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Prevalence of Plantar Verrucae in Patients with Human Immunodeficiency Virus Infection During the Post–Highly Active Antiretroviral Therapy Era

James Johnston California School of Podiatric Medicine, Samuel Merritt University, Oakland, CA. Dr. Johnston is now with the San Francisco VA Medical Center, San Francisco, CA. Dr. King is now with the Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Oakland, CA.

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Christy M. King California School of Podiatric Medicine, Samuel Merritt University, Oakland, CA. Dr. Johnston is now with the San Francisco VA Medical Center, San Francisco, CA. Dr. King is now with the Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Oakland, CA.

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Sky Shanks California School of Podiatric Medicine, Samuel Merritt University, Oakland, CA. Dr. Johnston is now with the San Francisco VA Medical Center, San Francisco, CA. Dr. King is now with the Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Oakland, CA.

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Saieh Khademi California School of Podiatric Medicine, Samuel Merritt University, Oakland, CA. Dr. Johnston is now with the San Francisco VA Medical Center, San Francisco, CA. Dr. King is now with the Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Oakland, CA.

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Joseph Nelson California School of Podiatric Medicine, Samuel Merritt University, Oakland, CA. Dr. Johnston is now with the San Francisco VA Medical Center, San Francisco, CA. Dr. King is now with the Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Oakland, CA.

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Jenny Yu California School of Podiatric Medicine, Samuel Merritt University, Oakland, CA. Dr. Johnston is now with the San Francisco VA Medical Center, San Francisco, CA. Dr. King is now with the Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Oakland, CA.

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Peter Barbosa California School of Podiatric Medicine, Samuel Merritt University, Oakland, CA. Dr. Johnston is now with the San Francisco VA Medical Center, San Francisco, CA. Dr. King is now with the Kaiser San Francisco Bay Area Foot and Ankle Residency Program, Oakland, CA.

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Background: Since the implementation of highly active antiretroviral therapy (HAART), the life expectancy of patients with human immunodeficiency virus (HIV) has significantly increased. This is likely to cause changes in podiatric medical manifestations, such as plantar verrucae, in this population.

Methods: Attendees at a San Francisco street fair in 2008 provided information about HIV status and the presence of verrucae via a survey. A total of 504 surveys were analyzed and compared with 1995 data, before HAART implementation. We examined if there was a statistically significant change in the increased likelihood of plantar verrucae in HIV-positive patients from 1995 to 2008. Then we examined the likelihood of HIV-positive patients (compared to HIV-negative patients) presenting with plantar verrucae in 2008, by using logistic regression, and controlling for age, sex, and race/ethnicity.

Results: Patients with HIV infection were 5.2 times more likely to present with plantar verrucae compared to patients without HIV infection in 2008 (95% confidence interval, 2.5–11.0, P < .0001) and 10.0 times more likely in 1995 (95% confidence interval, 3.4–29.0, P < .0001). This decrease in likelihood over time was not statistically significantly different (P = .33). Logistic regression analysis controlling for the covariates of age, race, and sex showed that patients with HIV in 2008 were 4.5 times more likely to present with verrucae compared to patients without HIV (95% confidence interval, 2.1–9.9, P = .0002).

Conclusions: Patients with HIV infection in 2008 are still significantly more likely to present with plantar verrucae after controlling for age, race, and sex. This increased likelihood has not changed significantly across time. Because HAART has increased the life expectancy of patients with HIV, this group of patients with plantar verrucae will continue to represent a significant population in the practice of podiatric medicine. (J Am Podiatr Med Assoc 101(1): 35–40, 2011)

Corresponding author: Peter Barbosa, PhD, California School of Podiatric Medicine, Samuel Merritt University, 450 30th St, Ste 3738, Oakland, CA 94609. (E-mail: pbarbosa@samuelmerritt.edu)