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 D. Strickler, Alexandra M. Levine, Henry S. Sacks, Michael Moxley, D. Heather Watts

Research output: Contribution to journalArticle

46 Scopus citations

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

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Keywords

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

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Massad, L. S., Silverberg, M. J., Springer, G., Minkoff, H., Hessol, N., Palefsky, J. M., Strickler, H. D., Levine, A. M., Sacks, H. S., Moxley, M., & Watts, D. H. (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, 190(5), 1241-1248. https://doi.org/10.1016/j.ajog.2003.12.037