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HPV oral lesions in HIV ‐infected patients: the impact of long‐term HAART
Author(s) -
AnayaSaavedra Gabriela,
FloresMoreno Bertha,
GarcíaCarrancá Alejandro,
IrigoyenCamacho Esther,
GuidoJiménez Miriam,
RamírezAmador Velia
Publication year - 2013
Publication title -
journal of oral pathology and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.887
H-Index - 83
eISSN - 1600-0714
pISSN - 0904-2512
DOI - 10.1111/jop.12032
Subject(s) - human immunodeficiency virus (hiv) , term (time) , medicine , immunology , quantum mechanics , physics
Background 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. Methods 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. Results 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. Conclusions 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 .