Published: 2017-12-29

A clinical study on genital warts and HIV in Bangladesh

Md. Jakir Hossain, Muhammad Afser Siddiqi, M. Mostafizur Rahman, Khairun Nahar Khan, Ahmed Imtiaj


Background: Like other sexually transmitted diseases (STD), ano-genital warts (AGW) is associated with human immunodeficiency virus (HIV) infection and this study of AGW was conducted among HIV positive and HIV negative patients. The aim of the study was to study the risk factors and clinical presentations of ano-genital warts in HIV infected patients.

Methods: A comparative, cross-sectional, descriptive study of 25 HIV positive and 25 HIV negative (n=50) AGW patients between 15-60 years of both sex was conducted in Northern part of Bangladesh from July 2015 to December 2016.  

Results: Significant association of HIV positivity (p<0.05) was observed between age group of 15-30 years and HIV negative status (p<0.05) in age group of 31-45 years. HIV positive status significantly higher in patients with self-admitted multiple sexual partners (p<0.01), homosexuality (p<0.05) and presentation with anal warts (p<0.01). HIV negative status correlated significantly with single sexual partner admission (p<0.01) and hetero-sexuality (p<0.05). Gender did not show significant association with number of sexual partners or HIV positivity. Extra-genital or only genital warts had no association with HIV status. Co-STDs though more in number in seropositive group, did not show any significant association with HIV positivity (p>0.05). No patient presented with changes of malignancy. Four were adolescents below 19 years. Two patients had atypical presentations of giant condylomata i.e., Buschke-Lowenstein tumour (BLT).

Conclusions: HIV positivity was significantly associated with the risk factors of age below 30 years, homo sexuality and multiple sexual partners. Anal warts were significantly common in HIV positive patients. Four adolescents with AGW underline the need for high risk behaviour counselling. No patient had malignant AGW. Follow up of these patients with human papilloma virus (HPV) sub-typing is necessary. 


Venereal, Comparison, Immunosupression, Peresentation

Full Text:



Seetharam K, Viral infections In: Sachhidanand S, editor. IADVL Textbook of Dermatology. 4th edition. Mumbai, India: Bhalani publications; 2015;1:595-600.

Nowak R, Gravitt P, He X, Ketende S, Dauda W, Omuh H, et al. Prevalence of anal high-risk Human papillomavirus infections among HIV-positive and HIV-negative men who have sex with men in Nigeria. Sex Transm Dis. 2016;43(4):243-8.

Peter V, Chin-Hong, Marla H, Ross D, Cranston, Grant C, et al. Human papilloma virus- ano-genital disease in HIV infected individuals. Dermatologic Therapy. 2005;18(1):67–76.

Caio C, Karen I, Monica B, Hélio A, Lenice D. Prevalence of ano-genital warts in men with HIV/AIDS and associated factors. Open AIDS J. 2014;8:25–30.

Yavorsky R, Hollman D, Steever J. Prevalence of sexually transmitted infections in at-risk adolescent females at a comprehensive, stand-alone adolescent health centre in New York city. Clin Pediatr (Phila). 2014;53(9):890-5.

Adler D, Wallace M, Bennie T. Cumulative impact of HIV and multiple concurrent Human papillomavirus infections on the risk of cervical dysplasia. Adv Virol. 2016;2016:7310894.

Agarwal S, Kumar G, Nirwal, Singh H. Buschke–Lowenstein tumour of glans penis. Int J Surg Case Rep. 2014;5(5):215–8.

Jane S. Rook’s Textbook of Dermatology. In: Griffins Christopher, Barker Jonathan, editors. Volume 1. 9th edition. UK: Wiley Blackwell publication; 2016: 25–43.

Patel H, Wagner M, Singhal P, Kothari S. Systematic review of the incidence and prevalence of genital warts. BMC Infect Dis. 2013;13:39.

Hornor G. Ano-genital warts in children: Sexual abuse or not? J Pediatr Health Care. 2004;18(4):165-70.

Stevenson F, Zimmerman MA, Caldwell CH. Growth trajectories of sexual risk behaviour in adolescence and young adulthood. American Journal of Public Health. 2007;97(6):1096-101.

Benard V, Johnson C, Thompson T, Roland K, Lai S, Cokkinides V, et al. Examining the association between socioeconomic status and potential Human papillomavirus-associated cancers. Cancer. 2008;113(10):2910-18.

Dunne E, Unger E, Sternberg M, Maquillan G, Swan D, Patel S, et al. Prevalence of HPV infection among female in the United States. JAMA. 2007;297(8):813-9.

Llata E, Stenger M, Bernstein K, Guerry S, Kerani R, Pugsley R, et al. Prevalence of genital warts among sexually transmitted disease clinic patients-Sexually transmitted disease surveillance network, United States, January 2010 to December 2011. Sex Transm Dis. 2014;41(2):89-93.

Jiamton S, Leeyaphan C, Maneeprasopchoke P, Omcharoen V. Prevalence and clinical manifestations of male patients with anogenital warts attending a sexually transmitted disease clinic prior HPV vaccine recommendation. Southeast Asian J Trop Med Public Health. 2014;45(6):1337-43.

Duke W, Larikov D, Skiest D. Extensive development of flat warts as a cutaneous manifestations of immune reconstitution syndrome. AIDS Read. 2008;18(10):524-7.

Dang C, Koehler A, Forschner T, Sehr P, Michael K, Pawlita M, et al. E6/E7 expression of human papilloma virus types in cutaneous squamous cell dysplasia and carcinoma in immunosuppressed organ transplant recipients. Br J Dermatol. 2006;155(1):129-36.

Arbyn M, Benoy I, Simoens C, Bogers J, Beutels P, Depuydt C. Prevaccination distribution of human papillomavirus types in women attending at cervical cancer screening in Belgium. Cancer Epidemiol Biomarkers Prev. 2009;18(1):321-30.

Ghosh I, Ghosh P, Bhar A, Mandal R, Biswas J, Basu P. Prevalence of Human papillomavirus and co-existent sexually transmitted infections among female sex workers, men having sex with men and injectable drug abusers from Eastern India. Asian Pacific J Cancer Prev. 2012;13(3):799-802.

Kumarasamy N, Balakrishnan P, Venkatesh K, Srikrishnan A, Cecelia A, Thamburaj E, et al. Prevalence and incidence of sexually transmitted infections among South Indians at increased risk of hiv infection. AIDS Patient Care STDs. 2008;22(8):677–82.

Levi G, Feldman J, Holman S, Salarieh A, Strickler HD, Alter S, et al. Relationship between HIV viral load and langerhans cells of the cervical epithelium. J Obstet Gynaecol Res. 2005;31(2):178-84.

Ward H, Rönn M. Contribution of sexually transmitted infections to the sexual transmission of HIV. Curr Opin HIVAIDS. 2010;5(4):305-10.