The number of immunocompromised patients is rising, and immunodeficiency is an independent risk factor for the development of premalignant and malignant lesions of the cervix and anogenital tract. The aim of this review was to summarize and update data on human papilloma virus (HPV) infections and HPV-based anogenital lesions detected in patients who were immunocompromised due to both organ transplantation and human immunodeficiency virus (HIV) infection. The incidence of HPV infections among solid organ recipients and HIV positive females is reported to be significantly higher when compared with age-matched healthy controls- i.e. higher by up to 65% and 46.6% respectively, vs 38% in the controls. These infections are also more often chronic, high risk HPV and multitype. Data suggest that HPV infections in these patients might not only occur more frequently, but that the course of the infection might also lead to faster oncogenesis. However, the treatment options for malignancies are limited; and this implies the need for intense primary and secondary prevention regimens. As infections with HPV types other than 16 and 18 and multitype infections are particularly frequently discovered in immunocompromised patients, they would probably benefit most from a nonavalent vaccine. Gynecological screening should be performed annually, including cervical smears and/ or HPV testing. In the group of non-responders, self-sampling methods should be considered.
Keywords: HIV; HPV; human papilloma virus; immunocompromise; malignancy; transplantation.
HPV Carcinomas in Immunocompromised Patients.J Clin Med. 2015 Jan 29;4(2):260-81. doi: 10.3390/jcm4020260. J Clin Med. 2015. PMID: 26239127 Free PMC article. Review.
Anal dysplasia screening: an evidence-based analysis.Ont Health Technol Assess Ser. 2007;7(4):1-43. Epub 2007 Jun 1. Ont Health Technol Assess Ser. 2007. PMID: 23074504 Free PMC article.
Anogenital malignancies in women after renal transplantation over 40 years in a single center.Transplantation. 2012 May 15;93(9):914-22. doi: 10.1097/TP.0b013e318249b13d. Transplantation. 2012. PMID: 22377788
p53 and bcl2 expression in malignant and premalignant lesions of uterine cervix and their correlation with human papilloma virus 16 and 18.South Asian J Cancer. 2014 Jan;3(1):48-53. doi: 10.4103/2278-330X.126524. South Asian J Cancer. 2014. PMID: 24665447 Free PMC article.
Quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine (gardasil(®)): a review of its use in the prevention of premalignant anogenital lesions, cervical and anal cancers, and genital warts.Drugs. 2014 Jul;74(11):1253-83. doi: 10.1007/s40265-014-0255-z. Drugs. 2014. PMID: 25022951 Review.