Prevention of human papillomavirus (HPV)-related tumors in people living with human immunodeficiency virus (HIV)

• Published in: Expert review of anti-infective therapy Vol. 15; no. 11; pp. 987 - 999
• Main Authors: Poljak, Mario, Šterbenc, Anja, Lunar, Maja M.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 02.11.2017
• Subjects: Adult; Anal cancer; Anti-HIV Agents - therapeutic use; Anus Neoplasms - immunology; Anus Neoplasms - prevention & control; Anus Neoplasms - virology; cervical cancer; Circumcision, Male - education; Coinfection; Early Detection of Cancer; Female; HIV; HIV - drug effects; HIV - pathogenicity; HIV - physiology; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - immunology; HIV Infections - virology; HPV; HPV vaccination; Humans; Male; Papillomaviridae - drug effects; Papillomaviridae - pathogenicity; Papillomaviridae - physiology; Papillomavirus Infections - epidemiology; Papillomavirus Infections - immunology; Papillomavirus Infections - prevention & control; Papillomavirus Infections - virology; Papillomavirus Vaccines - therapeutic use; Prevalence; prevention; screening; Smoking Cessation - methods; Uterine Cervical Neoplasms - immunology; Uterine Cervical Neoplasms - prevention & control; Uterine Cervical Neoplasms - virology; Vaccination; screening; HIV; HPV vaccination; Anal cancer; cervical cancer; prevention; HPV
• ISSN: 1478-7210; 1744-8336
• DOI: 10.1080/14787210.2017.1392854

Introduction: In comparison to their HIV-negative counterparts, people living with HIV (PLWH) have a higher prevalence of human papillomavirus (HPV) infection in various anatomical sites coupled with increased HPV persistence, higher risk of HPV-related tumors, and faster disease progression. Areas covered: Gender-neutral prevention strategies for HPV-related cancers in PLWH discussed: ABC approach, HPV vaccination, antiretroviral treatment (ART), anal cancer screening, and smoking cessation. Gender specific strategies: cervical cancer screening reduces the incidence and mortality of cervical cancer and circumcision might reduce the risk of HPV infections in men. Expert commentary: HPV-related cancer incidence has not declined (e.g. cervical cancer) and has even increased (e.g. anal cancer) in the ART era, demanding an effective HPV prevention strategy. HPV vaccination should be introduced into national prevention programs worldwide immediately because current prophylactic vaccines are safe, tolerable, and immunogenic in PLWH. HPV vaccine efficacy trials in PLWH are essential to determine the most appropriate immunization schedule. The population most at risk of anal cancer is HIV-positive men who have sex with men, who are not protected by herd immunity if only the female population is vaccinated. Unvaccinated PLWH need enhanced surveillance for early detection of HPV-related cancers and their precursors.