Abstract
BACKGROUND: Solid organ transplantation and hematopoietic stem cell transplantation are known risk factors for viral warts. However, large-scale studies on the association between transplantation and the risk of cutaneous and genital warts are limited. This study aimed to evaluate the relationship between transplantation and the risk of developing cutaneous and genital warts using a nationwide claims database. METHODS: We conducted a retrospective cohort study using the Korean National Health Insurance Claims Database. The incidence of cutaneous and genital warts in transplant recipients was compared to that in the control population using multivariable Cox proportional hazard regression analysis. The adjusted hazard ratio (aHR) and 95% confidence interval (CI) were calculated to assess the risk. RESULTS: Transplant recipients exhibited a significantly increased risk of cutaneous warts (aHR, 3.73; 95% CI, 3.49-3.98) and genital warts (aHR, 1.18; 95% CI, 1.07-1.29) compared to controls. The risk of cutaneous warts was elevated across all age groups, with the highest risk observed in individuals aged 20-39 years (aHR, 4.52; 95% CI, 3.92-5.22) and 40-59 years (aHR, 4.56; 95% CI, 4.14-5.02). In contrast, the risk of genital warts was highest in patients aged ≥ 60 years (aHR, 2.09; 95% CI, 1.47-2.99). CONCLUSION: This study demonstrates that transplantation is associated with an increased risk of both cutaneous and genital warts, with variations in risk based on age. These findings highlight the need for targeted surveillance and management strategies for wart prevention in transplant recipients.