Background Although HPV– and HSV–related conditions (HPVCs, HSVCs) have increased in PLWH, incidence, racial, and gender disparities of the conditions are unclear. We examined the public health burden of anogenital HPVCs and HSVCs among PLWH from a southeastern US HIV clinic.
Methods Electronic health records from the HIV Clinic at University of Alabama, Birmingham (01/2006—03/2018) were reviewed. Patients≥ 18 years at HIV diagnoses with≥ 2 clinical visits were analyzed. Incidence rates of HPVCs (cervical and vaginal/vulvar low and high grade squamous intraepithelial lesion (LSIL, HSIL) and cancers in women, penile cancers in men, warts, anal LSIL, HSIL, and cancers in both) and herpetic ulcers were calculated. Each condition was counted only once at its first diagnosis in the period. We used Joinpoint regression to estimate average annual percentage changes (AAPCs).
Results There were 1038 HPVCs, 546 HSVCs, and 3191 both condition-free, with mean ages: 38.3, 39.6, and 41.3 years, and median nadir CD4 counts: 243, 283, 323 cells/µL, respectively. Incidence of warts, anal LSIL, HSIL, and cancer were different between men (189, 252, 44, 26 per 10,000 PYs) and women (68, 15, 6, 0 per 10,000 PYs) (p<0.0001 for each). Racial disparities were observed in anal LSIL and cancer, cervical HSIL and cancer among whites (rates: 284, 28, 162, 50 per 10,000 PYs) and blacks (rates: 142, 14, 94, 15 per 10,000 PYs), respectively (p<0.05 for each). Incident ulcers were higher among women than men (260 vs 163 per 10,000 PYs) and blacks than whites (192 vs 183 per 10,000 PYs). Warts, anal HSIL and cancer, cervical LSIL and cancer increased significantly over time (AAPCs: 19.1, 25.3, 24.9, 13.0, 15.1%, P<0.0001 for each, respectively).
Conclusion HPVCs and HSVCs are common in the southeastern US PLWH, with substantial increases of warts, anal and cervical lesions and cancers. Better screenings are warranted in the high-risk population.
Disclosure No significant relationships.
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