Human papillomavirus infection in the oral cavity of HIV patients is not reduced by initiating antiretroviral therapy. Academic Article uri icon



  • OBJECTIVE: The incidence of human papillomavirus (HPV)-related oral malignancies is increasing among HIV-infected populations, and the prevalence of oral warts has reportedly increased among HIV patients receiving antiretroviral therapy (ART). We explored whether ART initiation among treatment-naive HIV-positive adults is followed by a change in oral HPV infection or the occurrence of oral warts. DESIGN: Prospective, observational study. METHODS: HIV-1 infected, ART-naive adults initiating ART in a clinical trial were enrolled. End points included detection of HPV DNA in throat-washes, changes in CD4 T-cell count and HIV RNA, and oral wart diagnosis. RESULTS: Among 388 participants, 18% had at least one HPV genotype present before initiating ART, and 24% had at least one genotype present after 12-24 weeks of ART. Among those with undetectable oral HPV DNA before ART, median change in CD4 count from study entry to 4 weeks after ART initiation was larger for those with detectable HPV DNA during follow-up than those without (Pā€Š=ā€Š 0.003). Both prevalence and incidence of oral warts were low (3% of participants having oral warts at study entry; 2.5% acquiring oral warts during 48 weeks of follow-up). CONCLUSION: These results suggest: effective immune control of HPV in the oral cavity of HIV-infected patients is not reconstituted by 24 weeks of ART; whereas ART initiation was not followed by an increase in oral warts, we observed an increase in oral HPV DNA detection after 12-24 weeks. The prevalence of HPV-associated oral malignancies may continue to increase in the modern ART era.


  • Wilkin, Timothy
  • Shiboski, Caroline H
  • Lee, Anthony
  • Chen, Huichao
  • Webster-Cyriaque, Jennifer
  • Seaman, Todd
  • Landovitz, Raphael J
  • John, Malcolm
  • Reilly, Nancy
  • Naini, Linda
  • Palefsky, Joel
  • Jacobson, Mark A

publication date

  • June 19, 2016



  • Anti-Retroviral Agents
  • HIV Infections
  • Mouth Diseases
  • Papillomavirus Infections
  • Warts


PubMed Central ID

  • PMC4900420

Scopus Document Identifier

  • 84959226580

Digital Object Identifier (DOI)

  • 10.1097/QAD.0000000000001072

PubMed ID

  • 26919735

Additional Document Info


  • 30


  • 10