CD4 ⁺ cell count and HIV load as predictors of size of anal warts over time in HIV-infected women

Background.Little is known about the associations between CD4 ⁺ cell counts, human immunodeficiency virus (HIV) load, and human papillomavirus "low-risk" types in noncancerous clinical outcomes. This study examined whether CD4 ⁺ count and HIV load predict the size of the largest anal warts in 976 HIV-infected women in an ongoing cohort.Methods.A linear mixed model was used to determine the association between size of anal wart and CD4 ⁺ count and HIV load.Results.The incidence of anal warts was 4.15 cases per 100 person-years (95% confidence interval [CI], 3.83-4.77) and 1.30 cases per 100 person-years (95% CI, 1.00-1.58) in HIV-infected and HIV-uninfected women, respectively. There appeared to be an inverse association between size of the largest anal warts and CD4 ⁺ count at baseline; however, this was not statistically significant. There was no association between size of the largest anal warts and CD4 ⁺ count or HIV load over time.Conclusions.There was no evidence for an association between size of the largest anal warts and CD4 ⁺ count or HIV load over time. Further exploration on the role of immune response on the development of anal warts is warranted in a larger study.