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Dermatologic manifestations of HPV in HIV-infected individuals

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Abstract

Dermatologic human papillomavirus (HPV) infection in HIV patients manifests as both anogenital and nongenital skin disease. Anogenital HPV-related disease includes benign condyloma acuminata, the most common cutaneous manifestation of genital HPV infection; intermediate malignancy or premalignant conditions including giant condyloma acuminata (also called Buschke-Loewenstein tumor), anal intraepithelial neoplasia, penile intraepithelial neoplasia, and vaginal or vulvar intraepithelial neoplasia; and frankly malignant disease including Bowen’s disease and invasive anal, penile, or vulvar carcinoma. Cutaneous HPV-related disease in nongenital skin is also increased in HIV-positive patients, in the form of benign common warts, epidermodysplasia verruciformis-like skin lesions, and nonmelanoma skin cancers. This review and update addresses the above listed dermatologic manifestations of HPV disease in HIV-infected individuals, with an emphasis on new findings and published data from 2006 to 2008.

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References and Recommended Reading

  1. Palefsky JM: Cutaneous and genital HPV-associated lesions in HIV-infected patients. Clin Dermatol 1997, 15:439–447.

    Article  PubMed  CAS  Google Scholar 

  2. Wilkins K, Turner R, Dolev JC, et al.: Cutaneous malignancy and human immunodeficiency virus disease. J Am Acad Dermatol 2006, 54:189–206; quiz 207–210.

    Article  PubMed  Google Scholar 

  3. de Villiers EM, Fauquet C, Broker TR, et al.: Classification of papillomaviruses. Virology 2004, 324:17–27.

    Article  PubMed  CAS  Google Scholar 

  4. Narisawa-Saito M, Kiyono T: Basic mechanisms of high-risk human papillomavirus-induced carcinogenesis: roles of E6 and E7 proteins. Cancer Sci 2007, 98:1505–1511.

    Article  PubMed  CAS  Google Scholar 

  5. Clifford GM, Goncalves MA, Franceschi S: Human papillomavirus types among women infected with HIV: a meta-analysis. AIDS 2006, 20:2337–2344.

    Article  PubMed  Google Scholar 

  6. Frisch M, Biggar RJ, Goedert JJ: Human papillomavirus-associated cancers in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome. J Natl Cancer Inst 2000, 92:1500–1510.

    Article  PubMed  CAS  Google Scholar 

  7. Partridge JM, Koutsky LA: Genital human papillomavirus infection in men. Lancet Infect Dis 2006, 6:21–31.

    Article  PubMed  Google Scholar 

  8. Del Mistro A, Chieco Bianchi L: HPV-related neoplasias in HIV-infected individuals. Eur J Cancer 2001, 37:1227–1235.

    Article  PubMed  Google Scholar 

  9. Palefsky JM, Holly EA, Ralston ML, et al.: High incidence of anal high-grade squamous intra-epithelial lesions among HIV-positive and HIV-negative homosexual and bisexual men. AIDS 1998, 12:495–503.

    Article  PubMed  CAS  Google Scholar 

  10. Ahmed AM, Madkan V, Tyring SK: Human papillomaviruses and genital disease. Dermatol Clin 2006, 24:157–165, vi

    Article  PubMed  CAS  Google Scholar 

  11. Brodell LA, Mercurio MG, Brodell RT: The diagnosis and treatment of human papillomavirus-mediated genital lesions. Cutis 2007, 79(Suppl):5–10.

    PubMed  Google Scholar 

  12. Mudrikova T, Jaspers C, Ellerbroek P, Hoepelman A: HPVrelated anogenital disease and HIV infection: not always ‘ordinary’ condylomata acuminata. Neth J Med 2008, 66:98–102.

    PubMed  CAS  Google Scholar 

  13. Brown TJ, Yen-Moore A, Tyring SK: An overview of sexually transmitted diseases. Part II. J Am Acad Dermatol 1999, 41:661–677; quiz 678–680.

    Article  PubMed  CAS  Google Scholar 

  14. Schofer H: Evaluation of imiquimod for the therapy of external genital and anal warts in comparison with destructive therapies. Br J Dermatol 2007, 157(Suppl 2):52–55.

    Article  PubMed  CAS  Google Scholar 

  15. Edwards L, Ferenczy A, Eron L, et al.: Self-administered topical 5% imiquimod cream for external anogenital warts. HPV Study Group. Arch Dermatol 1998, 134:25–30.

    Article  PubMed  CAS  Google Scholar 

  16. Sanclemente G, Herrera S, Tyring SK, et al.: Human papillomavirus (HPV) viral load and HPV type in the clinical outcome of HIV-positive patients treated with imiquimod for anogenital warts and anal intraepithelial neoplasia. J Eur Acad Dermatol Venereol 2007, 21:1054–1060.

    Article  PubMed  CAS  Google Scholar 

  17. Palefsky JM, Holly EA, Ralston ML, et al.: Prevalence and risk factors for anal human papillomavirus infection in human immunodeficiency virus (HIV)-positive and high-risk HIV-negative women. J Infect Dis 2001, 183:383–391.

    Article  PubMed  CAS  Google Scholar 

  18. Kreuter A, Brockmeyer NH, Weissenborn SJ, et al.: Penile intraepithelial neoplasia is frequent in HIV-positive men with anal dysplasia. J Invest Dermatol 2008, 128:2316–2324.

    Article  PubMed  CAS  Google Scholar 

  19. Palefsky JM, Holly EA, Ralston ML, et al.: Anal squamous intraepithelial lesions in HIV-positive and HIV-negative homosexual and bisexual men: prevalence and risk factors. J Acquir Immune Defic Syndr Hum Retrovirol 1998, 17:320–326.

    PubMed  CAS  Google Scholar 

  20. Palefsky JM, Holly EA, Efirdc JT, et al.: Anal intraepithelial neoplasia in the highly active antiretroviral therapy era among HIV-positive men who have sex with men. AIDS 2005, 19:1407–1414.

    Article  PubMed  Google Scholar 

  21. Piketty C, Darragh TM, Heard I, et al.: High prevalence of anal squamous intraepithelial lesions in HIV-positive men despite the use of highly active antiretroviral therapy. Sex Transm Dis 2004, 31:96–99.

    Article  PubMed  Google Scholar 

  22. Fox P, Stebbing J, Portsmouth S, et al.: Lack of response of anal intra-epithelial neoplasia to highly active antiretroviral therapy. AIDS 2003, 17:279–280.

    Article  PubMed  Google Scholar 

  23. Chin-Hong PV, Palefsky JM: Natural history and clinical management of anal human papillomavirus disease in men and women infected with human immunodeficiency virus. Clin Infect Dis 2002, 35:1127–1134.

    Article  PubMed  Google Scholar 

  24. Palefsky J: Human papillomavirus and anal neoplasia. Curr HIV/AIDS Rep 2008, 5:78–85.

    Article  PubMed  Google Scholar 

  25. Casolati E, Agarossi A, Valieri M, Ferrazzi E: Vulvar neoplasia in HIV positive women: a review. Med Wieku Rozwoj 2003, 7:487–493.

    PubMed  Google Scholar 

  26. Sideri M, Jones RW, Wilkinson EJ, et al.: Squamous vulvar intraepithelial neoplasia: 2004 modified terminology, ISSVD Vulvar Oncology Subcommittee. J Reprod Med 2005, 50:807–810.

    PubMed  Google Scholar 

  27. Conley LJ, Ellerbrock TV, Bush TJ, et al.: HIV-1 infection and risk of vulvovaginal and perianal condylomata acuminata and intraepithelial neoplasia: a prospective cohort study. Lancet 2002, 359:108–113.

    Article  PubMed  Google Scholar 

  28. Jamieson DJ, Paramsothy P, Cu-Uvin S, Duerr A; Group HIVERS: Vulvar, vaginal, and perianal intraepithelial neoplasia in women with or at risk for human immunodeficiency virus. Obstet Gynecol 2006, 107:1023–1028.

    PubMed  Google Scholar 

  29. Abercrombie PD, Korn AP: Vulvar intraepithelial neoplasia in women with HIV. AIDS Patient Care STDS 1998, 12:251–254.

    Article  PubMed  CAS  Google Scholar 

  30. de Gois NM, Costa RR, Kesselring F, et al.: Grade 3 vulvar and anal intraepithelial neoplasia in a HIV seropositive child—therapeutic result: case report. Clin Exp Obstet Gynecol 2005, 32:138–140.

    PubMed  Google Scholar 

  31. Cameron JE, Hagensee ME: Human papillomavirus infection and disease in the HIV+ individual. Cancer Treat Res 2007, 133:185–213.

    Article  PubMed  CAS  Google Scholar 

  32. Massad LS, Silverberg MJ, Springer G, et al.: Effect of antiretroviral therapy on the incidence of genital warts and vulvar neoplasia among women with the human immunodeficiency virus. Am J Obstet Gynecol 2004, 190:1241–1248.

    Article  PubMed  CAS  Google Scholar 

  33. Casolati E, Agarossi A, Valieri M, Ferrazzi E: Vulvar neoplasia in HIV-positive women: a review. Med Wieku Rozwoj 2003, 7:487–493.

    PubMed  Google Scholar 

  34. Schmitz MW, Goldberg LJ, Adler AJ: An extensive case of Bowen’s disease in an HIV-positive male. AIDS Patient Care STDS 2007, 21:78–80.

    Article  PubMed  Google Scholar 

  35. Kreuter A, Brockmeyer NH, Pfister H, et al.: Human papillomavirus type 26-associated periungual squamous cell carcinoma in situ in a HIV-infected patient with concomitant penile and anal intraepithelial neoplasia. J Am Acad Dermatol 2005, 53:737–739.

    Article  PubMed  Google Scholar 

  36. Taliaferro SJ, Cohen GF: Bowen’s disease of the penis treated with topical imiquimod 5% cream. J Drugs Dermatol 2008, 7:483–485.

    PubMed  Google Scholar 

  37. Theodore C, Androulakis N, Spatz A, et al.: An explosive course of squamous cell penile cancer in an AIDS patient. Ann Oncol 2002, 13:475–479.

    Article  PubMed  CAS  Google Scholar 

  38. Aboulafia DM, Gibbons R: Penile cancer and human papilloma virus (HPV) in a human immunodeficiency virus (HIV)-infected patient. Cancer Invest 2001, 19:266–272.

    Article  PubMed  CAS  Google Scholar 

  39. Palefsky JM: HPV infection in men. Dis Markers 2007, 23:261–272.

    PubMed  Google Scholar 

  40. Aynaud O, Ionesco M, Barrasso R: Penile intraepithelial neoplasia. Specific clinical features correlate with histologic and virologic findings. Cancer 1994, 74:1762–1767.

    Article  PubMed  CAS  Google Scholar 

  41. Meberg R, Kenyon E, Bierman R, et al.: Characterization of plantar verrucae among individuals with human immunodeficiency virus. J Am Podiatr Med Assoc 1998, 88:442–445.

    PubMed  CAS  Google Scholar 

  42. Kenyon E, Loveland L, Kilpatrick R, Barbosa P: Epidemiology of plantar verrucae in HIV-infected individuals. J Acquir Immune Defic Syndr Hum Retrovirol 1998, 17:94–95.

    PubMed  CAS  Google Scholar 

  43. Davis MD, Gostout BS, McGovern RM, et al.: Large plantar wart caused by human papillomavirus-66 and resolution by topical cidofovir therapy. J Am Acad Dermatol 2000, 43:340–343.

    Article  PubMed  CAS  Google Scholar 

  44. Hultgren TL, Srinivasan SK, DiMaio DJ: Epidermodysplasia verruciformis occurring in a patient with human immunodeficiency virus: a case report. Cutis 2007, 79:307–311.

    PubMed  Google Scholar 

  45. Hohenstein E, Rady PL, Hergersberg M, et al.: Epidermodysplasia verruciformis in a HIV-positive patient homozygous for the c917A→T polymorphism in the TMC8/EVER2 gene. Dermatology 2008, 218:114–118.

    Article  PubMed  CAS  Google Scholar 

  46. McHugh RW, Hazen P, Eliezri YD, Nuovo GJ: Metastatic periungual squamous cell carcinoma: detection of human papillomavirus type 35 RNA in the digital tumor and axillary lymph node metastases. J Am Acad Dermatol 1996, 34:1080–1082.

    Article  PubMed  CAS  Google Scholar 

  47. Pfister H: Chapter 8: Human papillomavirus and skin cancer. J Natl Cancer Inst Monogr 2003, 31:52–56.

    PubMed  Google Scholar 

  48. Nindl I, Gottschling M, Stockfleth E: Human papillomaviruses and non-melanoma skin cancer: basic virology and clinical manifestations. Dis Markers 2007, 23:247–259.

    PubMed  CAS  Google Scholar 

  49. Forslund O, Nordin P, Hansson BG: Mucosal human papillomavirus types in squamous cell carcinomas of the uterine cervix and subsequently on fingers. Br J Dermatol 2000, 142:1148–1153.

    Article  PubMed  CAS  Google Scholar 

  50. Alam M, Caldwell JB, Eliezri YD: Human papillomavirus-associated digital squamous cell carcinoma: literature review and report of 21 new cases. J Am Acad Dermatol 2003, 48:385–393.

    Article  PubMed  Google Scholar 

  51. Handisurya A, Rieger A, Bankier A, et al.: Human papillomavirus type 26 infection causing multiple invasive squamous cell carcinomas of the fingernails in an AIDS patient under highly active antiretroviral therapy. Br J Dermatol 2007, 157:788–794.

    Article  PubMed  CAS  Google Scholar 

  52. Dalle S, Depape L, Phan A, et al.: Squamous cell carcinoma of the nail apparatus: clinicopathological study of 35 cases. Br J Dermatol 2007, 156:871–874.

    Article  PubMed  CAS  Google Scholar 

  53. Del Mistro A, Bertorelle R, Franzetti M, et al.: Antiretroviral therapy and the clinical evolution of human papillomavirus-associated genital lesions in HIV-positive women. Clin Infect Dis 2004, 38:737–742.

    Article  PubMed  Google Scholar 

  54. Heard I, Palefsky JM, Kazatchkine MD: The impact of HIV antiviral therapy on human papillomavirus (HPV) infections and HPV-related diseases. Antivir Ther 2004, 9:13–22.

    PubMed  CAS  Google Scholar 

  55. Palefsky JM, Holly EA, Ralston ML, et al.: Effect of highly active antiretroviral therapy on the natural history of anal squamous intraepithelial lesions and anal human papillomavirus infection. J Acquir Immune Defic Syndr 2001, 28:422–428.

    PubMed  CAS  Google Scholar 

  56. Howley PM: HPV and human cancer: mechanisms of carcinogenesis. Presented at Grand Rounds Seminar Series, Department of Pathology and Laboratory Medicine, University of Pennsylvania. Philadelphia, PA; November 17, 2008.

  57. Palefsky JM, Gillison ML, Strickler HD: Chapter 16: HPV vaccines in immunocompromised women and men. Vaccine 2006, 24(Suppl 3):S3/140–S3/146.

    Google Scholar 

  58. De Vuyst H, Franceschi S: Human papillomavirus vaccines in HIV-positive men and women. Curr Opin Oncol 2007, 19:470–475.

    Article  PubMed  Google Scholar 

  59. Schiller JT, Castellsague X, Villa LL, Hildesheim A: An update of prophylactic human papillomavirus L1 virus-like particle vaccine clinical trial results. Vaccine 2008, 26(Suppl 10):K53–K61.

    Article  PubMed  CAS  Google Scholar 

  60. Emeny RT, Wheeler CM, Jansen KU, et al.: Priming of human papillomavirus type 11-specific humoral and cellular immune responses in college-aged women with a virus-like particle vaccine. J Virol 2002, 76:7832–7842.

    Article  PubMed  CAS  Google Scholar 

  61. Pinto LA, Edwards J, Castle PE, et al.: Cellular immune responses to human papillomavirus (HPV)-16 L1 in healthy volunteers immunized with recombinant HPV-16 L1 viruslike particles. J Infect Dis 2003, 188:327–338.

    Article  PubMed  CAS  Google Scholar 

  62. Bollen LJ, Chuachoowong R, Kilmarx PH, et al.: Human papillomavirus (HPV) detection among human immunodeficiency virus-infected pregnant Thai women: implications for future HPV immunization. Sex Transm Dis 2006, 33:259–264.

    PubMed  Google Scholar 

  63. Palefsky JM, Minkoff H, Kalish LA, et al.: Cervicovaginal human papillomavirus infection in human immunodeficiency virus-1 (HIV)-positive and high-risk HIV-negative women. J Natl Cancer Inst 1999, 91:226–236.

    Article  PubMed  CAS  Google Scholar 

  64. Goncalves MA, Massad E, Burattini MN, Villa LL: Relationship between human papillomavirus (HPV) genotyping and genital neoplasia in HIV-positive patients of Santos City, Sao Paulo, Brazil. Int J STD AIDS 1999, 10:803–807.

    Article  PubMed  CAS  Google Scholar 

  65. Ellerbrock TV, Chiasson MA, Bush TJ, et al.: Incidence of cervical squamous intraepithelial lesions in HIV-infected women. JAMA 2000, 283:1031–1037.

    Article  PubMed  CAS  Google Scholar 

  66. Clifford GM, Gallus S, Herrero R, et al.: Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet 2005, 366:991–998.

    Article  PubMed  CAS  Google Scholar 

  67. Garbuglia AR, Carletti F, Minosse C, et al.: Genetic variability in E6 and E7 genes of human papillomavirus-16, -18, -31 and -33 from HIV-1-positive women in Italy. New Microbiol 2007, 30:377–382.

    PubMed  CAS  Google Scholar 

  68. Harper DM, Franco EL, Wheeler CM, et al.: Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. Lancet 2006, 367:1247–1255.

    Article  PubMed  CAS  Google Scholar 

  69. Smith JF, Brownlow M, Brown M, et al.: Antibodies from women immunized with Gardasil cross-neutralize HPV 45 pseudovirions. Hum Vaccin 2007, 3:109–115.

    PubMed  CAS  Google Scholar 

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  1. Department of Dermatology, University of Pennsylvania, 2 Maloney Building, 3600 Spruce Street, Philadelphia, PA, 19104, USA

    Carrie L. Kovarik

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  1. Rachel H. Gormley
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Gormley, R.H., Kovarik, C.L. Dermatologic manifestations of HPV in HIV-infected individuals. Curr HIV/AIDS Rep 6, 130–138 (2009). https://doi.org/10.1007/s11904-009-0018-8

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