Recurrent Focal Epithelial Hyperplasia due to HPV13 in an HIV-Positive Patient

Abstract

There are few reports on focal epithelial hyperplasia (FEH) in association with human immunodeficiency virus (HIV) infection; thus the relationship between them has not been completely clarified yet. We present a case of recurrent FEH in an HIV-positive man (the first described in Belgium), which, according to the PCR-DNA testing, was due to human papilloma virus type 13 (HPV13). To our knowledge, based on the accessible literature, this type of HPV has not been detected in any other documented study of FEH in HIV-positive patients before. Our patient experienced three recurrences of FEH in 1 year. It is therefore suggested that immunodeficiency due to HIV infection is responsible for the HPV-related FEH and the subsequent recurrences. In order to support the consideration of FEH as an oral manifestation of an HIV-related opportunistic infection, every new ‘HPV-type’ oral lesion in HIV-positive patients must be completely documented.

The EVER Proteins as a Natural Barrier against Papillomaviruses: a New Insight into the Pathogenesis of Human Papillomavirus Infections

“…FEH results from an abnormal predisposition to the infection by two specific HPV genotypes (HPV13 and -32) related to genital alpha-HPV (16,33,138). These two viruses have been found in 75 to 100% of the reported cases of FEH (166).…”

“…Thus, FEH is now regarded as an oral manifestation of a human immunodeficiency virus-related opportunistic infection (138). These observations point to the fact that immunodeficiency and host genetic factors that could possibly also be related to an inherited (highly restricted and specific) immune defect confer sensitivity to HPV, manifested as FEH.…”

Focal Epithelial Hyperplasia (Heck’s Disease) – Case Report of a Rare Disease in an Adult Caucasian Man

“…The genetic predisposition has been suggested based on multiple reports of the disease occurring in various familial ethnic groups such as native communities from North and South America as well as in Inuit from Greenland [5,29], as it may make an individual's immune system susceptible to acquiring certain types of HPV infection [28]. An association between HLA-DR4 (DRBI*0404) and HPV infections has been discovered lately in a Mestizo population from Mexico [26].…”

Hyperplasie épithéliale focale et syndrome de Waldmann. Présentation d’un cas

“…Certains déficits immunitaires semblent donc favoriser l'infection par les VPH de types 13 et 32 [20]. Le déficit immunitaire induit par le syndrome de Waldmann constitue probablement un autre type de déficit immunitaire favorisant l'HEF.…”