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Cao F, Li YZ, Zhang DY, Wang XY, Chen WX, Liu FH, Men YX, Gao S, Lin CQ, Zou HC, Gong TT, Wu QJ. Human papillomavirus infection and the risk of cancer at specific sites other than anogenital tract and oropharyngeal region: an umbrella review. EBioMedicine 2024; 104:105155. [PMID: 38744109 PMCID: PMC11108822 DOI: 10.1016/j.ebiom.2024.105155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Despite numerous studies having evaluated the associations between human papillomavirus (HPV) infection and risk of specific cancers other than anogenital tract and oropharyngeal, the findings are inconsistent and the quality of evidence has not been systematically quantified. We aimed to summarise the existing evidence as well as to evaluate the strength and credibility of these associations. METHODS We conducted an umbrella review of systematic reviews and meta-analyses of observational studies. PubMed, EMBASE, and Web of Science were searched from inception to March 2024. Studies with systematic reviews and meta-analyses that examined associations between HPV or HPV-associated genotypes infection and specific cancers were eligible for this review. The quality of the methodology was evaluated using A Measurement Tool to Assess systematic Reviews (AMSTAR). The credibility of the evidence was assessed using GRADE. The protocol was preregistered with PROSPERO (CRD42023439070). FINDINGS The umbrella review identified 31 eligible studies reporting 87 associations with meta-analytic estimates, including 1191 individual studies with 336,195 participants. Of those, 29 (93.5%) studies were rated as over moderate quality by AMSTAR. Only one association indicating HPV-18 infection associated with an increased risk of breast cancer (odds ratio [OR] = 3.48, 95% confidence interval [CI] = 2.24-5.41) was graded as convincing evidence. There were five unique outcomes identified as highly suggestive evidence, including HPV infection increased the risk of oral squamous cell carcinoma (OR = 7.03, 95% CI = 3.87-12.76), oesophageal cancer (OR = 3.32, 95% CI = 2.54-4.34), oesophageal squamous cell carcinoma (OR = 2.69, 95% CI = 2.05-3.54), lung cancer (OR = 3.60, 95% CI = 2.59-5.01), and breast cancer (OR = 6.26, 95% CI = 4.35-9.00). According to GRADE, one association was classified as high, indicating that compared with the controls in normal tissues, HPV infection was associated with an increased risk of breast cancer. INTERPRETATION The umbrella review synthesised up-to-date observational evidence on HPV infection with the risk of breast cancer, oral squamous cell carcinoma, oesophageal cancer, oesophageal squamous cell carcinoma, and lung cancer. Further larger prospective cohort studies are needed to verify the associations, providing public health recommendations for prevention of disease. FUNDING National Key Research and Development Program of China, Natural Science Foundation of China, Outstanding Scientific Fund of Shengjing Hospital of China Medical University, and 345 Talent Project of Shengjing Hospital of China Medical University.
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Affiliation(s)
- Fan Cao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Zi Li
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - De-Yu Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao-Ying Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wen-Xiao Chen
- Department of Sports Medicine and Joint Surgery, The People's Hospital of Liaoning Province, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Xuan Men
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chun-Qing Lin
- National Clinical Research Center for Cancer, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Hua-Chun Zou
- School of Public Health, Fudan University, Shanghai, China; Kirby Institute, University of New South Wales, Sydney, Australia.
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China; Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China; NHC Key Laboratory of Advanced Reproductive Medicine and Fertility (China Medical University), National Health Commission, Shenyang, China.
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Dellino M, Pinto G, D’Amato A, Barbara F, Di Gennaro F, Saracino A, Laganà AS, Vimercati A, Malvasi A, Malvasi VM, Cicinelli E, Vitagliano A, Cascardi E, Pinto V. Analogies between HPV Behavior in Oral and Vaginal Cavity: Narrative Review on the Current Evidence in the Literature. J Clin Med 2024; 13:1429. [PMID: 38592283 PMCID: PMC10932293 DOI: 10.3390/jcm13051429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Abstract
Human genital papilloma virus infection is the most prevalent sexually transmitted infection in the world. It is estimated that more than 75% of sexually active women contract this infection in their lifetime. In 80% of young women, there is the clearance of the virus within 18-24 months. In developed countries, oral squamous cell carcinoma (OSCC) is now the most frequent human papilloma virus (HPV)-related cancer, having surpassed cervical cancer, and it is predicted that by 2030 most squamous cell carcinomas will be the HPV-related rather than non-HPV-related form. However, there are currently no screening programs for oral cavity infection. While the natural history of HPV infection in the cervix is well known, in the oropharynx, it is not entirely clear. Furthermore, the prevalence of HPV in the oropharynx is unknown. Published studies have found wide-ranging prevalence estimates of 2.6% to 50%. There are also conflicting results regarding the percentage of women presenting the same type of HPV at two mucosal sites, ranging from 0 to 60%. Additionally, the question arises as to whether oral infection can develop from genital HPV infection, through oral and genital contact or by self-inoculation, or whether it should be considered an independent event. However, there is still no consensus on these topics, nor on the relationship between genital and oral HPV infections. Therefore, this literature review aims to evaluate whether there is evidence of a connection between oral and cervical HPV, while also endorsing the usefulness of the screening of oral infection in patients with high-risk cervical HPV as a means of facilitating the diagnosis and early management of HPV-related oral lesions. Finally, this review emphasizes the recommendation for the use of the HPV vaccines in primary prevention in the male and female population as the most effective means of successfully counteracting the increasing incidence of OSCC to date.
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Affiliation(s)
- Miriam Dellino
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (M.D.); (A.V.); (A.M.); (E.C.); (A.V.); (V.P.)
| | - Grazia Pinto
- Dentistry Unit, Department of Interdisciplinary Medicine, University of Bari Medical School, 70124 Bari, Italy;
| | - Antonio D’Amato
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (M.D.); (A.V.); (A.M.); (E.C.); (A.V.); (V.P.)
| | - Francesco Barbara
- Unit of Otolaryngology, Department of Ophtalmology and Otolaryngology, University of Bari, 70124 Bari, Italy;
| | - Francesco Di Gennaro
- Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, Polyclinic of Bari, University Hospital Polyclinic, University of Bari, Piazza Giulio Cesare n. 11, 70124 Bari, Italy; (F.D.G.); (A.S.)
| | - Annalisa Saracino
- Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, Polyclinic of Bari, University Hospital Polyclinic, University of Bari, Piazza Giulio Cesare n. 11, 70124 Bari, Italy; (F.D.G.); (A.S.)
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy;
| | - Antonella Vimercati
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (M.D.); (A.V.); (A.M.); (E.C.); (A.V.); (V.P.)
| | - Antonio Malvasi
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (M.D.); (A.V.); (A.M.); (E.C.); (A.V.); (V.P.)
| | | | - Ettore Cicinelli
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (M.D.); (A.V.); (A.M.); (E.C.); (A.V.); (V.P.)
| | - Amerigo Vitagliano
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (M.D.); (A.V.); (A.M.); (E.C.); (A.V.); (V.P.)
| | - Eliano Cascardi
- Pathology Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari, Piazza Giulio Cesare 11, 70121 Bari, Italy;
| | - Vincenzo Pinto
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy; (M.D.); (A.V.); (A.M.); (E.C.); (A.V.); (V.P.)
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Lim YX, D'Silva NJ. HPV-associated oropharyngeal cancer: in search of surrogate biomarkers for early lesions. Oncogene 2024; 43:543-554. [PMID: 38191674 PMCID: PMC10873204 DOI: 10.1038/s41388-023-02927-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/10/2024]
Abstract
The incidence of oropharyngeal cancer (OPSCC) has escalated in the past few decades; this has largely been triggered by high-risk human papillomavirus (HPV). Early cancer screening is needed for timely clinical intervention and may reduce mortality and morbidity, but the lack of knowledge about premalignant lesions for OPSCC poses a significant challenge to early detection. Biomarkers that identify individuals at high risk for OPSCC may act as surrogate markers for precancer but these are limited as only a few studies decipher the multistep progression from HPV infection to OPSCC development. Here, we summarize the current literature describing the multistep progression from oral HPV infection, persistence, and tumor development in the oropharynx. We also examine key challenges that hinder the identification of premalignant lesions in the oropharynx and discuss potential biomarkers for oropharyngeal precancer. Finally, we evaluate novel strategies to improve investigations of the biological process that drives oral HPV persistence and OPSCC, highlighting new developments in the establishment of a genetic progression model for HPV + OPSCC and in vivo models that mimic HPV + OPSCC pathogenesis.
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Affiliation(s)
- Yvonne X Lim
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 N. University Ave, Ann Arbor, MI, USA
| | - Nisha J D'Silva
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 N. University Ave, Ann Arbor, MI, USA.
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.
- Rogel Cancer Center, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, USA.
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4
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Wierzbicka M, San Giorgi MRM, Dikkers FG. Transmission and clearance of human papillomavirus infection in the oral cavity and its role in oropharyngeal carcinoma - A review. Rev Med Virol 2023; 33:e2337. [PMID: 35194874 PMCID: PMC10078185 DOI: 10.1002/rmv.2337] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 01/28/2023]
Abstract
The majority of sexually active individuals becomes infected with human papillomavirus (HPV) at least once in their lifetime. Pathways for HPV transmission vary across different mucosal sites per individual. They include autoinoculation within one host, direct transmission between individuals (including perinatal transmission and transmission during sexual activity), and indirect transmission through contact with hands. The authors aim to clarify the prevalence and route of transmission per anatomic site, inter- and intra-individually, using a narrative review of the literature. In conclusion, transmission of HPV to the oral cavity and oropharynx is hypothesised to occur mainly through sexual contact. Transmission of particles through saliva has not been proven and daily living activities are not a documented source of HPV infection. Oropharyngeal HPV related cancer survivors and their partners do not show increased risk of infection during sexual intercourse. Transmission of HPV to the oral cavity (autoinoculation with fingers or transmission through saliva in deep kissing) is probably of limited importance.
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Affiliation(s)
- Małgorzata Wierzbicka
- Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, Poznan, Poland
| | - Michel R M San Giorgi
- Department of Otorhinolaryngology, University Medical Center Groningen, Groningen, The Netherlands
| | - Frederik G Dikkers
- Department of Otorhinolaryngology & Head and Neck Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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5
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Riddell J, Brouwer AF, Walline HM, Campredon LP, Meza R, Eisenberg MC, Andrus EC, Delinger RL, Yost ML, McCloskey JK, Thomas TB, Huang S, Ferris RL, Shin DM, Fakhry C, Ow T, Li D, Berlot A, Carey TE, Schlecht NF. Oral human papillomavirus prevalence, persistence, and risk-factors in HIV-positive and HIV-negative adults. Tumour Virus Res 2022; 13:200237. [PMID: 35460939 PMCID: PMC9062318 DOI: 10.1016/j.tvr.2022.200237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/06/2022] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background HIV has been shown to increase the likelihood of oral HPV infection. In this study, we evaluated the risk of oral HPV in HIV infected patients compared with HIV-negative controls. Methods 101 healthy adult volunteers (HIV-) and 245 adults living with HIV infection (HIV+) were recruited from 5 academic medical centers. Questionnaires and saliva samples were obtained every 3–8 months over a period of 2 years (2015–2017). DNA was isolated from the saliva samples and tested for 18 high- and low-risk genotypes. Results Oral HPV was detected in 23% of HIV + vs. 10% of HIV- participants (p < 0.0001). Men had a higher oral HPV prevalence than women (27% vs. 15% HIV+, p = 0.03, 16% vs. 5% HIV-, p = 0.01). Risk factors among HIV + participants included more lifetime deep kissing and oral sex partners, and history of AIDS. Persistent oral HPV was detected in 23% of HIV + vs. 5% of HIV- participants (p < 0.001). Among 8 HIV + participants with CD4 counts <200 cell/μL none had cleared their HPV infection during the study. Conclusions Risk of oral HPV infection and persistence was significantly higher in HIV + adults with a history of poorly controlled HIV, which may put them at increased risk of HPV-associated cancer.
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Affiliation(s)
- James Riddell
- Division of Infectious Diseases, University of Michigan Medical School
| | | | | | | | - Rafael Meza
- Department of Epidemiology, University of Michigan
| | - Marisa C Eisenberg
- Department of Epidemiology, University of Michigan; Department of Otolaryngology, University of Michigan Medical School
| | | | | | | | | | | | | | - Robert L Ferris
- Department of Otolaryngology, and University of Pittsburgh Cancer Institute, Pittsburgh, PA
| | - Dong Moon Shin
- Department of Internal Medicine and Winship Cancer Center, Emory University, Atlanta, GA
| | - Carole Fakhry
- Departments of Epidemiology and Otolaryngology and Kimmel Cancer Center, John Hopkins University, Baltimore, MD
| | - Thomas Ow
- Department of Otolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY; Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Daniel Li
- Department of Otolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Ashley Berlot
- Department of Otolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Thomas E Carey
- Departments of Otolaryngology Head & Neck Surgery and Pharmacology, and Rogel Cancer Center, University of Michigan, Michigan Medicine, Ann Arbor, MI
| | - Nicolas F Schlecht
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY; Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY; Department of Epidemiology & Population Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY.
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6
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Rodriguez-Archilla A, Suarez-Machado R. Influence of sexual habits on human papillomavirus infection risk and oral cancer. SCIENTIFIC DENTAL JOURNAL 2022. [DOI: 10.4103/sdj.sdj_73_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Nagelkerke N, Seedat S, Abu-Raddad LJ. Sexual Behavior Surveys Should Ask More: Covering the Diversity of Sexual Behaviors That May Contribute to the Transmission of Pathogens. Sex Transm Dis 2021; 48:e119-e121. [PMID: 33346590 PMCID: PMC8360661 DOI: 10.1097/olq.0000000000001347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 12/09/2020] [Indexed: 11/26/2022]
Abstract
Supplemental digital content is available in the text.
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Affiliation(s)
- Nico Nagelkerke
- From the Infectious Disease Epidemiology Group, Weill Cornell Medicine—Qatar, Cornell University
| | - Shaheen Seedat
- From the Infectious Disease Epidemiology Group, Weill Cornell Medicine—Qatar, Cornell University
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine—Qatar, Cornell University, Qatar Foundation—Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY
| | - Laith J. Abu-Raddad
- From the Infectious Disease Epidemiology Group, Weill Cornell Medicine—Qatar, Cornell University
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine—Qatar, Cornell University, Qatar Foundation—Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY
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8
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Shigeishi H, Sugiyama M, Ohta K. Relationship between the prevalence of oral human papillomavirus DNA and periodontal disease (Review). Biomed Rep 2021; 14:40. [PMID: 33728046 PMCID: PMC7953200 DOI: 10.3892/br.2021.1416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/02/2021] [Indexed: 12/16/2022] Open
Abstract
Human papillomavirus (HPV) is a small DNA virus that infects the basal keratinocytes of squamous epithelium in the skin, and in the oral and genital mucosa. Smoking and sexual behavior have been recognized as significant risk factors for oral HPV infection. In the present review, the findings of recent studies of oral HPV infection in relation to periodontitis are discussed, as well as periodontopathic bacteria and periodontal herpes virus. Previous research suggests that HPV localizes to the inflammatory periodontal tissue. Inflammatory periodontal pockets may thus act as a reservoir for HPV. The interactions between HPV and periodontopathic bacteria remain unclear, but it is hypothesized that oral HPV infection may be related to a characteristic oral microbiome. Smoking is associated with HPV and periodontitis, as smoking induces destruction of periodontal tissue and suppresses the host defense, allowing HPV to infect periodontal tissue. Carcinogenic HPV and periodontitis may lead to the development of oral cavity cancer. However, oral HPV E6/E7 expression (transcriptionally active HPV) has not yet been fully investigated in patients with periodontitis. Collectively, the evidence suggests that oral HPV prevalence may be associated with periodontitis. The effect of clinical factors (age, sex, smoking, immunosuppressive condition and vaccination) on oral HPV DNA prevalence should be considered when clarifying the relationship between oral HPV and periodontitis. Additionally, the sampling method should be carefully chosen to directly detect HPV DNA in periodontal tissues.
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Affiliation(s)
- Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima 734-8553, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima 734-8553, Japan
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima 734-8553, Japan
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Gonçalves HM, Silva J, Pintado Maury I, Tavares A, Campos C, Sousa H, Jacinto A, Aguiar P, Caldeira L, Medeiros R. The prevalence and risk-factors of oral HPV DNA detection among HIV-infected men between men who have sex with men and heterosexual men. Infect Dis (Lond) 2020; 53:19-30. [PMID: 32915107 DOI: 10.1080/23744235.2020.1811373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV)-associated oropharyngeal carcinomas are becoming more common with epidemiological impact on human immunodeficiency virus (HIV)- positive individuals. Objective: We evaluated prevalence and risk factors for oral HPV DNA among HIV-infected men who have sex with men (MSM) or heterosexual men. Methods: This cross-sectional hospital-based study included 255 HIV-infected men with different sexual orientation 142 MSM and 113 heterosexual men, who answered a self-administered questionnaire on sociodemographic, clinical and behavioural data. Oral swab and mouthwash samples were analysed by polymerase chain reaction and genotyped by AnyplexTM II 28 (Seegene®). Results: Oral HPV was detected in 17.6% (95% Confidence Interval (CI) 13.5-22.8%), 17.6% in MSM and 17.7% in heterosexual men (p = .984). Multiple HPV infections were detected in 86.7% of HPV-positive men. HPV 56 (13.7%) was the most prevalent high-risk genotype, HPV 66 (7.8%) and HPV 70 (12.3%) were the most prevalent probable HR and low-risk HPV genotypes (12.3% and 7.1%, respectively). At multivariable analysis models, oral HPV was associated with >100 lifetime sexual partners (Odds Ratio (OR) 3.73; 95% CI 1.42-9.77) or lifetime tongue-kissing partners (OR 3.20; 95% CI 1.22-8.39) and lower education level (OR 2.90; 95% CI 1.08-7.78 and 2.74; 95% CI 1.04-7.27, respectively). Conclusions: Oral HPV prevalence was similar between HIV-infected MSM and heterosexual men. Oral HPV was associated with lifetime sexual partners, lifetime tongue-kissing partners and being undergraduate, independently of sexual orientation.
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Affiliation(s)
- Helena M Gonçalves
- Public Health Unit, Agrupamento de Centros de Saúde (ACES), Lisboa Ocidental e Oeiras, Lisbon, Portugal
| | - Jani Silva
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal
| | - Inês Pintado Maury
- Infectious Disease Service, Centro Hospitalar Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon, Portugal
| | - Ana Tavares
- Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Carla Campos
- Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Hugo Sousa
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal.,Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Amado Jacinto
- Public Health Unit, Agrupamento de Centros de Saúde (ACES), Lisboa Ocidental e Oeiras, Lisbon, Portugal
| | - Pedro Aguiar
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Luís Caldeira
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rui Medeiros
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal.,Infectious Disease Service, Centro Hospitalar Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon, Portugal.,Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal.,Nacional School of Public Heath, New University of Lisbon, Lisbon, Portugal.,FP-ENAS Research Unit, UFP Energy, Environment and Health Research Unit, CEBIMED Fernando Pessoa University, Porto, Portugal.,LPCC, Research Department, Portuguese League Against Cancer (LPPC - NRN), Porto, Portugal
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10
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Sindrewicz K, Kędzierska-Kapuza K, Jaworowska E, Ciechanowski K. Prevalence of Human Papillomavirus Infection in the Head and Neck Area of Patients After Kidney Transplantation Treated With Immunosuppressive Therapy. Transplant Proc 2020; 52:2388-2393. [PMID: 32402451 DOI: 10.1016/j.transproceed.2020.01.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 01/26/2020] [Indexed: 11/18/2022]
Abstract
The introduction of new and stronger immunosuppressive agents has significantly improved the overall survival rate of patients with transplanted organs; however, prolonged use of immunosuppressive agents has led to severe complications, such as the development of de novo malignant cancers. The incidence of malignant tumors is 3 to 5 times greater among renal transplant recipients than that of the overall population. Traditional neoplasms of the head and neck region are associated with the addiction to smoking and drinking alcohol. However, recent studies indicate that cancers of the throat, tongue, and tonsils are primarily associated with the human papillomavirus (HPV) infection. At present, approximately 25% of the head and neck squamous cell carcinomas are associated with HPV infection. Therefore, we aimed to determine the incidence of oropharyngeal HPV infection in recipients with kidney transplants treated with immunosuppressive therapy and to determine the factors that may favor the contraction of infectious diseases. Furthermore, we considered the purpose of vaccination against HPV among transplant recipients. A total of 32 recipients with kidney transplants were included in this study. Medical history was obtained and a throat swab was collected from each patient. The presence of the HPV DNA in the throat was determined using the GP5+/GP6+ primers. According to our results, 28% of the recipients with kidney transplants were positive for oropharyngeal HPV infection. In addition, among the investigated risk factors, early commencement of the sexual life (below the age of 16 years) was significantly correlated with the development of oropharyngeal HPV infection.
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Affiliation(s)
- Krzysztof Sindrewicz
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland; Department of Adult and Children Otolaryngology and Otolaryngological Oncology, Pomeranian Medical University, Szczecin, Poland.
| | - Karolina Kędzierska-Kapuza
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Ewa Jaworowska
- Department of Adult and Children Otolaryngology and Otolaryngological Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Kazimierz Ciechanowski
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
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11
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Wong MCS, Vlantis AC, Liang M, Wong PY, Ho WCS, Boon SS, Sze RKH, Leung C, Chan PKS, Chen Z. Prevalence and Epidemiologic Profile of Oral Infection with Alpha, Beta, and Gamma Papillomaviruses in an Asian Chinese Population. J Infect Dis 2019; 218:388-397. [PMID: 29982800 PMCID: PMC6049037 DOI: 10.1093/infdis/jiy160] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/26/2018] [Indexed: 12/25/2022] Open
Abstract
Background Knowledge of the prevalence of and risk factors for oral human papillomavirus (HPV) infection, especially cutaneous types, is limited. Methods A population-based study using next-generation sequencing consecutively recruited asymptomatic individuals aged 18–64 years from a proportional sampling of the general population of Hong Kong, according to age groups, gender, and regions of residence. We examined associations of alpha-, beta-, and gamma-HPVs from oral rinse samples with participants’ sociodemographics by logistic regression models. Results The prevalence of oral HPV infection among 1426 ethnic Chinese was 15.5% (95% confidence interval [CI], 13.7%–17.5%), 2.5% (95% CI, 1.8%–3.5%), 11.9% (95% CI, 10.3%–13.6%), and 2.9% (95% CI, 2.1%–3.9%) for any type, alpha-, beta-, and gamma-HPV, respectively. Prevalence of any high-risk HPV was 0.8% (95% CI, 0.4%–1.4%), and that of HPV-16 was 0.4% (95% CI, 0.2%–0.8%). HPV-8 and HPV-98 were the most common beta types detected, while HPV-4 and HPV-SD2R were the most common gamma types. Prevalence of alpha- and beta/gamma-HPV infection showed a similar pattern of increase with age, and was higher in men than women. Smoking, drinking, oral sex, and more sexual partners were associated with alpha-HPV. Teeth brushing before sleep was protective for beta/gamma-HPVs. Discussion The epidemiologic factors associated with oral infection with alpha-HPVs are different from those of beta/gamma-HPVs, suggesting different modes of acquisition and persistence.
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Affiliation(s)
- Martin C S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, People's Republic of China
| | - Alexander C Vlantis
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, People's Republic of China
| | - Miaoyin Liang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, People's Republic of China
| | - Po Yee Wong
- Department of Microbiology, The Chinese University of Hong Kong, People's Republic of China
| | - Wendy C S Ho
- Department of Microbiology, The Chinese University of Hong Kong, People's Republic of China
| | - Siaw S Boon
- Department of Microbiology, The Chinese University of Hong Kong, People's Republic of China
| | - Ryan Kin Ho Sze
- Department of Microbiology, The Chinese University of Hong Kong, People's Republic of China
| | - Colette Leung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, People's Republic of China
| | - Paul K S Chan
- Department of Microbiology, The Chinese University of Hong Kong, People's Republic of China.,Stanley Ho Center for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, People's Republic of China
| | - Zigui Chen
- Department of Microbiology, The Chinese University of Hong Kong, People's Republic of China.,Stanley Ho Center for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, People's Republic of China
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12
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Wissing MD, Louvanto K, Comète E, Burchell AN, El-Zein M, Rodrigues A, Tellier PP, Coutlée F, Franco EL. Human Papillomavirus Viral Load and Transmission in Young, Recently Formed Heterosexual Couples. J Infect Dis 2019; 220:1152-1161. [PMID: 31063542 DOI: 10.1093/infdis/jiz238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/06/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND We studied the association between human papillomavirus (HPV) viral load (VL) and HPV concordance. METHODS The HITCH cohort study included young, heterosexual, recently formed, sexually active couples. Questionnaires and genital samples were collected at 0 and 4 months. Samples were tested for HPV DNA by polymerase chain reaction (PCR; Linear Array). VLs of HPV6/11/16/18/31/42/51 were quantified using type-specific real-time PCR. Correlations between VL and type-specific HPV prevalence and incidence were evaluated using multilevel, mixed-effects linear/logistic regression models. RESULTS We included 492 couples. VLs were higher in penile than vaginal samples. VL at subsequent visits correlated significantly within men (r, 0.373), within women (r, 0.193), and within couples (r range: 0.303-0.328). Men with high VL had more type-specific persistent HPV infections (odds ratio [OR], 4.6 [95% confidence interval {CI}, 2.0-10.5]). High VL in men was associated with prevalent (OR, 5.3 [95% CI, 2.5-11.2]) and incident (OR, 6.7 [95% CI, 1.5-30.7]) type-specific HPV infections in their partner. Women's VL was associated with type-specific HPV prevalence in their partner at the same (OR, 5.9) and subsequent (OR, 4.7) visit. CONCLUSIONS Persistent HPV infections have limited VL fluctuations. VL between sex partners are correlated and seem predictive of transmission episodes.
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Affiliation(s)
- Michel D Wissing
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Karolina Louvanto
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada.,Department of Gynaecology and Obstetrics, Helsinki University Hospital, Finland
| | - Emilie Comète
- Departement de Biologie médicale et service de microbiologie, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Quebec
| | - Ann N Burchell
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada.,Department of Family and Community Medicine and Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario
| | - Mariam El-Zein
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Allita Rodrigues
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | | | - François Coutlée
- Departement de Biologie médicale et service de microbiologie, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Quebec
| | - Eduardo L Franco
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
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13
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Human papillomavirus and lung cancer: an overview and a meta-analysis. J Cancer Res Clin Oncol 2019; 145:1919-1937. [PMID: 31236668 DOI: 10.1007/s00432-019-02960-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/20/2019] [Indexed: 01/07/2023]
Abstract
PURPOSE This review is devoted to assessing the prevalence of human papillomavirus (HPV) in lung cancer (LC) in the world. HPV is recognized as the etiological factor of cervical cancer, however, there is widespread evidence that this virus is detected not only in gynecological carcinomas, but also in tumors of other organs, in particular the upper respiratory tract and digestive tract. MATERIALS AND METHODS A search was conducted to a depth of 29 years in the PubMed, Web of Science, Scopus, databases. The review includes 95 articles. RESULTS Of all the analyzed studies (9195 patients), 12 works showed a complete absence of HPV in the biological material in patients with LC. The absence of a virus among lung cancer patients has been established for Canada, the Netherlands and Singapore. The highest average percent of occurrence of this virus is shown for such countries as: Brazil, Korea, Greece and Taiwan (more than 40%). But the highest percentage of HPV occurrence by region is observed in Latin America (33.5%), followed by the Asian countries (31%), in European countries the frequency is 18%. Interestingly, the highest occurrence of high oncogenic types (16 and 18) is observed in Asia (40.3%), then in Latin America (33.6%), Europe (25.6%) and North America (15.4%). Low-oncogenic types (6 and 11) are also predominantly observed in Asia (39.9%), while in Europe and North America 30% and 12.8%, respectively. A meta-analysis of the prevalence of HPV was conducted using Comprehensive Meta-Analysis 3.0. Program, which included 26 studies, the results of which revealed: the prevalence of HPV infection in tumor lung tissue was compared with normal lung tissue OR (95% CI) = 5.38 (3.21-9.00) p < 0.0001, significance was also found for Chinese studies OR = 6.3, 95% CI 3.42-11.53, p < 0.0001, I2 = 71.8% and for nine studies in Europe OR = 6.3, 95% CI 1.8-22.18, p = 0.004, I2 = 51.0%. However, given the fact that the frequency of occurrence of HPV in lung tumor tissue varies greatly, a question may arise about the real role of HPV in LC carcinogenesis, which makes further research relevant and promising.
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14
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El-Zein M, Coutlée F, Tellier PP, Roger M, Franco EL, Burchell AN. Human Papillomavirus Infection and Transmission Among Couples Through Heterosexual Activity (HITCH) Cohort Study: Protocol Describing Design, Methods, and Research Goals. JMIR Res Protoc 2019; 8:e11284. [PMID: 30650383 PMCID: PMC6352011 DOI: 10.2196/11284] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/17/2018] [Accepted: 10/18/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) epidemiological research has generally been individual based, typically focusing on women, with couple-based research mostly consisting of cross-sectional assessment of prevalent HPV infection in both partners. OBJECTIVE The HPV Infection and Transmission among Couples through Heterosexual activity (HITCH) study was set up to investigate the transmissibility of HPV among young, recently formed couples in Montreal, Canada. This paper provides an overview of the HITCH cohort study design and procedures as well as a narrative summary of the most important findings. METHODS HITCH is a longitudinal investigation of HPV transmission in recently formed heterosexual partnerships initiated within 6-month pre-enrollment, a time at which considerable transmission is believed to occur. A total of 549 newly formed dyads were recruited (2005-2011) from postsecondary institutions, including 502 young women and their male partners. An additional 46 males were enrolled at follow-up, as some women enrolled a subsequent partner at follow-up. Women aged 18-24 years were followed for 24 months for acquisition of HPV types not present at enrollment, whereas men returned for a single follow-up visit at month 4, for a sum total of 3361 clinic visits. The last follow-up visit occurred in January 2014. Extensive sociodemographic, sexual behavioral, and medical history data were collected every 2-4 months using computer-assisted, self-administered questionnaires. Furthermore, participants provided genital, blood, oral, and hand specimens for HPV assessment. RESULTS Although in its early analysis stage, HITCH has produced important publications. Findings from HITCH have increased the available knowledge about the natural history of HPV transmission and its determinants, provided further evidence regarding oral-oral and oral-genital routes of HPV transmission, and supplied empirically valid epidemiological parameters of HPV transmission to assist mathematical modelers in health economic assessments. In addition, HITCH data were made available to several multistudy collaborations evaluating new HPV detection assays and evidence for-or-against HPV type replacement following the introduction of HPV vaccination. CONCLUSIONS HITCH will continue to offer a unique resource for research on HPV transmission. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/11284.
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Affiliation(s)
- Mariam El-Zein
- Division of Cancer Epidemiology, Gerald Bronfman Department of Oncology, McGill University, Montreal, QC, Canada
| | - François Coutlée
- Centre Hospitalier de l'Université de Montréal, Département de Microbiologie Médicale et Infectiologie, Université de Montréal, Montreal, QC, Canada
| | | | - Michel Roger
- Centre Hospitalier de l'Université de Montréal, Département de Microbiologie Médicale et Infectiologie, Université de Montréal, Montreal, QC, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, Gerald Bronfman Department of Oncology, McGill University, Montreal, QC, Canada
| | - Ann N Burchell
- Division of Cancer Epidemiology, Gerald Bronfman Department of Oncology, McGill University, Montreal, QC, Canada
- Li Ka Shing Knowledge Intitute, Department of Family and Community Medicine and Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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15
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Laprise C, Madathil SA, Schlecht NF, Castonguay G, Soulières D, Nguyen-Tan PF, Allison P, Coutlée F, Hier M, Rousseau MC, Franco EL, Nicolau B. Increased risk of oropharyngeal cancers mediated by oral human papillomavirus infection: Results from a Canadian study. Head Neck 2019; 41:678-685. [PMID: 30605251 DOI: 10.1002/hed.25436] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 07/23/2018] [Accepted: 08/15/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study aimed to estimate the extent to which oral sex behavior is associated with an increased risk of oropharyngeal cancers (OPCs), and how much of the association is mediated by oral human papillomavirus (HPV) infection. METHODS We used data from a hospital-based case-control study conducted in Montreal, Canada. Information on oral sex behaviors was collected. Oral rinse and oral brush specimens were analyzed for HPV positivity and genotyping. Logistic regression estimated the odds ratios (OR) and 95% confidence intervals (CI) for the association between oral sex behaviors and OPC. RESULTS Onset of oral sex practice at age 16 years or younger had an increased risk of OPCs relative to those with onset after age 30 years (OR = 2.98; 95% CI 1.37-6.47). This association decreased (OR = 1.09; 95% CI 0.25-4.71) when restricted to those positive for HPV. CONCLUSIONS Our results suggest that the association between oral sex and OPC seems mediated by oral HPV infection.
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Affiliation(s)
- Claudie Laprise
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Sreenath Arekunnath Madathil
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, Quebec, Canada
| | - Nicolas F Schlecht
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Geneviève Castonguay
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Denis Soulières
- Department of Radiation Oncology, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Phuc Felix Nguyen-Tan
- Department of Hemato-Oncology, Hôpital Notre-Dame du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Paul Allison
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - François Coutlée
- Department of Microbiology and Infectious Diseases, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Michael Hier
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Marie-Claude Rousseau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, Quebec, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Belinda Nicolau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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16
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Tam S, Fu S, Xu L, Krause KJ, Lairson DR, Miao H, Sturgis EM, Dahlstrom KR. The epidemiology of oral human papillomavirus infection in healthy populations: A systematic review and meta-analysis. Oral Oncol 2018; 82:91-99. [PMID: 29909908 DOI: 10.1016/j.oraloncology.2018.04.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 04/02/2018] [Accepted: 04/07/2018] [Indexed: 10/16/2022]
Abstract
Human papillomavirus (HPV) is a potentially oncogenic sexually transmitted infection. As the incidence of oropharyngeal cancer (OPC) caused by oral HPV infections is rising, further investigation into the natural history of such infections is needed. This systematic review and meta-analysis aimed to synthesize data on the prevalence, incidence, clearance, and persistence of oral HPV infections in healthy individuals. A systematic review of literature published between January 1995 and August 2017 was conducted using Ovid MEDLINE, PubMed, Embase, and the Cochrane Library. Meta-analysis of prevalence and incidence data was conducted. Clearance and persistence data were extracted. Sixty-six studies met the inclusion criteria. Meta-analysis demonstrated an overall prevalence of 7.7% for all types of HPV and 1.4% for high-risk HPV16. The overall incidence was 4.38 cases per 1000 person-months for all HPV types and 0.92 cases per 1000 person-months for HPV16. This systematic review and meta-analysis demonstrated that oral HPV infection has a lower prevalence and incidence than cervicogenital HPV infection in healthy individuals. Nonetheless, oral HPV is still an important concern, given its oncogenicity and the rising incidence of oropharyngeal cancer. Consistency of methodology will allow for better future comparisons, particularly of infection clearance and persistence.
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Affiliation(s)
- Samantha Tam
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1445, Houston, TX 77030, USA.
| | - Shuangshuang Fu
- Department of Epidemiology, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA.
| | - Li Xu
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1445, Houston, TX 77030, USA.
| | - Kate J Krause
- Research Medical Library, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1445, Houston, TX 77030, USA.
| | - David R Lairson
- Department of Management, Policy, and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA.
| | - Hongyu Miao
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA.
| | - Erich M Sturgis
- Department of Head and Neck Surgery, Division of Surgery, and Department of Epidemiology, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1445, Houston, TX 77030, USA.
| | - Kristina R Dahlstrom
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1445, Houston, TX 77030, USA.
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17
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Egawa-Takata T, Ueda Y, Morimoto A, Tanaka Y, Yagi A, Terai Y, Ohmichi M, Ichimura T, Sumi T, Murata H, Okada H, Nakai H, Mandai M, Matsuzaki S, Kobayashi E, Yoshino K, Kimura T, Saito J, Hori Y, Morii E, Nakayama T, Asai-Sato M, Miyagi E, Sekine M, Enomoto T, Horikoshi Y, Takagi T, Shimura K. Motivating Mothers to Recommend Their 20-Year-Old Daughters Receive Cervical Cancer Screening: A Randomized Study. J Epidemiol 2018; 28:156-160. [PMID: 29129894 PMCID: PMC5821693 DOI: 10.2188/jea.je20160155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background In Japan, the rate of cervical cancer screening is remarkably low, especially among women in their twenties and thirties, when cervical cancer is now increasing dramatically. The aim of this study was to test whether a modified government reminder for 20-year-old women to engage in cervical cancer screening, acting through maternal education and by asking for a maternal recommendation to the daughter to receive the screening, could increase their participation rate. Methods In two Japanese cities, 20-year-old girls who had not received their first cervical cancer screening before October of fiscal year 2014 were randomized into two study arms. One group of 1,274 received only a personalized daughter-directed reminder leaflet for cervical cancer screening. In the second group of 1,274, the daughters and their mothers received a combination package containing the same reminder leaflet as did the first group, plus an additional informational leaflet for the mother, which requested that the mother recommend that her daughter undergo cervical cancer screening. The subsequent post-reminder screening rates of these two study arms were compared. Results The cervical cancer screening rate of 20-year-old women whose mothers received the information leaflet was significantly higher than that for women who received only a leaflet for themselves (11% vs 9%, P = 0.0049). Conclusions An intervention with mothers, by sending them a cervical cancer information leaflet with a request that they recommend that their daughter receive cervical cancer screening, significantly improved their daughters’ screening rate.
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Affiliation(s)
- Tomomi Egawa-Takata
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine
| | - Yutaka Ueda
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine
| | - Akiko Morimoto
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine
| | - Yusuke Tanaka
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine
| | - Asami Yagi
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine
| | - Yoshito Terai
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka Medical College Graduate School of Medical Sciences
| | - Masahide Ohmichi
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka Medical College Graduate School of Medical Sciences
| | - Tomoyuki Ichimura
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka City University Graduate School and Faculty of Medicine
| | - Toshiyuki Sumi
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka City University Graduate School and Faculty of Medicine
| | - Hiromi Murata
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Kansai Medical University Graduate School of Medicine
| | - Hidetaka Okada
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Kansai Medical University Graduate School of Medicine
| | - Hidekatsu Nakai
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Kinki University Graduate School of Medical Sciences
| | - Masaki Mandai
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Kinki University Graduate School of Medical Sciences
| | - Shinya Matsuzaki
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine
| | - Eiji Kobayashi
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine
| | - Kiyoshi Yoshino
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine
| | - Tadashi Kimura
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine
| | - Junko Saito
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka)
| | - Yumiko Hori
- Department of Pathology, Osaka University Graduate School of Medicine
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine
| | - Tomio Nakayama
- Cancer Control Center, Osaka International Cancer Institute
| | - Mikiko Asai-Sato
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences
| | - Takayuki Enomoto
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka).,Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences
| | | | - Tetsu Takagi
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka)
| | - Kentaro Shimura
- OCEAN Study Group (Obstetrical Gynecological Society of Osaka)
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18
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Xiong WM, Xu QP, Li X, Xiao RD, Cai L, He F. The association between human papillomavirus infection and lung cancer: a system review and meta-analysis. Oncotarget 2017; 8:96419-96432. [PMID: 29221217 PMCID: PMC5707111 DOI: 10.18632/oncotarget.21682] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 09/21/2017] [Indexed: 12/19/2022] Open
Abstract
To estimate the global attributable fraction of human papillomavirus (HPV) in lung cancer, we provided updated information through a system review and meta-analysis. We did a literature search on PubMed, Ovid and Web of Science to identify case-control studies and cohort studies that detected HPV in lung carcinomas. We included studies that tested 30 or more cases and were published before Feb 28, 2017. We collected information about gender, smoking status, HPV detection methods, HPV types, materials and clinical features. If it was not possible to abstract the required information directly from the papers, we contacted the authors. A meta-analysis was performed to calculate the pooled effect sizes (OR/RR) with 95% confidence intervals (CI) including subgroup analysis and meta-regression to explore sources of heterogeneity, by Stata 13.0 software. 36 case-control studies, contributing data for 6,980 cases of lung cancer and 7,474 controls from 17 countries and one cohort study with 24,162 exposed and 1,026,986 unexposed from China were included. HPV infection was associated with cancer of lung, pooled OR was 3.64 (95% CI: 2.60–5.08), calculated with the random-effects model. Pooled OR for allogeneic case-control studies, self-matched case-control studies and nested case-control studies were 6.71 (95% CI: 4.07–11.07), 2.59 (95% CI: 1.43–4.69) and 0.92 (95% CI: 0.63–1.36), respectively. Pooled OR for HPV 16 and HPV 18 infection, were 3.14 (95% CI: 2.07–4.76) and 2.25 (95% CI: 1.49–3.40), respectively. We also found that HPV infection may be associated with squamous cell carcinoma, adenocarcinoma and small cell carcinoma. There is evidence that HPV infection, especially HPV 16 and HPV 18 infection, significantly increase the risk of lung cancer. Future research needs to focus attention toward whether an HPV vaccine can effectively reduce the incidence of lung cancer.
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Affiliation(s)
- Wei-Min Xiong
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350108, China.,Fujian Provincial Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, 350108, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350108, China
| | - Qiu-Ping Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350108, China.,Fujian Provincial Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, 350108, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350108, China
| | - Xu Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, China
| | - Ren-Dong Xiao
- Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, China
| | - Lin Cai
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350108, China.,Fujian Provincial Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, 350108, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350108, China
| | - Fei He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350108, China.,Fujian Provincial Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, 350108, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350108, China
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19
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Breast Milk Is a Potential Vehicle for Human Papillomavirus Transmission to Oral Mucosa of the Spouse. Pediatr Infect Dis J 2017; 36:627-630. [PMID: 28604561 DOI: 10.1097/inf.0000000000001546] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) DNA has been detected in breast milk, but its origin has remained obscure. The aim of the study was to analyze the prevalence and persistence of HPV in breast milk in the Finnish Family HPV cohort study. The association of breast milk HPV positivity with the family members' oral HPV status was evaluated. METHODS We included 308 families to the study where the mother was breast feeding her offspring. Mothers collected the milk samples manually at day 3, and at months 2, 6 and 12. Cervical and/or oral samples were collected from all family members. HPV testing was performed using nested polymerase chain reaction and Luminex-based Multimetrix kit. RESULTS Breast milk HPV DNA was found in 10.1% (31/308), 20.1% (39/194) and 28.8% (17/59) of samples at day 3, months 2 and 6, respectively. The following HPV genotypes were detected: 6, 16, 18, 33, 45, 53, 56, 59, 66 and 82. Breast milk HPV persisted among 5.5% (9/164) of the lactating mothers. No significant associations were detected between the persistent breast milk HPV and the offspring's oral incident HPV infection. Breast milk HPV positivity showed a strong association with the fathers' oral HPV positivity at baseline, as well as at 6- and 12-month follow-up visits, with odds ratio (OR) = 3.24 [95% confidence interval (CI): 1.04-10.12], OR = 6.34 (95% CI: 1.84-21.89) and OR = 14.25 (95% CI: 1.16-174.80), respectively. CONCLUSIONS HPV in breast milk is prevalent among the lactating mothers and HPV can also persist in breast milk. The breast milk is a potential vehicle for HPV transmission to oral mucosa of the spouse but not of the offspring.
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20
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Cooper DL, Hernandez ND, Rollins L, Akintobi TH, McAllister C. HPV vaccine awareness and the association of trust in cancer information from physicians among males. Vaccine 2017; 35:2661-2667. [PMID: 28396210 DOI: 10.1016/j.vaccine.2017.03.083] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/29/2017] [Accepted: 03/30/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Black and Hispanic men are diagnosed with more HPV-related cancers and at later stages compared to other racial/ethnic groups. Physician communication with men about HPV vaccination may be beneficial to increasing HPV vaccinations and decreasing HPV transmission. The purpose of this study was to examine HPV and HPV vaccine awareness among men by race, and the association between trust in cancer information from physicians and ever hearing about HPV and the HPV vaccine. METHODS U.S. adult males (age 18+) were identified from the 2014 Health Information National Trends Survey (HINTS) (n=1203). Binomial logistic regression models assessed the influences of race/ethnicity and trust of cancer information from physicians on men having heard of HPV and the HPV vaccination. RESULTS Approximately 50% of the sample had never heard of HPV and 53% had never heard of the vaccine. Black men were less likely to know that HPV is sexually transmitted compared to White and Hispanic men (p<0.001). Hispanic and Black men were less likely to have heard about the HPV vaccine when compared to White men (p<0.001). Additionally, Hispanic men were less likely to trust a doctor about cancer information compared to White and Black men (p<0.001). CONCLUSION Findings highlight the lack of awareness about HPV among men. Furthermore, statistically significant racial/ethnic differences were found in HPV vaccine knowledge and trust in receiving cancer information from physicians. Future interventions should include community-based approaches and improved physicians' HPV-related communication to increase knowledge and uptake of the HPV vaccine.
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Affiliation(s)
- Dexter L Cooper
- Morehouse School of Medicine, Department of Community Health and Prevention Medicine, Prevention Research Center, United States.
| | - Natalie D Hernandez
- Morehouse School of Medicine, Department of Community Health and Prevention Medicine, Prevention Research Center, United States
| | - Latrice Rollins
- Morehouse School of Medicine, Department of Community Health and Prevention Medicine, Prevention Research Center, United States
| | - Tabia Henry Akintobi
- Morehouse School of Medicine, Department of Community Health and Prevention Medicine, Prevention Research Center, United States
| | - Calvin McAllister
- Morehouse School of Medicine, Department of Community Health and Prevention Medicine, Prevention Research Center, United States
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21
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Zhang C, Liu F, Pan Y, Deng Q, Li X, He Z, Liu M, Ning T, Guo C, Liang Y, Xu R, Zhang L, Cai H, Ke Y. Incidence and clearance of oral human papillomavirus infection: A population-based cohort study in rural China. Oncotarget 2017; 8:59831-59844. [PMID: 28938686 PMCID: PMC5601782 DOI: 10.18632/oncotarget.16306] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 02/20/2017] [Indexed: 11/25/2022] Open
Abstract
The natural history of oral human papillomavirus (HPV) infection which is linked with the increased incidence of oropharyngeal squamous cell cancer (OPSCC) has been incompletely studied. Oral swab specimens and questionnaire data were obtained bi-annually for up to 6 visits from 4314 healthy adults aged 25-69 in rural Anyang, China. HPV infection status was evaluated with PCR-based sequencing. Participants with at least two consecutive valid HPV results within the study period were included in the incidence and clearance analysis. Among 3289 participants included in this analysis (median follow-up time 18.3 months), incidence rates of mucosal HPV, oncogenic mucosal HPV and cutaneous HPV were 0.53 (95% CI: 0.39-0.73), 0.30 (95% CI: 0.20-0.46), and 4.17 (95% CI: 3.70-4.70) per 1,000 person-months respectively. Most newly acquired infections were cleared within one year. Recent practice of oral sex increased the risk of incident infection with mucosal HPV (Adjusted HR, 5.03; 95% CI, 1.16-21.73) and oncogenic mucosal HPV (Adjusted HR, 10.13; 95% CI, 2.14-48.06). Newly acquired oral mucosal HPV infections are rare and most are cleared within one year in rural Chinese. This study expands understanding of the natural history of oral HPV in countries with a lower incidence of HPV-OPSCC.
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Affiliation(s)
- Chaoting Zhang
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Fangfang Liu
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yaqi Pan
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Qiuju Deng
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Xiang Li
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Zhonghu He
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Mengfei Liu
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Tao Ning
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Chuanhai Guo
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yongmei Liang
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Ruiping Xu
- Anyang Cancer Hospital, Anyang 455000, China
| | - Lixin Zhang
- Anyang Cancer Hospital, Anyang 455000, China
| | - Hong Cai
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yang Ke
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, China
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22
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Shigeishi H, Sugiyama M, Ohta K, Rahman MZ, Takechi M. Higher prevalence and gene amplification of HPV16 in oropharynx as compared to oral cavity. J Appl Oral Sci 2016; 24:397-403. [PMID: 27556212 PMCID: PMC4990370 DOI: 10.1590/1678-775720160009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/28/2016] [Indexed: 01/23/2023] Open
Abstract
Objective The objective of this study was to clarify differences regarding HPV16 infection and gene amplification between the oral cavity and oropharynx in healthy individuals. Material and Methods The subjects were 94 healthy asymptomatic individuals (41 males, 53 females; mean age 58.6 years, range 16-97 years) who visited the Department of Oral and Maxillofacial Reconstructive Surgery of the Hiroshima University Hospital from 2014 to 2015. Oral epithelial cells were collected from oral rinse and pharynx gargle samples and placed in saline. The human endogenous retrovirus gene ERV3-1 was used as a reference to estimate the number of human cells in each sample. DNA samples were extracted from approximately 10,000 human cells and tested for HPV16 DNA by PCR using a type-specific primer. Similarly, we analyzed the HPV16 viral copy number in HPV16-positive cases using real-time PCR to examine genomic amplification. Results The percentage of HPV16-positive cases was higher in the gargle (28.7%) as compared to the rinse (16.0%) samples. In the oral rinse samples, males (26.8%) showed a significantly higher rate of HPV16 than females (7.5%) (P=0.021). Importantly, in older subjects (aged 60-89 years), gargle samples showed a significantly higher rate of HPV16 (33.3%) than oral rinse samples (13.7%) (P=0.034). The average number of viral copies was approximately 8 times higher in the gargle than in the oral rinse samples (0.16±0.27 vs. 1.35±1.26 copy numbers per cell), a significant difference (P<0.001). Conclusion Our findings suggest that the oropharynx is more susceptible to HPV16 infection as compared to the oral cavity, while HPV16 gene amplification is also more commonly found in the oropharynx.
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Affiliation(s)
- Hideo Shigeishi
- - Hiroshima University, Institute of Biomedical and Health Sciences, Department of Oral and Maxillofacial Surgery, Hiroshima, Japan
| | - Masaru Sugiyama
- - Hiroshima University, Institute of Biomedical and Health Sciences, Department of Public Oral Health, Hiroshima, Japan
| | - Kouji Ohta
- - Hiroshima University, Institute of Biomedical and Health Sciences, Department of Oral and Maxillofacial Surgery, Hiroshima, Japan
| | - Mohammad Zeshaan Rahman
- - Hiroshima University, Institute of Biomedical and Health Sciences, Department of Oral and Maxillofacial Surgery, Hiroshima, Japan
| | - Masaaki Takechi
- - Hiroshima University, Institute of Biomedical and Health Sciences, Department of Oral and Maxillofacial Surgery, Hiroshima, Japan
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23
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Shigeishi H, Sugiyama M. Risk Factors for Oral Human Papillomavirus Infection in Healthy Individuals: A Systematic Review and Meta-Analysis. J Clin Med Res 2016; 8:721-9. [PMID: 27635177 PMCID: PMC5012241 DOI: 10.14740/jocmr2545w] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Oral human papillomavirus (HPV) infection is associated with oral cancer development. However, few epidemiologic investigations have focused on oral HPV prevalence in healthy individuals. The objective of this study was to provide updated information regarding oral HPV prevalence in patients without oral cancer worldwide. METHODS We systematically reviewed 29 studies reporting the prevalence of oral HPV infection that included 22,756 subjects (10,124 males, 12,623 females, and nine unknown gender; age range 2 - 89 years) and were published from January 2012 to June 2015. RESULTS The prevalence of overall HPV, low-risk type HPV, high-risk type HPV, and HPV16 in the reported cases was 5.5%, 2.2%, 2.7%, and 1.0%, respectively. The prevalence of overall HPV was considerably higher in males who had sex with males (12.2%) as compared to heterosexual males (4.7%) and females (2.9%). A meta-analysis was performed to elucidate significant risk factors for oral HPV infection, which revealed a significant statistical association for oral sex and smoking with oral HPV infection (odds ratio (OR): 1.90, 95% confidence interval (CI): 1.51 - 2.39, P < 0.0001; OR: 2.13, 95% CI: 1.32 - 3.43, P = 0.002). CONCLUSIONS Our findings suggest that sexual behavior and smoking are importantly related to oral HPV infection in healthy individuals.
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Affiliation(s)
- Hideo Shigeishi
- Department of Oral and Maxillofacial Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
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24
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Handler MZ, Handler NS, Majewski S, Schwartz RA. Human papillomavirus vaccine trials and tribulations: Clinical perspectives. J Am Acad Dermatol 2016; 73:743-56; quiz 757-8. [PMID: 26475534 DOI: 10.1016/j.jaad.2015.05.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/20/2015] [Accepted: 05/23/2015] [Indexed: 01/05/2023]
Abstract
Human papillomavirus (HPV) affects hundreds of millions of people worldwide and is associated with both benign and malignant neoplasms in men and women. It is a double-stranded DNA virus with an icosahedral capsid. Forty HPV types are known to infect mucosal keratinocytes. If not cured by the immune system, the infection can lead to genital warts, mucosal dysplasia, or cancer. The most common oncogenic types are 16 and 18. The vaccine to prevent HPV and its associated morbidity and mortality has existed since 2006. Several variations protect against an increasing number of HPV types. The recommended vaccination age is before sexual exposure; administration of the vaccine to children has been controversial. This continuing medical education review evaluates the current HPV vaccines available to clinicians. Part I focuses on the debate over who should be vaccinated, at what age, and in which populations.
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Affiliation(s)
- Marc Z Handler
- Dermatology, Rutgers University New Jersey Medical School, Newark, New Jersey
| | - Nancy S Handler
- Dermatology, Rutgers University New Jersey Medical School, Newark, New Jersey; University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska
| | - Slawomir Majewski
- Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland
| | - Robert A Schwartz
- Dermatology, Rutgers University New Jersey Medical School, Newark, New Jersey; Pathology, Rutgers University New Jersey Medical School, Newark, New Jersey; Pediatrics, Rutgers University New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers University New Jersey Medical School, Newark, New Jersey; School of Public Affairs and Administration, Rutgers University, Newark, New Jersey.
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25
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Liu F, Hang D, Deng Q, Liu M, Xi L, He Z, Zhang C, Sun M, Liu Y, Li J, Pan Y, Ning T, Guo C, Liang Y, Xu R, Zhang L, Cai H, Ke Y. Concurrence of oral and genital human papillomavirus infection in healthy men: a population-based cross-sectional study in rural China. Sci Rep 2015; 5:15637. [PMID: 26503510 PMCID: PMC4621523 DOI: 10.1038/srep15637] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/28/2015] [Indexed: 01/08/2023] Open
Abstract
Human papillomavirus (HPV) infection, a primary cause of genital cancer, is also related to the increasing incidence of oropharyngeal cancer among young men. Relatively little is known about the concurrence of oral and genital infection among healthy individuals. Oral and genital swab exfoliated cells were collected simultaneously from 2566 men in rural China. Using general primer-mediated (SPF1/GP6+) PCR and sequencing, HPV testing results were obtained from 2228 men with both valid oral and genital specimens (β-globin-positive). The prevalence of HPV infection was 6.7% in the oral cavity and 16.9% for the external genitalia. Among 43 men (1.9%, 43/2228) with oral-genital coinfection, 60.5% (26/43) harbored an identical HPV type at both sites. The risk of oral HPV infection was higher among men with genital infection than among uninfected men (11.4% vs. 5.7%, Adjusted OR = 2.3, 95% CI: 1.6-3.4). In addition, having multiple lifetime sexual partners was a significant risk for oral-genital HPV coinfection (Adjusted OR = 2.6, 95% CI: 1.0-7.0; 2 partners vs. 1 partner). These findings provide a basis for further understanding the natural history and transmission dynamics of oral HPV infection.
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Affiliation(s)
- Fangfang Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Dong Hang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qiuju Deng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Mengfei Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Longfu Xi
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.,Department of Pathology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Zhonghu He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Chaoting Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Min Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Ying Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Jingjing Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Yaqi Pan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Tao Ning
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Chuanhai Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Yongmei Liang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Ruiping Xu
- Anyang Cancer Hospital, Anyang, Henan Province, People's Republic of China
| | - Lixin Zhang
- Anyang Cancer Hospital, Anyang, Henan Province, People's Republic of China
| | - Hong Cai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
| | - Yang Ke
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital &Institute, Beijing, China
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26
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Gillison ML, Chaturvedi AK, Anderson WF, Fakhry C. Epidemiology of Human Papillomavirus-Positive Head and Neck Squamous Cell Carcinoma. J Clin Oncol 2015; 33:3235-42. [PMID: 26351338 PMCID: PMC4979086 DOI: 10.1200/jco.2015.61.6995] [Citation(s) in RCA: 773] [Impact Index Per Article: 85.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Human papillomavirus (HPV) is now established as the principal cause of an increase in incidence of a subset of head and neck squamous cell cancers (HNCs) in numerous geographic regions around the world. Further study of the epidemiology of HPV-positive HNC will be critical to the development and implementation of public health interventions to reverse these global incidence trends. Here, recent data are reviewed to provide insight into several topics, including incidence trends and projections for HPV-positive HNC; the worldwide HPV-attributable fraction; sex disparities in cancer risk; the epidemiology of oral HPV infection; the latency period between infection and cancer; the potential impact of prophylactic HPV vaccination; and prospects for secondary prevention through screening for oral HPV infection or seroreactivity to viral antigens. The identification of a single necessary cause for any cancer provides a rare and perhaps extraordinary opportunity for cancer prevention.
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Affiliation(s)
- Maura L Gillison
- Maura L. Gillison, The Ohio State University Wexner Medical Center, Columbus, OH; Anil K. Chaturvedi and William F. Anderson, National Cancer Institute, National Institutes of Health, Rockville; and Carole Fakhry, Johns Hopkins Hospital, Baltimore, MD.
| | - Anil K Chaturvedi
- Maura L. Gillison, The Ohio State University Wexner Medical Center, Columbus, OH; Anil K. Chaturvedi and William F. Anderson, National Cancer Institute, National Institutes of Health, Rockville; and Carole Fakhry, Johns Hopkins Hospital, Baltimore, MD
| | - William F Anderson
- Maura L. Gillison, The Ohio State University Wexner Medical Center, Columbus, OH; Anil K. Chaturvedi and William F. Anderson, National Cancer Institute, National Institutes of Health, Rockville; and Carole Fakhry, Johns Hopkins Hospital, Baltimore, MD
| | - Carole Fakhry
- Maura L. Gillison, The Ohio State University Wexner Medical Center, Columbus, OH; Anil K. Chaturvedi and William F. Anderson, National Cancer Institute, National Institutes of Health, Rockville; and Carole Fakhry, Johns Hopkins Hospital, Baltimore, MD
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27
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Laprise C, Madathil SA, Allison P, Abraham P, Raghavendran A, Shahul HP, ThekkePurakkal AS, Castonguay G, Coutlée F, Schlecht NF, Rousseau MC, Franco EL, Nicolau B. No role for human papillomavirus infection in oral cancers in a region in southern India. Int J Cancer 2015; 138:912-7. [PMID: 26317688 DOI: 10.1002/ijc.29827] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 08/14/2015] [Indexed: 01/11/2023]
Abstract
Oral cancer is a major public health issue in India with ∼ 77,000 new cases and 52,000 deaths yearly. Paan chewing, tobacco and alcohol use are strong risk factors for this cancer in India. Human papillomaviruses (HPVs) are also related to a subset of head and neck cancers (HNCs). We examined the association between oral HPV and oral cancer in a sample of Indian subjects participating in a hospital-based case-control study. We recruited incident oral cancer cases (N = 350) and controls frequency-matched by age and sex (N = 371) from two main referral hospitals in Kerala, South India. Sociodemographic and behavioral data were collected by interviews. Epithelial cells were sampled using Oral CDx® brushes from the oral cancer site and the normal mucosa. Detection and genotyping of 36 HPV genotypes were done using a polymerase chain reaction protocol. Data collection procedures were performed by qualified dentists via a detailed protocol with strict quality control, including independent HPV testing in India and Canada. HPV DNA was detected in none of the cases or controls. Associations between oral cancer and risk factors usually associated with HPV infection, such as oral sex and number of lifetime sexual partners, were examined by logistic regression and were not associated with oral cancer. Lack of a role for HPV infection in this study may reflect cultural or religious characteristics specific to this region in India that are not conducive to oral HPV transmission. A nationwide representative prevalence study is needed to investigate HPV prevalence variability among Indian regions.
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Affiliation(s)
- Claudie Laprise
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Sreenath A Madathil
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Paul Allison
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Priya Abraham
- Department of Clinical Virology, Christian Medical College, Vellore, India
| | | | - Hameed P Shahul
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | | | - Geneviève Castonguay
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - François Coutlée
- Department of Microbiology and Infectious Diseases, Hôpital Notre-Dame Du Centre De Recherche Du Centre Hospitalier De L'université De Montréal, Montreal, QC, Canada
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY
| | - Marie-Claude Rousseau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Belinda Nicolau
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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28
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Muller K, Kazimiroff J, Fatahzadeh M, Smith RV, Wiltz M, Polanco J, Grossberg RM, Belbin TJ, Strickler HD, Burk RD, Schlecht NF. Oral Human Papillomavirus Infection and Oral Lesions in HIV-Positive and HIV-Negative Dental Patients. J Infect Dis 2015; 212:760-8. [PMID: 25681375 DOI: 10.1093/infdis/jiv080] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/05/2015] [Indexed: 12/11/2022] Open
Abstract
We evaluated the risk factors associated with oral human papillomavirus (HPV) infection and oral lesions in 161 human immunodeficiency virus (HIV)-positive patients and 128 HIV-negative patients presenting for oral examination at 2 urban healthcare centers. Patients were interviewed on risk factors and provided oral-rinse samples for HPV DNA typing by polymerase chain reaction. Statistical associations were assessed by logistic regression. Oral HPV was prevalent in 32% and 16% of HIV-positive patients and HIV-negative patients, respectively, including high-risk HPV type 16 (8% and 2%, respectively; P = .049) and uncommon HPV types 32/42 (6% and 5%, respectively; P = .715). Among HIV-negative patients, significant risk factors for oral HPV included multiple sex partners (≥21 vs ≤5; odds ratio [OR], 9.1; 95% confidence interval [CI], 1.7-49.3), heavy tobacco smoking (>20 pack-years vs none; OR, 9.2; 95% CI, 1.4-59.4), and marijuana use (OR, 4.0; 95% CI, 1.3-12.4). Among HIV-positive patients, lower CD4(+) T-cell count only was associated with oral HPV detection (≤200 vs ≥500 cells/mm(3); OR, 4.5; 95% CI, 1.3-15.5). Detection of high-risk HPV was also associated with concurrent detection of potentially cancerous oral lesions among HIV-negative patients but not among HIV-positive patients. The observed risk factor associations with oral HPV in HIV-negative patients are consistent with sexual transmission and local immunity, whereas in HIV-positive patients, oral HPV detection is strongly associated with low CD4(+) T-cell counts.
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Affiliation(s)
- Katia Muller
- Department of Oral Health and Society, McGill Dentistry, Montreal, Canada
| | | | - Mahnaz Fatahzadeh
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Richard V Smith
- Department of Otorhinolaryngology-Head and Neck Surgery Department of Pathology
| | | | | | | | | | | | - Robert D Burk
- Department of Epidemiology and Population Health Division of Genetics, Department of Pediatrics Department of Microbiology and Immunology Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Nicolas F Schlecht
- Division of Oncology, Department of Medicine Department of Epidemiology and Population Health
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