Acquired Epidermodysplasia Verruciformis Due to Multiple and Unusual HPV Infection Among Vertically-Infected, HIV-Positive Adolescents in Zimbabwe


Lowe, SM; Katsidzira, L; Meys, R; Sterling, JC; de Koning, M; Quint, W; Nathoo, K; Munyati, S; Ndhlovu, CE; Salisbury, JR; Bunker, CB; Corbett, EL; Miller, RF; Ferrand, RA; (2012) Acquired Epidermodysplasia Verruciformis Due to Multiple and Unusual HPV Infection Among Vertically-Infected, HIV-Positive Adolescents in Zimbabwe. Clinical infectious diseases, 54 (10). E119-E123. ISSN 1058-4838 DOI: https://doi.org/10.1093/cid/cis118

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Abstract

Background. We have previously described the presentation of epidermodysplasia verruciformis (EV)-like eruptions in almost a quarter of hospitalized adolescents with vertically-acquired human immunodeficiency virus (HIV) infection in Harare, Zimbabwe, a region with a high prevalence of HIV infection. Methods. We performed a clinical case note review and skin biopsy from affected sites in 4 HIV-infected adolescents with EV-like lesions in Harare. Biopsies were processed for histology and for human papillomavirus (HPV) typing. Results. All patients had long-standing skin lesions that pre-dated the diagnosis of HIV by several years. The histology of skin biopsies from all patients was consistent with EV. In each biopsy, EV-associated beta-HPV type 5 was identified (additionally, type 19 was found in 1 biopsy). Cutaneous wart-associated HPV types 1 and 2 were detected in all biopsies, together with genital lesion-associated HPV types 6, 16, and 52, (as well as >= 3 other genital lesion-associated HPV types). Despite immune reconstitution with combination antiretroviral therapy (cART), there was no improvement in EV-like lesions in any patient. Conclusions. EV is a disfiguring and potentially stigmatizing condition among this patient group and is difficult to treat; cART appears to have no impact on the progression of skin disease. Among adolescents with long-standing HIV-induced immunosuppression and with high levels of sun exposure, close dermatological surveillance for potential skin malignancy is required.

Item Type: Article
Keywords: active antiretroviral therapy, human papillomaviruses, nested pcr, virus, eruption, patient, skin, dna
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
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PubMed ID: 22474219
Web of Science ID: 304049300006
URI: http://researchonline.lshtm.ac.uk/id/eprint/60780

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