Diagnosis and Management of Genital Warts in HIV Disease

Giovanna Orlando, MD, Maria Michela Fasolo, MD, Rosangela Beretta, MD, Antonietta Cargnel, MD


AIDS Read. 2000;10(1) 

In This Article

Abstract and Introduction

Human papillomavirus (HPV) infection affects approximately 50% of young sexually active women, occurring in HIV-infected women at an even higher rate. Because HPV infections can lead to neoplasms and the course may be more aggressive among HIV-infected populations, early diagnosis and proper management is crucial. The options available for managing HPV-related genital warts include drug therapy and surgery.

The incidence of human papillomavirus (HPV) infection is related to the number of sexual partners and the degree of immunosuppression of the patient.[1,2] Infection of the genital tract with HPV is extremely common, affecting approximately 50% of young sexually active women,[3,4] and the prevalence of this infection in HIV-1-infected patients is reported to be higher than that observed in the general population.[5,6,7] Critchlow and associates[1] found that among 322 HIV-positive men, 91.6% had a positive anal HPV DNA compared with a prevalence rate of 65.9% in men who were not infected with HIV. A similar rate was seen in the sexually transmitted disease (STD) service at our clinic, with HPV genital tract infections found in 66 (63.3%) of 106 HIV-positive patients.[8] Because most of the HPV infections were asymptomatic and subclinical, actual prevalence rates may be underestimated both in HIV-positive patients and in the general population.

Various strains of HPV are associated with several different diseases, ranging from anogenital warts to malignant neoplasms. Anogenital warts are generally related to HPV serotypes 6 through 11 but have also been seen in HIV-infected patients who have HPV serotypes associated with a high risk of neoplastic evolution, such as serotypes 16, 18, 31, 33, and 35.[9] Important to note is that several different serotypes can coexist in the same patient.