HPV oral lesions in HIV-infected patients: The impact of long-term HAART
Por:
Anaya-Saavedra G., Flores-Moreno B., García-Carrancá A., Irigoyen-Camacho E., Guido-Jiménez M., Ramírez-Amador V.
Publicada:
1 jul 2013
Resumen:
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. © 2012 John Wiley & Sons A/S.
Filiaciones:
Anaya-Saavedra G.:
Universidad Autónoma Metropolitana-Xochimilco, Ciudad de Mexico, Mexico
Flores-Moreno B.:
Universidad Autónoma Metropolitana-Xochimilco, Ciudad de Mexico, Mexico
García-Carrancá A.:
UNAM, Inst Invest Biomed, Unidad Virus & Canc, Ciudad De Mexico, Mexico
Irigoyen-Camacho E.:
Universidad Autónoma Metropolitana-Xochimilco, Ciudad de Mexico, Mexico
Guido-Jiménez M.:
UNAM, Inst Invest Biomed, Unidad Virus & Canc, Ciudad De Mexico, Mexico
Ramírez-Amador V.:
Universidad Autónoma Metropolitana-Xochimilco, Ciudad de Mexico, Mexico
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