Human papillomavirus-associated skin cancers among organ transplant recipients: A systematic review and meta-analysis

Background: Human Papillomavirus (HPV) is known to be associated with various types of skin neoplasms. Organ transplant recipients (OTR) are generally at a higher risk for developing skin neoplasms, including those related to HPV, due to their immunosuppressed state. In the current meta-analysis, we aimed to evaluate the frequency of HPV-related skin cancers and related factors among OTRs. Methods: This meta-analysis study was conducted under the guidelines of the preferred reporting items for systematic review and meta-analysis (PRISMA). The generalized I2 statistics was perfumed for assessing heterogeneity. Odds ratio (OR) and effective size were calculated in comprehensive meta‐analysis (CMA) software Version 3. In addition, meta-regression analysis was conducted to examine the temporal trends in the incidence of HPV-related skin cancer among OTRs over the study years. Results: Out of 417 potentially eligible studies, seven were included for final analysis. The most frequently reported skin cancers in OTRs were squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). The result of meta-analysis also revealed a high prevalence of 61.7% (95% CI: 35.4% - 82.5%) of HPV-related skin cancer among OTRs. The male-to-female ratio was 2.14 (95% CI 0.58-7.87), and the mean time from transplantation to the first diagnosis of skin cancer was about eight years. The frequency of HPV among tumor lesions ranged from 37.7% to 74.1%. Conclusions: These findings collectively provide insights into the prevalence of HPV among OTRs with skin neoplasms, emphasizing the need for careful consideration of heterogeneity when interpreting the overall estimate