Factors associated with the seroprevalence of 26 cutaneous and two genital human papillomavirus types in organ transplant patients

Viral skin infections are commonly present in organ transplant recipients (OTR). In this study, we aimed to identify factors associated with human papillomavirus (HPV) infections in OTR. Patients with solid-organ transplants were recruited from the outpatient nephrology and dermatology clinics in five European countries. Only patients with no current or past skin cancer were included in this analysis. Serum samples were analysed for antibodies to the L1 proteins of 26 cutaneous and two genital HPV types from five phylogenetic genera (alpha, beta, gamma, mu and nu). The most consistent association was found between recreational sun exposure and the seroprevalence of all tested genera, except alpha. The antibody presence of any beta type was higher among people who had been transplanted at least 23 years prior to participation than in those who had been transplanted for less than 7 years. The prevalence of two gamma-HPV types (60 and 65) and three beta-HPV types (15, 38 and 49) was associated with time since transplantation. The presence of a high number of warts was associated with the presence of any mu-PV or nu-PV types, and having greater than 50 keratotic skin lesions was almost significantly associated with the presence of antibodies to two or more gamma-PV. Discrepancies in the results of the present study, as well as in previous reports, may depend on different methodologies and on geographical variations. Our results also indicate that further research with more standardized methods is needed to clarify the role of cutaneous HPV in OTR.