Oral Human Papillomavirus Infection in HIV-Positive and HIV-Negative Individuals.

Abstract

Abstract Background: Recent studies have shown that human papillomavirus (HPV) is an etiologic agent for oropharyngeal squamous cell carcinomas (OPSCC). Although individuals with HIV are presumably at increased risk of developing OPSCC, it is unknown to what extent the HIV status contributes to prevalence of oral HPV infections. This study was conducted to evaluate the prevalence and risk factors in three diverse groups in Washtenaw and surrounding counties in Michigan. Methods: Participants were recruited to form three study groups: 1) HIV-positive patients seen at the University of Michigan Health System; 2) HIV-negative individuals tested at an HIV screening clinic; and 3) self-reported HIV-negative individuals. Oral rinse samples were collected from participants and were tested for presence and type of HPV DNA with PGMY09/11 primers and Sanger sequencing. In addition, HPV type and copy number were examined by HPV MultiPlex PCR-MassArray for 15 discrete high-risk HPV types (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68 and 73) and 3 low-risk HPV types (HPV 6, 11, and 90). Study participants completed a survey to ascertain medical, social, and behavioral risk factors. Clinical information pertaining to HIV disease status was collected for HIV patients. Results: The total of 266 community-based participants (107 HIV-infected, 69 tested HIV-negative, and 90 self-reported HIV-negative) were enrolled. The overall crude prevalence of oral HPV DNA was 10.5%. The HIV-infected group had the highest prevalence (20.1%), followed by the self-reported HIV-negative group (5.6%) and the HIV-negative group that received HIV testing (1.4%). Male partner's circumcision status was significantly associated with oral HPV infection (aOR=3.85). In univariate analysis, male gender, lifetime number of vaginal sex partners, and higher viral load were associated with increased risk of oral HPV infection. Conclusion: The data supports previous findings that higher prevalence of oral HPV infection is observed in HIV-positive individuals compared to HIV-negative individuals.