Acquired Epidermodysplasia Verruciformis Due to Multiple and Unusual HPV Infection Among Vertically-Infected, HIV-Positive Adolescents in Zimbabwe

Lowe, Sara; Katsidzira, Leolin; Meys, Rhonda; Sterling, Jane; Koning, Maurits de; Quint, Wim; Nathoo, K.; Munyati, Shungu; Ndhlovu, Chiratidzo E.; Salisbury, Jonathan R.; Bunker, C.B.; Corbett, Elizabeth L.; Miller, R F; Ferrand, Rashida A

doi:10.1093/cid/cis118

Cited by 36 publications

(31 citation statements)

References 22 publications

(30 reference statements)

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“…In addition, a high level of BetaPV in proliferative skin lesions with a documented risk of progression to skin cancer has been recently reported in an unclassified primary T cell immunodeficiency , as well as in patients with T cell defects associated with mutations in the RHOH and MST1 genes . Patients with acquired immunodeficiency, such as can occur following HIV infection, can also develop EV‐like proliferative lesions . Whether EV should be considered an immunodeficiency in its own right deserves further study, given that EVER polymorphisms seem to affect the formation of T cell memory populations .…”

Section: Betapv and Keratinocyte Carcinomas In Vivomentioning

confidence: 99%

Human Beta‐papillomavirus infection and keratinocyte carcinomas

Quint

Genders

Koning

et al. 2014

The Journal of Pathology

112

127

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Section: Betapv and Keratinocyte Carcinomas In Vivomentioning

confidence: 99%

Human Beta‐papillomavirus infection and keratinocyte carcinomas

Quint

Genders

Koning

et al. 2014

The Journal of Pathology

112

127

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“…Histology and HPV types accord with epidermodysplasia verruciformis, a potentially premalignant condition, and little improvement takes place with antiretroviral treatment, despite immune reconstitution. 76 Use of topical glycolic acid can speed resolution. 77 Other skin manifestations improve with antiretroviral treatment, although transient worsening or initial presentation might be associated with immune reconstitution.…”

Section: Chronic Diseasementioning

confidence: 99%

Perinatally acquired HIV infection in adolescents from sub-Saharan Africa: a review of emerging challenges

Lowenthal

Bakeera-Kitaka

Marukutira

et al. 2014

The Lancet Infectious Diseases

369

397

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Worldwide, more than three million children are infected with HIV, 90% of whom live in sub-Saharan Africa. As the HIV epidemic matures and antiretroviral treatment is scaled up, children with HIV are reaching adolescence in large numbers. The growing population of adolescents with perinatally acquired HIV infection living within this region presents not only unprecedented challenges but also opportunities to learn about the pathogenesis of HIV infection. In this Review, we discuss the changing epidemiology of paediatric HIV and the particular features of HIV infection in adolescents in sub-Saharan Africa. Longstanding HIV infection acquired when the immune system is not developed results in distinctive chronic clinical complications that cause severe morbidity. As well as dealing with chronic illness, HIV-infected adolescents have to confront psychosocial issues, maintain adherence to drugs, and learn to negotiate sexual relationships, while undergoing rapid physical and psychological development. Context-specific strategies for early identification of HIV infection in children and prompt linkage to care need to be developed. Clinical HIV care should integrate age-appropriate sexual and reproductive health and psychological, educational, and social services. Health-care workers will need to be trained to recognise and manage the needs of these young people so that the increasing numbers of children surviving to adolescence can access quality care beyond specialist services at low-level health-care facilities.

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“…This study showed that there was no statistically significant difference between patients infected with HIV when compared to patients uninfected with HIV in terms of multiple HPV types. Multiple infections with cutaneous HPV types have been reported, but the link with progression to skin cancers has not been firmly established [Lowe et al, ]. In a multicenter study of five European countries [de Koning et al, ], the percentage of participants with multiple types ranged from 69% to 81% in the immunocompetent population and from 75% to 96% in the immunosuppressed population.…”

Section: Discussionmentioning

confidence: 99%

Frequency of Betapapillomavirus infections among HIV infected and uninfected Black Zimbabweans with cutaneous lesions

Murahwa

Muchemwa

Duri

et al. 2014

Journal of Medical Virology

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Human papillomavirus (HPV) types from the Betapapillomavirus (β-HPV) genus are plentiful in non-melanoma skin cancers and warts among Caucasians, but there is paucity of information among black Africans. To determine the frequency of β-HPV genotypes in cutaneous infections among Black Zimbabweans, a cross-sectional study was carried out in which blood samples and skin biopsies were collected from patients infected and uninfected with HIV attending a referral hospital. We included 144 participants (72 infected and 72 uninfected with HIV) with clinically apparent cutaneous warts (n = 34), suspected non-melanoma skin cancers (n = 98) and Kaposi sarcoma (KS) (n = 18). The skin biopsies were analyzed for HPV DNA presence and type. β-HPV DNA was identified among 70% (101/144) and was significantly higher among patients infected with HIV, 79% (57/72) compared to the HIV uninfected 61% (44/72) [OR = 2.42, 95% CI (1.09-5.47), P = 0.018]. All patients with warts, 89% of those with KS and 58% of those with non-melanoma skin cancers were HPV DNA positive and β-HPV type 14 was identified in nearly half of the study participants 49.3% (71/144). Single HPV infections were observed in 33.7% (34/101) of the participants that were HPV DNA positive, 66.3% (67/101) had multiple HPV types. There was no significant difference between patients infected and uninfected with HIV in terms of multiple HPV infections. The distribution of different HPV types did not reveal any association with age and gender but there was an association between HPV 14 and HIV immune status. β-HPVs are not uncommon among the Black Zimbabweans with skin lesions.

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Acquired Epidermodysplasia Verruciformis Due to Multiple and Unusual HPV Infection Among Vertically-Infected, HIV-Positive Adolescents in Zimbabwe

Abstract: We have characterized the EV-like dermatosis of acquired HIV in 4 adolescents. Multiple HPV types were isolated in skin tissue samples, including β-HPV, but also high levels of HPV 1 and 2. ARV did not improve the EV eruption.

Cited by 36 publications

References 22 publications

Human Beta‐papillomavirus infection and keratinocyte carcinomas

Human Beta‐papillomavirus infection and keratinocyte carcinomas

Perinatally acquired HIV infection in adolescents from sub-Saharan Africa: a review of emerging challenges

Frequency of Betapapillomavirus infections among HIV infected and uninfected Black Zimbabweans with cutaneous lesions

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