Risk of genital warts in renal transplant recipients—A registry‐based, prospective cohort study

• Published in: American journal of transplantation Vol. 19; no. 1; pp. 156 - 165
• Main Authors: Larsen, Helle Kiellberg, Thomsen, Louise T., Haedersdal, Merete, Dehlendorff, Christian, Schwartz Sørensen, Søren, Kjaer, Susanne K.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Limited 01.01.2019
• Subjects: Adult; Anogenital; clinical research/practice; Cohort analysis; Condyloma acuminatum; Condylomata Acuminata - complications; Condylomata Acuminata - diagnosis; Condylomata Acuminata - epidemiology; Denmark - epidemiology; Dialysis; Epidemiology; Female; Graft rejection; Grafts; Health risk assessment; Heart Transplantation; Human papillomavirus; Humans; Immunosuppression; Immunosuppression Therapy; Immunosuppressive Agents - therapeutic use; Incidence; infection and infectious agents—viral: papillomavirus; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - surgery; Kidney Transplantation; kidney transplantation/nephrology; Kidney transplants; Male; Middle Aged; Proportional Hazards Models; Prospective Studies; Registries; registry/registry analysis; Risk Factors; Statistical analysis; Transplant Recipients; Transplants & implants; Vaccination; Warts; Young Adult; Denmark; epidemiology; infection and infectious agents-viral: papillomavirus; registry/registry analysis; clinical research/practice; kidney transplantation/nephrology
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/ajt.15056

Genital warts (GWs) are a risk factor for subsequent human papillomavirus (HPV)–related anogenital cancers. In this register‐based, prospective cohort study, we estimated the risk of GWs in renal transplant recipients (RTRs) compared with a nontransplanted cohort. In a nationwide database, we identified first‐time RTRs in Denmark during 1996 to 2015. For each RTR, 50 age‐ and sex‐matched nontransplanted individuals were selected from the population registry. Information on GWs, sociodemographic characteristics, HPV vaccination, and other causes of immunosuppression was retrieved from registries. We estimated the cumulative incidence of GWs and used Cox regression to estimate hazard ratios (HR) of GWs in RTRs vs non‐RTRs. We included 3268 RTRs and 162 910 non‐RTRs without GWs 1 year before baseline. RTRs had higher hazard of GWs than non‐RTRs (HR = 3.30; 95% confidence interval, 2.76‐3.93, adjusted for sex, age, education, and income). The increased hazard of GWs compared with non‐RTRs was more pronounced in female than in male RTRs. Although not statistically significant, the hazard tended to be higher in RTRs with functioning grafts compared with RTRs on dialysis after graft failure. The hazard of GWs was increased <1 year after transplantation and remained increased during ≥10 years. In conclusion, RTRs had substantially higher risk of GWs than non‐RTRs. The risk of genital warts in renal transplant recipients is approximately three times higher than in nontransplant recipients, and the increased risk is more pronounced in female than male renal transplant recipients. See the editorial from Chin‐Hong on page 11.