Prevalence of Oral High-Risk HPV and HPV16 infection among people living with HIV: a systematic review and meta-analysis
Abstract
BACKGROUND
Little is known about the natural history of oral HPV in people living with HIV (PLWH). This systematic review and meta-analysis evaluated oral HPV prevalence among PLWH.
METHODS
Studies with ≥18-year-old PLWH (n≥10), published in English, were included from searching four databases: Ovid MEDLINE(R), Embase (Elsevier), Web of Science (Clarivate), and APA PsycArticles (EBSCO). The AXIS appraisal tool was used to assess the risk of bias of selected studies. A meta-analysis was performed using random-effects models, reporting the pooled prevalence (95% CI) for any HPV, HR-HPV, and HPV16. Heterogeneity was quantified via I². This systematic review was registered in the Open Science Framework (OSF) on December 4th 2024 and is available at [https://doi.org/10.17605/OSF.IO/NGMFV].
RESULTS
From 37 studies, pooled prevalence among PLWH was: any HPV, 22% (95% CI: 16-29%; I²=94%); HR-HPV, 12% (9-16%); HPV16, 4% (3-5%); LR-HPV, 16% (10-24%). HR-HPV prevalence was higher pre-2011 (15% [11-20%]) vs. post-2011 (9% [6-14%]) and similar between males (11%; 7-17%) and females (10%; 5-17%) (I²=89% and 75%, respectively).
CONCLUSIONS
We observed oral HPV prevalence of 22%, about half of which was due to HR-HPV types, and a decline in HR-HPV prevalence post-2011, suggesting a potential impact of HPV vaccination programs. Our findings highlight the ongoing burden of oral HPV among PLWH and underscore the importance of continued vaccination and prevention efforts.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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