Effect of antiretroviral therapy on the incidence of genital warts and vulvar neoplasia among women with the human immunodeficiency virus

L. Stewart Massad, Michael J. Silverberg, Gayle Springer, Howard Minkoff, Nancy Hessol, Joel M. Palefsky, Howard Strickler, Alexandra M. Levine, Henry S. Sacks, Michael Moxley, D. Heather Watts

Research output: Contribution to journalArticle

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Abstract

Objective: The purpose of this study was to determine the incidence and predictors of genital warts and vulvar intraepithelial neoplasia among women with the human immunodeficiency virus. Study design: This was a multicenter prospective cohort study comprised of women without warts or vulvar intraepithelial neoplasia at baseline who underwent CD4 count, human immunodeficiency virus RNA measurement, examination, Papanicolaou test, and biopsy, as indicated, every 6 months. Human papillomavirus DNA typing was examined at baseline. Results: The incidence of warts among women who were human immunodeficiency virus seronegative was 1.31 versus 5.01 per 100 person-years among women who were seropositive (P < .001). Incidence of vulvar intraepithelial neoplasia among women who were seronegative was 1.31 versus 4.67 per 100 person-years among women who were seropositive (P < .001). In multivariable analysis, warts were associated with highly active antiretroviral therapy (relative hazard, 0.76), CD4 count (relative hazard, 0.91/100 cell/cm2 increase), acquired immunodeficiency syndrome (relative hazard, 1.25), abnormal Papanicolaou test results (relative hazard, 2.18), high- or medium-risk human papillomavirus types (relative hazard, 1.91), low-risk human papillomavirus types (relative hazard, 1.48), smoking (relative hazard, 1.43), having 1 child (relative hazard, 1.54), and age (relative hazard, 0.74/10 years). Vulvar intraepithelial neoplasia was linked to highly active antiretroviral therapy (relative hazard, 0.65), CD4 count (relative hazard, 0.92), abnormal Papanicolaou test results (relative hazard, 16.03), high- or medium-risk human papillomavirus types (relative hazard, 1.37), and age (relative hazard, 0.85/10 years). Conclusion: Warts and vulvar intraepithelial neoplasia are common among women with human immunodeficiency virus. Highly active antiretroviral therapy decreases their incidence.

Original languageEnglish (US)
Pages (from-to)1241-1248
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Volume190
Issue number5
DOIs
StatePublished - May 2004

Fingerprint

Condylomata Acuminata
HIV
Warts
Papanicolaou Test
Incidence
Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
Neoplasms
Therapeutics
DNA Fingerprinting
Acquired Immunodeficiency Syndrome
Cohort Studies
Smoking
Prospective Studies
RNA
Biopsy

Keywords

  • Genital warts
  • Human immunodeficiency virus
  • Human papillomavirus
  • Vulvar cancer
  • Vulvar neoplasia

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Effect of antiretroviral therapy on the incidence of genital warts and vulvar neoplasia among women with the human immunodeficiency virus. / Massad, L. Stewart; Silverberg, Michael J.; Springer, Gayle; Minkoff, Howard; Hessol, Nancy; Palefsky, Joel M.; Strickler, Howard; Levine, Alexandra M.; Sacks, Henry S.; Moxley, Michael; Watts, D. Heather.

In: American Journal of Obstetrics and Gynecology, Vol. 190, No. 5, 05.2004, p. 1241-1248.

Research output: Contribution to journalArticle

Massad, LS, Silverberg, MJ, Springer, G, Minkoff, H, Hessol, N, Palefsky, JM, Strickler, H, Levine, AM, Sacks, HS, Moxley, M & Watts, DH 2004, 'Effect of antiretroviral therapy on the incidence of genital warts and vulvar neoplasia among women with the human immunodeficiency virus', American Journal of Obstetrics and Gynecology, vol. 190, no. 5, pp. 1241-1248. https://doi.org/10.1016/j.ajog.2003.12.037
Massad, L. Stewart ; Silverberg, Michael J. ; Springer, Gayle ; Minkoff, Howard ; Hessol, Nancy ; Palefsky, Joel M. ; Strickler, Howard ; Levine, Alexandra M. ; Sacks, Henry S. ; Moxley, Michael ; Watts, D. Heather. / Effect of antiretroviral therapy on the incidence of genital warts and vulvar neoplasia among women with the human immunodeficiency virus. In: American Journal of Obstetrics and Gynecology. 2004 ; Vol. 190, No. 5. pp. 1241-1248.
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abstract = "Objective: The purpose of this study was to determine the incidence and predictors of genital warts and vulvar intraepithelial neoplasia among women with the human immunodeficiency virus. Study design: This was a multicenter prospective cohort study comprised of women without warts or vulvar intraepithelial neoplasia at baseline who underwent CD4 count, human immunodeficiency virus RNA measurement, examination, Papanicolaou test, and biopsy, as indicated, every 6 months. Human papillomavirus DNA typing was examined at baseline. Results: The incidence of warts among women who were human immunodeficiency virus seronegative was 1.31 versus 5.01 per 100 person-years among women who were seropositive (P < .001). Incidence of vulvar intraepithelial neoplasia among women who were seronegative was 1.31 versus 4.67 per 100 person-years among women who were seropositive (P < .001). In multivariable analysis, warts were associated with highly active antiretroviral therapy (relative hazard, 0.76), CD4 count (relative hazard, 0.91/100 cell/cm2 increase), acquired immunodeficiency syndrome (relative hazard, 1.25), abnormal Papanicolaou test results (relative hazard, 2.18), high- or medium-risk human papillomavirus types (relative hazard, 1.91), low-risk human papillomavirus types (relative hazard, 1.48), smoking (relative hazard, 1.43), having 1 child (relative hazard, 1.54), and age (relative hazard, 0.74/10 years). Vulvar intraepithelial neoplasia was linked to highly active antiretroviral therapy (relative hazard, 0.65), CD4 count (relative hazard, 0.92), abnormal Papanicolaou test results (relative hazard, 16.03), high- or medium-risk human papillomavirus types (relative hazard, 1.37), and age (relative hazard, 0.85/10 years). Conclusion: Warts and vulvar intraepithelial neoplasia are common among women with human immunodeficiency virus. Highly active antiretroviral therapy decreases their incidence.",
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AU - Hessol, Nancy

AU - Palefsky, Joel M.

AU - Strickler, Howard

AU - Levine, Alexandra M.

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N2 - Objective: The purpose of this study was to determine the incidence and predictors of genital warts and vulvar intraepithelial neoplasia among women with the human immunodeficiency virus. Study design: This was a multicenter prospective cohort study comprised of women without warts or vulvar intraepithelial neoplasia at baseline who underwent CD4 count, human immunodeficiency virus RNA measurement, examination, Papanicolaou test, and biopsy, as indicated, every 6 months. Human papillomavirus DNA typing was examined at baseline. Results: The incidence of warts among women who were human immunodeficiency virus seronegative was 1.31 versus 5.01 per 100 person-years among women who were seropositive (P < .001). Incidence of vulvar intraepithelial neoplasia among women who were seronegative was 1.31 versus 4.67 per 100 person-years among women who were seropositive (P < .001). In multivariable analysis, warts were associated with highly active antiretroviral therapy (relative hazard, 0.76), CD4 count (relative hazard, 0.91/100 cell/cm2 increase), acquired immunodeficiency syndrome (relative hazard, 1.25), abnormal Papanicolaou test results (relative hazard, 2.18), high- or medium-risk human papillomavirus types (relative hazard, 1.91), low-risk human papillomavirus types (relative hazard, 1.48), smoking (relative hazard, 1.43), having 1 child (relative hazard, 1.54), and age (relative hazard, 0.74/10 years). Vulvar intraepithelial neoplasia was linked to highly active antiretroviral therapy (relative hazard, 0.65), CD4 count (relative hazard, 0.92), abnormal Papanicolaou test results (relative hazard, 16.03), high- or medium-risk human papillomavirus types (relative hazard, 1.37), and age (relative hazard, 0.85/10 years). Conclusion: Warts and vulvar intraepithelial neoplasia are common among women with human immunodeficiency virus. Highly active antiretroviral therapy decreases their incidence.

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KW - Human immunodeficiency virus

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KW - Vulvar cancer

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