Oral Human Papillomavirus Infection in Adults Is Associated with Sexual Behavior and HIV Serostatus

TLDR

The prevalence and risk factors for oral HPV infection are unknown, though HPV type 16—most common in HPV‑associated tonsillar cancers—is the most prevalent high‑risk oral HPV infection. The study tested oral samples for HPV DNA in 396 HIV‑seronegative and 190 HIV‑seropositive adults. High‑risk oral HPV was detected in 2.1 % of tonsil and 6.3 % of oral‑rinse samples, with a higher prevalence in HIV‑seropositive adults (13.7 % vs 4.5 %); logistic regression showed increased odds with age, male sex, HSV‑2 seropositivity in HIV‑seronegative participants, and with low CD4 count, HSV‑2, oral mucosal abnormalities, and multiple oral sex partners in HIV‑seropositive participants (OR 12.8), and HPV 16 was the most common high‑risk type.

Abstract

The prevalence and risk factors for oral human papillomavirus (HPV) infection are unknown, despite evidence for an etiological role for HPV in oral cancers. Oral samples from human immunodeficiency virus (HIV)-seronegative (n=396) and HIV-seropositive (n=190) adults were tested for HPV DNA. High-risk HPV infections were present in 2.1% of tonsil and 6.3% of oral-rinse specimens. The prevalence of oral high-risk HPV infection was greater in HIV-seropositive individuals (13.7% vs. 4.5%; P<.001). In multiple logistic regression, odds of oral HPV infection increased with age, male sex, and herpes simplex virus (HSV)-2 seropositivity in HIV-seronegative individuals and with CD4 cell count <200 cells/mL, HSV-2 seropositivity, oral mucosal abnormalities, and >1 oral sex partner during the previous year (odds ratio, 12.8; 95% confidence interval, 3.1-52.7) among HIV-seropositive individuals. HPV type 16, which is present in most HPV-associated tonsillar cancers, was the most prevalent high-risk oral HPV infection.