Human papillomavirus-related disease in people with HIV.
OBJECTIVE
The incidence of human papillomavirus (HPV)-related cancers has increased among people with HIV infection compared with the general population. This review will describe recent findings in HPV-associated cancer incidence since the introduction of antiretroviral therapy, HPV/disease prevalence at sites other than cervix and anus, and recent data on screening and treatment of anal intraepithelial neoplasia.


RESULTS
Consistent with high prevalence of anogenital HPV infection, new data on cervical intraepithelial neoplasia and anal intraepithelial neoplasia in HIV-positive men and women show that the incidence of cervical cancer has not declined since the introduction of antiretroviral therapy and that the incidence of anal cancer is rising. Several studies also highlight high rates of HPV infection and HPV-associated disease at sites other than the cervix and anus, including the penis and the mouth. Treatment methods for anal intraepithelial neoplasia have been described and show reasonable efficacy.


CONCLUSIONS
New data imply that the problem of HPV-related cancers will not decline among HIV-positive men and women in the antiretroviral therapy era, highlighting the need to perform studies to determine if screening and treatment of anal intraepithelial neoplasia will prevent development of anal cancer. Recent data show progress in both these areas.
Palefsky
Joel
J
University of California, San Francisco, California 94143, USA. Joel.Palefsky@ucsf.edu