

“…3,9 Surprisingly however, in contrast to most oral complications that have decreased after the beginning of the HAART area, the incidence of oral warts seems to have increased in HIV-patients undergoing HAART, 5 a treatment that leads to the reconstitution of the peripheral immune system. 5,6 Reported treatments for HPV-oral lesions include caustic/acid agents, cantharidin, podophyllin resin, tretinoin, intralesional bleomycin, topical 5-fluorouracil, surgical modalities (cryosurgery, CO2 slush, electrosurgery and curettage, blunt dissection, excision, CO2 laser), imiquimod, vitamin A (oral etretinate), cimetidine, zinc sulphate, x-ray, heat and tape occlusion, or a combination of the above. 7,10 However, a very limited number of case reports have addressed treatments specifically targeted to intraoral warts in HIV-patients.…”

“…High rates of oral warts associated with long-term use of HAART and old age have also been reported. 5 Additionally, the likelihood of oral HPV-infections increased in HIV-patients undergoing HAART, after adjusting for CD4-lymphocyte count and HIV-viral load; and specifically, the incidence of oral SCP increases with logarithmic decline in the HIV-viral load after institution of HAART. 5,6 Oral SCP-lesions in HIV-patients are frequently multiple, larger, and commonly widespread; triggering chronic functional and aesthetic disturbances.…”

“…5 Additionally, the likelihood of oral HPV-infections increased in HIV-patients undergoing HAART, after adjusting for CD4-lymphocyte count and HIV-viral load; and specifically, the incidence of oral SCP increases with logarithmic decline in the HIV-viral load after institution of HAART. 5,6 Oral SCP-lesions in HIV-patients are frequently multiple, larger, and commonly widespread; triggering chronic functional and aesthetic disturbances. 1 Several therapeutic modalities have been used in order to manage oral HPV-related lesions in HIV-patients; however, persistence of lesions and/or recurrences are commonly observed.…”

“…3 Recent evidence indicates that HPV-related oral diseases are more frequent in human immunodeficiency virus (HIV)-infected patients. 4,5 The prevalence of oral SCP in patients under treatment with highly active anti-retroviral therapy (HAART) has dramatically increased from 5% in the pre-HAART era to 23%. High rates of oral warts associated with long-term use of HAART and old age have also been reported.…”

Manejo Quirúrgico de Múltiples Condilomas de la Mucosa Oral en Paciente Bajo Terapia Antirretroviral de Gran Actividad

“…Por otro lado, estudios han encontrado un aumento en la prevalencia de lesiones verruciformes de la mucosa oral en TARGA de larga data, principalmente asociadas al Virus Papiloma Humano (VPH) (Greenspan et al, 2001;King et al, 2002;Anaya-Saavedra et al, 2013). Entre estas, se pueden citar: papiloma escamoso oral, verruga vulgar, condiloma e hiperplasia epitelial focal (Anaya-Saavedra et al).…”