title: Human papillomavirus and immunosuppression.
abstract: Chronic immunosuppression for various reasons is an important risk factor for persistent infections with human papillomaviruses (HPV) and HPV-associated disease. Anogenital cancers and their precursor lesions play an important role in modern HIV medicine. Anal intraepithelial neoplasia and anal cancer are especially prevalent in HIV-positive men who have sex with men, and experts have advocated screening similarly to cervical cancer screening for this high-risk group. HPV-induced skin warts are a frequent problem of organ transplant recipients (OTRs) and a severe manifestation (generalized verrucosis) of certain primary immunodeficiencies. HIV-positive individuals are very often affected by genital warts (condylomata acuminata). Iatrogenic immunosuppression in OTRs allows more active replication of the commensal β-papillomavirus spectrum in the entire skin. A high viral DNA load in plucked eyebrow hairs was shown to imply a significant risk for the development of cutaneous squamous cell carcinoma. This may explain the up to 250-fold increased risk of OTRs to develop precancerous actinic keratoses and skin cancer.
authors.affiliation: Institute of Virology, National Reference Center for Papilloma- and Polyomaviruses, University of Cologne, Cologne, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Wieland
authors.forename: Alexander
authors.initials: A
authors.lastname: Kreuter
authors.forename: Herbert
authors.initials: H
authors.lastname: Pfister
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000821:virology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000209:etiology*; D012307:Risk Factors; D017193:Skin Diseases, Viral / Q000473:pathology / Q000821:virology*; D014565:Urogenital Neoplasms / Q000821:virology*; D014860:Warts / Q000821:virology*