The Burden of HPV infections and HPV-Related Diseases Among People with
HIV: a Systematic Literature Review
Abstract
Human papillomavirus (HPV) is associated with significant global burden
of precancer lesions and cancer. People with HIV (PWH) are at higher
risk of HPV infection and HPV-related diseases. This systematic review
was conducted to identify data on burden of HPV infection and
HPV-related diseases among PWH. Studies published between January
2018–June 2023 were sourced from databases and conferences. Included
were 221 publications of epidemiological data on HPV infections and the
clinical burden of HPV-related diseases among PWH. The burden varied by
geographical region, age, sex, and sexual orientation. Compared to
people without HIV (PWoH), PWH had higher prevalence and incidence of
HPV infection and HPV-related diseases. Among PWH, the prevalence of
anal HPV infection ranged between 44–83%; men had a higher prevalence
and incidence of anogenital warts than women. Incident anal HPV
infection was over two-fold greater among transgender women with HIV and
men who have sex with men with HIV than respective counterparts without
HIV. Incident HPV-related anal cancer is up to two-fold higher among PWH
than PWoH, and incident cervical cancer is up to six times higher among
women with HIV than those without. The most prevalent high-risk (hr) HPV
genotypes with HPV-related disease were vaccine genotype HPV16/18/52/58.
HPV35 was one of the most prevalent genotypes with anal or cervical HPV
infection among PWH of African descent. PWH have a high burden of hrHPV
infections and HPV-related diseases, and this calls for strengthening
appropriate HPV vaccine delivery and increasing uptake by potentially by
integrating with routine HIV care.