Human Papillomavirus

HPV is a virus in the papovavirus family. It is a double-stranded DNA virus and generally infects stratified squamous epithelium, such as mucosal and squamous cells.274 The genome is approximately 8,000 bp in size, and based on genome sequence comparisons, over 100 HPV types have been identified to date. Approximately 30 of the known HPV types infect genital epithelium, and HPV is one of the most common sexually transmitted infections.

Among HIV-infected individuals, human HPV infection has a well-established relationship with the elevated risk of invasive cervical cancer, anal cancer, and precursor lesions of both types of cancer, cervical intraepithelial neoplasia (CIN) and anal intraepithelial neoplasia (AIN).275-278 In addition, other HPV-associated intraepithelial neoplastic lesions and malignancies appear to be more prevalent among HIV-infected individuals. Petry et al.279 reported an increased prevalence among HIV-infected women of high-risk HPV infection associated vulval intraep-ithelial neoplasia (VIN). Frisch et al.280 reported an increase in both invasive and in situ forms of not only cervical and anal cancer, but also of vulvar/vaginal and penile cancers among HIV-infected individuals. In Africa, several studies have found evidence of increasing conjuctival carcinoma as well as an association between HPV infection and the risk of squamous cell carcinoma of the conjunctiva.281,282 Moubayed et al.283 found that HPV 6/11, 16 or 18 were found in the majority of 14 cases of conjunctival carcinoma in Tanzania using a highly sensitive in situ hybridization technique. Nine of these 14 cases were HIV positive.

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