Human papillomavirus (HPV) is a major global public health concern, causing genital warts and cancers of the cervix, anus, oropharynx, vulva, and penis. People living with HIV (PLWH) face a disproportionately elevated burden of HPV infection and HPV-related malignancies due to chronic immunosuppression. We conducted a systematic review and meta-analysis searching six databases from January 2006 to June 2026 without language restrictions. Twenty-five studies were included in the systematic review; 12 independent studies (N = 1,493 for HPV16) were included in the quantitative meta-analysis. Using a DerSimonian-Laird random-effects model with logit transformation, pooled seroconversion rates were: HPV16 97.8% (95% CI: 94.9-99.1%; I[2] = 89.6%; 15 datasets), HPV18 94.2% (95% CI: 86.1-97.7%; I[2] = 95.8%; 13 datasets), HPV6 97.0% (95% CI: 93.7-98.6%; I[2] = 66.1%; 10 studies), and HPV11 97.1% (95% CI: 90.5-99.1%; I[2] = 95.5%; 10 studies). CD4 count was the most consistently reported modifier of immunogenic response: HPV16 seroconversion was 98.5% in PLWH with CD4 > 350 cells/μL vs. 71.1% in those with CD4 ≤ 200 cells/μL (ACTG A5240). All three vaccine generations demonstrated high immunogenicity. Two doses of the nonavalent vaccine were non-inferior to three doses in virologically suppressed women (Papillon RCT). No vaccine-related serious adverse events were reported. GRADE certainty of evidence was moderate for HPV16, HPV6, and HPV11, and low for HPV18. Prophylactic HPV vaccination achieves high seroconversion rates across all vaccine generations in PLWH. CD4 count significantly modifies vaccine response, underscoring the importance of vaccination before severe immunosuppression develops. These findings support current international recommendations advocating HPV vaccination for all PLWH.

Human Papillomavirus (HPV) causes various infections and serious health complications, including cancer. Vaccine hesitancy and anxiety continue to hinder its control. This study assessed HPV-related knowledge, infection anxiety, and vaccine hesitancy among the adult population in Saudi Arabia (including both citizens and non-Saudi residents), as well as exposure to skin and genital warts. A total of 2014 adults (≥ 18 years) completed an online survey covering demographics, HPV knowledge, and the modified Generalized Anxiety Disorder-7 (GAD-7) scale adapted to measure HPV-specific concerns. Skin warts were common, particularly among females aged 21-50 years, whereas genital warts were less frequent, peaking in the 21-40 age group. Anxiety was highest among participants aged 18-30 years. Notable knowledge gaps existed regarding HPV transmission and vaccine benefits. Younger participants showed better understanding, but males were less aware of vaccine availability. Healthcare professionals and medical students demonstrated superior knowledge. Multinomial logistic regression showed that gender was the only significant predictor of vaccine willingness (p < 0.001). Males were more likely than females to say "yes" (aOR = 1.409, p = 0.009) and "no" (aOR = 1.633, p < 0.001), indicating that females were disproportionately hesitant ("not sure"). A high school education (vs. a medical background) was associated with lower willingness (aOR = 0.631, p = 0.030). Overall, the findings emphasize the need for targeted educational campaigns to improve HPV awareness and promote vaccine acceptance.

A phase I study was conducted in 20 healthy subjects with 20 µg adeno-associated virus 2 (AAV2)-like particles displaying L2 residues 17-36 of both human papillomavirus (HPV) type 16 and HPV31 (AAVLP-HPV) or placebo. AAVLP-HPV vaccination was well tolerated and induced a modest L2-specific serum antibody titer that neutralizes HPV16, HPV31, and HPV5 in vitro. Here, we show that upon passive transfer into naïve mice, the sera from a subset of patients vaccinated with AAVLP-HPV conferred protection against HPV16, HPV31, and HPV5, but not HPV76. HPV16-naïve patients required three AAVLP-HPV doses to develop protection, whereas previously exposed individuals achieved protection after two doses and exhibited higher L2-specific and neutralizing antibody titers. The avidity of the L2-specific antibody response was low, but broadly cross-reactive. Prior exposure to AAV2 compromised the strength and duration of the L2 neutralizing antibody response, as well as protective immunity against HPV16, suggesting original antigenic sin. AAVLP-HPV induced high AAV2 neutralizing titers after one vaccination in AAV2-exposed or three in AAV2-naive patients. Thus, prior HPV and AAV2 infections impact the interpretation of AAVLP-HPV immunogenicity.IMPORTANCEHPV is among the most prevalent sexually transmitted infections. Persistent infection with a high-risk genotype (hrHPV) can cause cervical and other anogenital, and oropharyngeal cancers. There are a dozen hrHPV genotypes, HPV16 being the dominant type in these cancers; only ≤7 are targeted by licensed HPV vaccines. Ten intermediate-risk genotypes are also found in small proportions of cervical cancers. HPV6 and HPV11, while commonly associated with benign genital warts, can be carcinogenic in humans. The HPV+ cancer burden is highest in developing countries where cervical screening and vaccination rates are low, resulting in >500,000 cervical cancer cases annually. The plethora of skin-tropic HPVs are transmitted non-sexually and generally cause benign, self-limiting infections, but a subset of betapapillomaviruses is associated with cutaneous squamous cell carcinoma in epidermodysplasia verruciformis and immunocompromised patients. A simple, low-cost vaccine preventing infection by all of these medically significant HPV types is needed.CLINICAL TRIALSThis study is registered with ClinicalTrials.gov as NCT03929172.

Condyloma acuminata is an uncommon epithelial proliferative and infiltrative growth associated with human papillomavirus (HPV) subtypes 6 and 11. Giant condyloma acuminata is a more aggressive variant characterised by extensive growth, anatomical disfigurement, psychosocial morbidity and a high recurrence rate. Extragenital involvement in an immunocompetent individual is uncommonly reported in the literature. We report a case of an immunocompetent young woman who developed a rapidly progressive verrucous growth involving the vulva, lower vagina, perianal region and also extragenital sites (inframammary fold and axilla). Pelvic MRI demonstrated a large exophytic lesion without underlying stromal involvement. Complete surgical excision with histopathological confirmation demonstrated condyloma acuminata with low-risk HPV type 11. Early recurrence occurred within 3 months, which was managed by topical medication. This case highlights the importance of clinical examination, the role of MRI followed by surgical excision with long-term follow-up even in immunocompetent patients.

Human papillomavirus (HPV) types 6 and 11 cause 90% of condyloma acuminata (CA). Timely vaccination reduces CA-related disease burdens, especially among sexually inexperienced college students, a critical catch-up group for vaccination. Few studies investigate sexually inexperienced college students' views on CA and HPV vaccination, despite research on general student HPV awareness. This cross-sectional study was conducted in Guangdong in May 2017, and recruited college students who self-identified as having no prior sexual relations. Participants completed a WeChat-based online questionnaire to assess their knowledge of HPV, CA, and acceptance of HPV vaccination for CA. A total of 2037 valid questionnaires were collected and analyzed. Knowledge of CA (26.3%) and HPV (18.9%) was low among college students who self-reported no sexual experience, as was the HPV vaccination rate (2.6%). However, their acceptance of the HPV vaccine for CA was relatively high (54.7%). Respondents were more likely to have received the HPV vaccine for CA if they had heard of CA (OR = 1.40, 95% CI: 1.05-1.85), had actively learned about CA (OR = 1.62, 95% CI: 1.10-2.38), considered the vaccine safe (OR = 1.94, 95% CI: 1.03-3.65), and believed the vaccine effective in preventing CA (OR = 5.08, 95% CI: 2.05-12.59). Sexually inexperienced college students demonstrated insufficient knowledge of CA and HPV vaccines. Higher awareness of the safety and efficacy of the HPV vaccine, as well as knowledge about CA, were positive associated with the willingness to receive the HPV vaccine.

A substantial proportion of mpox cases occur in people with HIV, but how HIV coinfection and immune status affect clinical outcomes remains unclear. We systematically searched major databases up to March 2025 for observational studies comparing mpox patients with and without HIV coinfection. Pooled effect sizes were calculated using random-effects models. Risk ratios (RRs) or standardized mean differences (SMDs) with 95% confidence intervals were used for dichotomous or continuous outcomes. Post hoc subgroup analyses explored differences by economic development, viral suppression, and advanced HIV disease (AHD) proportion. Among 15,522 patients from 29 studies, 52.43% had HIV. HIV coinfection was associated with higher hospitalization [RR = 1.50, 95% CI (1.17, 1.93)] and mortality [RR = 4.54, 95% CI (2.11, 9.77)]. Coinfected patients had more syphilis, HBV, and HCV coinfections, and higher rates of fever, proctitis, malaise, rectal irritation syndrome, diarrhoea, skin and soft tissue infections, and pneumonia. Blood tests showed lower albumin, calcium, and haemoglobin, and higher CK-MB. Perianal lesions were more common with HIV. HIV coinfection is linked to greater clinical severity, mortality, and STI coinfections. Exploratory analyses suggest poor viral suppression may drive adverse outcomes, and lesion severity relates to immune status. All subgroup findings are post hoc and hypothesis-generating, limited by aggregate data. Intensified monitoring and supportive care, vaccination, and optimized ART initiation are crucial for this population.

Background/Objective: The psychosexual burden of human papillomavirus (HPV)-induced genital warts (GWs) in men remains underexplored. This study aimed to determine the prevalence of sexual dysfunction in men with GWs and to evaluate the effects of disease duration and condom use on the sexual cycle using the International Index of Erectile Function (IIEF-15). Methods: This single-center, cross-sectional study was conducted in the dermatology outpatient clinic of Kayseri City Education and Research Hospital between May and June 2026 and enrolled 150 sexually active male patients with clinically diagnosed, currently present genital wart lesions. To minimize reading comprehension and social desirability biases, a two-stage protocol was implemented. First, a clinician explained each IIEF-15 item face-to-face. Patients then completed the questionnaire independently and submitted it in a sealed envelope. Associations were analyzed using Spearman's rank correlation, and group comparisons used the Mann-Whitney U and Kruskal-Wallis tests. Results: The median age was 30.0 years (IQR 25.0-36.0) and the median disease duration was 18.0 months (IQR 8.0-35.8). Erectile dysfunction (ED) of varying severity was detected in 84.7% (n = 127) of patients. In unadjusted analysis, longer disease duration was associated with lower sexual function scores; however, these associations did not remain significant after adjustment for age. As ED severity increased, all other sexual function domains declined concurrently and strongly (Spearman rho ranging from -0.679 to -0.821; p < 0.0001). Condom users exhibited higher total sexual function scores than non-users (median 55.5, IQR 43.2-61.0 vs. median 49.5, IQR 37.0-60.0); however, this difference did not reach statistical significance (p = 0.076). Conclusions: Genital warts in men constitute a major psychosexual condition that disrupts multiple phases of the sexual response cycle, not merely a dermatological lesion. Our cross-sectional findings suggest that lesion-directed treatment alone may not fully address this psychosexual burden: whether the proactive integration of multidisciplinary sexual counseling improves outcomes should be tested in controlled, longitudinal studies.

Giant condyloma of Buschke-Loewenstein is a rare benign tumor characterized by viral etiology, slow growth, the ability to cause disfigurement of the affected areas and a certain potential for malignancy. The main treatment option for this disease is surgery. Our clinical case is dedicated to the successful surgical treatment of a 57-year-old patient, in whom giant condyloma of Buschke-Loewenstein of the penis developed over 10 years without malignant transformation.

Genital warts are common benign lesions caused predominantly by human papillomavirus types 6 and 11 and are associated with significant psychosocial morbidity. Cryotherapy remains a widely used ablative modality, yet data on patient-reported outcomes in real-world settings remain limited. To evaluate the therapeutic efficacy, safety profile, and patient-reported outcomes of cryotherapy in the management of genital warts. A case series of seven treatment-naive patients with clinically and dermoscopically confirmed genital warts was analyzed. All patients underwent cryotherapy with a cryoprobe using two freeze-thaw cycles per session at 2-week intervals. Pain was assessed using the Visual Analogue Scale (VAS), and quality-of-life changes were measured using the Dermatology Life Quality Index (DLQI) before treatment and two weeks after the final session. Complete or near-complete clearance was achieved in 71.4% of patients after 1-2 sessions. Adverse effects occurred in 57.1%, predominantly procedural pain and transient hypopigmentation. DLQI scores improved markedly among patients with complete clearance, indicating significant psychosocial recovery, whereas incomplete responders-particularly immunocompromised individuals-showed minimal improvement. Recurrence occurred in 14% of cases. Cryotherapy is a safe, cost-effective, and efficacious first-line treatment for genital warts, especially in immunocompetent patients. Incorporating patient-reported outcomes such as DLQI and VAS provides a holistic assessment of therapeutic success and should be adopted routinely.