External genital warts in HIV-infected patients with sexually transmitted infections in Ibadan, Nigeria
Abstract
Background: Human Papilloma Virus (HPV) infection in the genital area is usually asymptomatic, and when symptomatic, manifests in either benign or malignant forms. This study aims at providing information on the prevalence of external genital warts (EGWs) among people living with HIV (PLWHIVs) attending Antiretroviral Treatment (ART) clinic at the University College Hospital, Ibadan, Nigeria.
Methods: This is a descriptive cross-sectional survey of PLWHIVs attending ART clinic between January 2006 and December 2007. Diagnosis of genital warts was based on the findings of typical lesions on the external genitalia, vaginal, cervix or perianal region after clinical examination and informed consent from each participant. Antibodies against Herpes and HPV were measured using, Enzyme-linked immunosorbent Assay (ELISA).
Results: A total of 5,207 patients, 3519 female and 1688 males attended the ART clinic during the period. The mean age of the patients was 34.67 yrs (± 9.16). Five hundred and forty-two (10.0%) had various sexually transmitted infections (STIs). The prevalence of anogenital warts was 3.65% among the HIV-infected patients and 35.0 % among the subset of HIV- infected patients with STIs. The prevalence of genital warts was 1.5 times higher in treatment experienced patients (OR =1.46; 95%CI: 1.02, 2.10). Genital wart was found to be associated with low CD4 count, high viral load, treatment- experience and non-use of condom during sexual intercourse. (P = 0.002).
Conclusions: External genital warts are common among people living with HIV infection. According to the appropriate guidelines, HPV vaccine should also be offered to HIV-infected adolescents that are non-reactive to the virus.
Keywords: External Genital warts, Human papilloma virus, HIV, Sexually transmitted infections
Résumé
Contexte: L’infection par le virus du papillome humain (VPH) dans la région génitale est généralement asymptomatique et, lorsqu’elle est symptomatique, se manifeste sous forme bénigne ou maligne. Cette étude vise à fournir des informations sur la prévalence des verrues génitales externes (EGW) chez les personnes vivant avec le VIH (PVVIH) qui fréquentent une clinique de traitement antirétroviral (ART) à l’hôpital collège universitaire, Ibadan, au Nigeria.
Méthodes: Il s’agit d’une étude descriptive transversale des PVVIH fréquentant la clinique ART entre janvier 2006 et décembre 2007. Le diagnostic des verrues génitales était basé sur les résultats de lésions typiques sur l’organe génital externe, vaginal, cervical ou péri-anal après examen clinique et consentement informé de chaque participant. Les anticorps contre l’herpès et le VPH ont été mesurés en utilisant un dosage immunosorbant enzymatique (ELISA).
Résultats: Au total, 5 207 patients, 3519 femmes et 1688 hommes ont assisté à la clinique ART pendant la période. L’âge moyen des patients était de 34,67 ans (± 9,16). Cinq cent quarante-deux (10,0%) avaient des diverses infections sexuellement transmissibles (IST). La prévalence des verrues ano-génitales était de 3,65% parmi les patients infectés par le VIH et de 35,0% parmi le sous-groupe de patients infectés par le VIH atteints d’IST. La prévalence des verrues génitales était 1,5 fois plus élevée dans le traitement expérimentés des patients (OR = 1,46; IC à 95%: 1,02, 2,10). On a constaté que la verrue génitale était associée à un faible taux de CD4, à une charge virale élevée, à une expérience de traitement et à la non-utilisation du préservatif pendant les rapports sexuels. (P = 0,002).
Conclusions: Les verrues génitales externes sont fréquentes chez les personnes vivant avec l’infection VIH. Selon les directives appropriées, le vaccin contre le VPH devrait également être offert aux adolescents infectés par le VIH qui ne sont pas réactifs au virus.
Mots-clés: Verrues génitales externes, virus du papillome humain, VIH, infections sexuellement transmissibles
Correspondence: Dr. S.A. Fayemiwo, Department of Medical Microbiology nand Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria, E-mail: dayteet@yahoo.com.
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