Incidence of venereal warts in human immunodeficiency virus-infected and uninfected women

A cohort of human immunodeficiency virus (HIV)-infected (n = 253) and uninfected (n = 658) women was prospectively studied to assess the relationship between venereal warts and HIV status, adjusting for self-reported and biologic measures of sexual risk behavior. Participants were assessed every 6 months for venereal warts and other sexually transmitted diseases, self-reported sexual behavior, and CD4 cell counts. The incidence of venereal warts was significantly increased in HIV-infected women (8.2 vs. 0.8/100 person-years of follow-up). This difference remained after adjusting for measures of high-risk sexual behavior and was observed in women at all levels of immune function, including those with 500/mm³ CD4 cells. The increased risk of venereal warts in HIV infection can occur relatively early in HIV disease and appears chiefly attributable to a higher risk of progression from subclinical to clinical human papillomavirus (HPV) disease rather than to a higher risk of HPV acquisition.