AEGiS-13IAC: Emergence of oral HPV infection among HIV-infected patients in the HAART era.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Emergence of oral HPV infection among HIV-infected patients in the HAART era.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrB304)

Blumberg HM, King MD, O'Daniels CM, Larsen NM, Reznik DA
H. M. Blumberg, Emory University, Division of Infectious Diseases, 69 Butler Street, Atlanta, GA 30303, United States, Tel.: +404-616-6145, Fax: +404-880-9305, E-mail: hblumbe@emory.edu

INTRODUCTION: Since the introduction of highly active antiretroviral therapy (HAART), we have recognized with increasing frequency the development of oral Human Papilloma Virus (HPV) infection among HIV+ patients receiving care at an urban oral health center (OHC). Objective and

METHODS: To identify risk factors for oral HPV in HIV+ patients, a nested case-control study was performed. Cases were defined as HIV+ patients diagnosed with oral HPV in 1997-1999. Controls (2 for each case) were randomly chosen from HIV+ patients scheduled to be seen at the OHC on the same day as the case diagnosis date. Medical and dental records were reviewed; logistic regression was performed for univariate and multivariate analysis.

RESULTS: During the 3-year study period, 52 patients with oral HPV (cases) were identified among the 2194 HIV+ patients seen at the OHC (prevalence 2.4%). Cases were significantly more likely to have been diagnosed in 1999 (34 cases) compared to 1997-98 (18 cases) `OR 2.20, 95% CI 1.20-4.06'. Among the 887 new patients who entered the OHC during the study period, 30 new cases were diagnosed for an incidence of 3.4%. The median CD4 count did not differ significantly between cases (202/ml) and controls (218/ml), and there were no significant differences in the proportion receiving HAART or HIV risk factors. Risk factors for oral HPV in univariate analysis included viral load suppression > 400 copies/ml (OR 2.27, 95% CI 1.03-5.01) or é ú 1,000 copies/ml (OR 2.13, 95% CI 1.04-4.34), and male sex (OR 3.59, 95% CI 1.00-12.87). In multivariate analysis, there was a trend toward increased risk of oral HPV associated with viral load suppression > 400 copies/ml (OR 2.25, 95% CI 0.99-5.07) and rectal HPV (OR 2.06, 95% CI 0.97-4.40).

CONCLUSION: Oral HPV was not an uncommon finding, and the prevalence of this disease appears to be increasing in the HAART era. Viral load suppression and rectal HPV may be potential risk factors for the development of oral HPV.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, HIV, Papillomavirus, Human, HIV Infections, Mouth Diseases, HIV Seropositivity, CD4 Lymphocyte Count, Viral Load, Prevalence, Risk Factors, Incidence, Anti-HIV Agents, HIV Seronegativity, Case-Control Studies, Human, Male, immunology
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TuOrB304