A 41-Year-Old Man Comes to the Physician Because Ofintermittent Rectal

A 41-year-old man comes to the physician because ofintermittent rectal bleeding and itching for 2 weeks. He has a history of HIV infection for which he takes zidovudine, emtricitabine, and efavirenz. he has been sexually active with 3 male partners. He uses condoms inconsistently. Digital rectal examination and anoscopy show an exophytic mass on the anal margin that is protruding into the anal canal. The mass is tender to palpation and bleeds easily on contact. Laboratory studies show a leukocyte count of 7,600/mm3 and a CD4+ T-lymphocyte count of 410/mm3. Which of the following factors is most likely responsible for the development of this patient's anal lesion?

A) BRAF mutation
B) Human herpesvirus 8
C) Human papillomavirus
D) Mismatch repair gene mutation
E) Poxvirus
F) Treponema pallidum