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Amato M, Santonocito S, Bruno MT, Polizzi A, Mastroianni A, Chaurasia A, Isola G. Oral and periodontal manifestation related during human papilloma virus infections: Update on early prognostic factors. Heliyon 2024; 10:e31061. [PMID: 38813162 PMCID: PMC11133762 DOI: 10.1016/j.heliyon.2024.e31061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/11/2024] [Accepted: 05/09/2024] [Indexed: 05/31/2024] Open
Abstract
Human Papilloma Virus (HPV) is considered one of the most common sexually transmitted infections and has been shown to play an important role in the pathogenesis of squamous cell carcinomas (SCC) of the cervix and head and neck. Manifestations of HPV infections can be manifold, ranging from asymptomatic infections to benign or potentially malignant lesions to intraepithelial neoplasms and invasive carcinomas. The heterogeneity of clinical manifestations from HPV infection depends on the interactions between the viral agent and the host, a direct consequence of the ability on the part of HPV is to remain silent and to evade and convey the action of the host immune system. The oral mucosa represents one of the tissues for which HPV has a distinct tropism and is frequently affected by infection. While much information is available on the role that HPV infection plays in the development of SCC in the oral cavity, there is less information on asymptomatic infections and benign HPV-induced oral lesions. Therefore, the purpose of this review is to analyze, in light of current knowledge, the early clinical and bio-humoral prognostic features related to the risk of HPV malignant transformation, focusing on subclinical conditions, benign lesions, and the correlation between oral infection and infection in other districts. The data show that the main risk associated with HPV infection is related to malignant transformation of lesions. Although HPV-driven OPSCC is associated with a better prognosis than non-HPV-driven OPSCC, primary prevention and early detection of the infection and affected genotype are essential to reduce the risk of malignant neoplastic complications and improve the prognosis.
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Affiliation(s)
- Mariacristina Amato
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy
| | - Maria Teresa Bruno
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
- Research Center of “Human Papilloma Virus” University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Alessandro Mastroianni
- Dentistry Unit, Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, 00133, Rome, Italy
| | - Akhilanand Chaurasia
- Department of Oral Medicine & Radiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
- Research Center of “Human Papilloma Virus” University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
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Gheit T, Muwonge R, Lucas E, Galati L, Anantharaman D, McKay-Chopin S, Malvi SG, Jayant K, Joshi S, Esmy PO, Pillai MR, Basu P, Sankaranarayanan R, Tommasino M. Impact of HPV vaccination on HPV-related oral infections. Oral Oncol 2023; 136:106244. [PMID: 36402055 PMCID: PMC9833124 DOI: 10.1016/j.oraloncology.2022.106244] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Although the efficacy of the HPV vaccine in preventing the development of cervical pre-malignant lesions has been well demonstrated, the efficacy of the HPV vaccine in preventing HPV infection in the upper respiratory tract has been poorly studied. METHODS In the context of the IARC cohort study of two versus three doses of HPV vaccine in India, we compared the HPV type prevalence in the oral cavity of women vaccinated with three doses, two doses, or a single dose of quadrivalent HPV vaccine with that of unvaccinated women. A total of 997 oral samples, from 818 vaccinated women and 179 unvaccinated women, were collected at three study sites. All the participants were sexually active at the time of sample collection. RESULTS The age-standardized proportion (ASP) of HPV16/18 infections was 2.0 % (95 % CI, 1.0-3.0 %) in vaccinated women and 4.2 % (95 % CI, 1.2-7.2 %) in unvaccinated women. HPV16 was detected in 3.5 % of single-dose recipients, 1.2 % of two-dose recipients (days 1 and 180), and 1.5 % of three-dose recipients (days 1, 60, and 180), whereas 3.3 % of the unvaccinated women tested positive for HPV16. The same trend was observed for HPV18. DISCUSSION Our findings agree with those of previous studies on the efficacy of HPV vaccination in reducing oral HPV infections and provide indications that a single vaccine dose may be less efficient than two or three doses in preventing oral HPV infection.
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Affiliation(s)
- Tarik Gheit
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Richard Muwonge
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Eric Lucas
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Luisa Galati
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Devasena Anantharaman
- Rajiv Gandhi Centre for Biotechnology, Poojappura, Thiruvananthapuram, Kerala, India
| | - Sandrine McKay-Chopin
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Sylla G Malvi
- Tata Memorial Centre Rural Cancer Project, Nargis Dutt Memorial Cancer Hospital, Barshi District Solapur, Maharashtra, India
| | - Kasturi Jayant
- Tata Memorial Centre Rural Cancer Project, Nargis Dutt Memorial Cancer Hospital, Barshi District Solapur, Maharashtra, India
| | - Smita Joshi
- Jehangir Clinical Development Centre, Jehangir Hospital Premises, Pune, India
| | - Pulikkottil O Esmy
- Christian Fellowship Community Health Centre, Ambillikai, Dindigul District, Tamil Nadu, India
| | | | - Partha Basu
- International Agency for Research on Cancer, World Health Organization, Lyon, France
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Abstract
Human papillomavirus is the most common sexually transmitted infection in the world and had been linked to both anogenital and oropharyngeal cancers. It causes nearly 100% of cervical cancers and an increasing portion of oropharyngeal cancers. The geographical burden of cervical HPV infection and associated cancers is not uniform and is mainly found in low middle income countries in South America, Africa, and Asia. However, HPV-positive oropharyngeal cancer is rapidly becoming more prevalent in high middle income countries. With the development of vaccines which prevent HPV infection, the World Health Organization has designated the extirpation of HPV and its associated cancers a priority. Countries that have implemented adequate vaccine programs have shown a decrease in HPV prevalence. Understanding the epidemiology of HPV and its associated cancers is fundamental in improving vaccine programs and other health programs.
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Affiliation(s)
- Nicholas Scott-Wittenborn
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
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Ahn D, Heo SJ, Lee GJ, Sohn JH, Jeong JY. Prevalence and characteristics of tonsillar human papillomavirus infection in tumor-free patients undergoing tonsillectomy. Auris Nasus Larynx 2021; 49:229-234. [PMID: 34404549 DOI: 10.1016/j.anl.2021.07.011] [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: 04/28/2021] [Revised: 07/02/2021] [Accepted: 07/20/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study evaluated the prevalence and characteristics of tonsillar human papillomavirus (HPV) infection in tumor-free patients undergoing tonsillectomy. METHODS We prospectively enrolled healthy patients who underwent tonsillectomy for tumor-free tonsillar disease. Their tonsillar HPV infections were evaluated using CLART HPV2, and subsequent p16 immunohistochemistry was performed in patients with positive HPV infection. Moreover, the results of tonsillar HPV infection were analyzed according to sex, age, and indication of tonsillectomy. RESULTS A total of 362 patients were included. HPV test was positive in 8 patients, with an overall prevalence of 2.2%. All detected HPV types were high-risk, including HPV 16 in six patients, HPV 52 in one patient, and HPV 58 in one patient. P16 was negative in all 8 patients with HPV infection. The prevalence of tonsillar HPV infection in males and females was 2.4% (6/246) and 1.7% (2/116), respectively (P > 0.999), and in pediatric and adult patients, 2.2% (5/228) and 2.2% (3/134), respectively (P > 0.999). The prevalence showed a bimodal peak at 1st and 6th decades, with the prevalence of 2.6% (5/194) and 7.9% (3/38), respectively. The prevalence of tonsillar HPV infection in tonsillitis and non-tonsillitis groups were 0.0% (0/104) and 3.1% (8/258), respectively (P = 0.111). CONCLUSION The prevalence of tonsillar HPV infection in tumor-free patients was low, but all detected HPV infections were high-risk types. Our results support using a 9-valent vaccine which covers all high-risk HPV types found in this study.
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Affiliation(s)
- Dongbin Ahn
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-g, Daegu 41944, Republic of Korea.
| | - Sung Jae Heo
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-g, Daegu 41944, Republic of Korea.
| | - Gil Joon Lee
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-g, Daegu 41944, Republic of Korea
| | - Jin Ho Sohn
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-g, Daegu 41944, Republic of Korea; Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Ji Yun Jeong
- Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Wierzbicka M, Klussmann JP, San Giorgi MR, Wuerdemann N, Dikkers FG. Oral and laryngeal HPV infection: Incidence, prevalence and risk factors, with special regard to concurrent infection in head, neck and genitals. Vaccine 2021; 39:2344-2350. [PMID: 33812740 DOI: 10.1016/j.vaccine.2021.03.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 12/20/2022]
Abstract
This review focuses on the importance of oral and laryngeal HPV infection which is present in majority of sexually active individuals at least once in their lifetime. Despite testing, still little is known about prevalence rates, determinants and, especially, the concurrent HPV infection in head and neck, and genitals. The purpose of this review is to clarify some issues of oral HPV incidence, prevalence, and to demonstrate the difficulties in identification of asymptomatic oral HPV carriers. The main premise to take up this topic is the high and still increasing risk for development of oropharyngeal cancer, and potential benefit from screening strategies, education programs and HPV vaccination. Transmission of HPV to the oral cavity and oropharynx is hypothesized to occur mainly through sexual contact. The exposure of oropharyngeal mucosa to HPV infection with consequence of increased risk for oropharyngeal carcinoma depends on specific sexual behavior. Male gender, older age, race or ethnicity, oral hygiene and current cigarette smoking are independently associated with any prevalent oral HPV infection.
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Affiliation(s)
- Malgorzata Wierzbicka
- Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, 49 Stanisława Przybyszewskiego, 60-357 Poznań, Poland
| | - Jens Peter Klussmann
- ENT Clinic of the University Hospital of Cologne, Kerpener Str. 62, 50931 Cologne, Germany
| | - Michel R San Giorgi
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - Nora Wuerdemann
- ENT Clinic of the University Hospital of Cologne, Kerpener Str. 62, 50931 Cologne, Germany
| | - Frederik G Dikkers
- Amsterdam UMC, University of Amsterdam, Department of Otorhinolaryngology, Head and Neck Surgery, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
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Choi JS, Tang L, Yu AJ, Swanson MS, Chambers TN, Kokot NC, Sinha UK. Prevalence of oral human papillomavirus infections by race in the United States: An association with sexual behavior. Oral Dis 2020; 26:930-940. [PMID: 32011771 DOI: 10.1111/odi.13292] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 07/13/2024]
Abstract
OBJECTIVES To investigate the differences in oral HPV infection and sexual behaviors by race in the US. MATERIALS AND METHODS We analyzed data from the 2011-2014 US National Health and Nutrition Examination Survey during which participants aged 18-69 years completed oral rinse exam for HPV detection (n = 8,229). Logistic regression was used to examine the associations of race with various types of oral HPV infection and sexual behaviors. RESULTS The prevalence of overall oral HPV infection and HPV type16 infection was 7.5% [95% CI: 6.6-8.4] and 1.1% [95% CI: 0.7-1.3], respectively. Blacks were more likely to have any oral HPV infection [OR: 1.22, 95% CI: 1.01-1.47] and Asian Americans were less likely to have any oral HPV infection [OR: 0.33, 95% CI: 0.24-0.49] than Whites. In a multivariate model, Whites were less likely to have any oral HPV infections than Blacks while having higher order of impact by the number of lifetime sex partners. Overall, Asian Americans were less likely to have type16 infection [OR: 0.21, 95% CI: 0.06-0.67] than Whites; however, that difference disappears when adjusting for sexual behaviors. CONCLUSIONS In this nationally representative sample of US adults, the prevalence of overall oral HPV infections was higher among Blacks and lower among Asians in comparison to Whites. Further analysis with sexual behavior data suggested that the racial differences in prevalence are likely due to different sexual behaviors.
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Affiliation(s)
- Janet S Choi
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Liyang Tang
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Alison J Yu
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Mark S Swanson
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Tamara N Chambers
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Niels C Kokot
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Uttam K Sinha
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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Sastre-Cantón M, Pérez-Vilar S, Vilata-Corell JJ, Díez-Domingo J. Prevalence of oral human papillomavirus infection among university students in Valencia, Spain. Vaccine 2019; 37:6276-6281. [PMID: 31515148 DOI: 10.1016/j.vaccine.2019.08.058] [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: 05/19/2019] [Revised: 08/19/2019] [Accepted: 08/23/2019] [Indexed: 11/24/2022]
Abstract
Human papillomavirus (HPV) infection contributes to the pathogenesis of oropharyngeal squamous cell carcinomas. We estimated prevalence and six-month persistence of oral HPV infections among university students ages 18-25 years living in Valencia, Spain, during the 2012-2013 academic year. Participants provided oral rinse samples; HPV-positive subjects provided a follow-up sample. The study included 543 students; 70 (12.9%) women had received HPV vaccination. Prevalence among vaccinees and non-vaccinees were 10.0% (95% CI: 4.1-19.5%) and 6.8% (95% CI: 4.7-9.4%), respectively. All HPV infections among vaccinees were non-typeable genotypes; 59.4% of non-vaccinees had high-risk genotype infections. Follow-up samples were obtained from 36 participants; one vaccinee (whose specimen was non-typeable) and seven non-vaccinees were found to be HPV positive. Among non-vaccinees, six-month persistence was 10.3% (95% CI: 2.2-27.4%); all persistent infections were with high-risk genotypes. Our results, although subject to study limitations, may support the need to implement new public health strategies.
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Affiliation(s)
- Macrina Sastre-Cantón
- Vaccine Research Department, Foundation for the Promotion of Health and Biomedical Research, FISABIO-Public Health, Valencia, Spain.
| | - Silvia Pérez-Vilar
- Vaccine Research Department, Foundation for the Promotion of Health and Biomedical Research, FISABIO-Public Health, Valencia, Spain
| | | | - Javier Díez-Domingo
- Vaccine Research Department, Foundation for the Promotion of Health and Biomedical Research, FISABIO-Public Health, Valencia, Spain
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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: 65] [Impact Index Per Article: 10.8] [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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Castillejos-García I, Ramírez-Amador VA, Carrillo-García A, García-Carrancá A, Lizano M, Anaya-Saavedra G. Type-specific persistence and clearance rates of HPV genotypes in the oral and oropharyngeal mucosa in an HIV/AIDS cohort. J Oral Pathol Med 2018; 47:396-402. [PMID: 29380908 DOI: 10.1111/jop.12687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Oral high-risk human papillomavirus (HR-HPV) infections are frequent and persistent among the HIV-positive population and are associated with an increased risk for head and neck cancer (HNC). In this study, we sought to determine the incidence, persistence and clearance of HPV infections in oral and oropharyngeal samples from HIV/AIDS subjects. METHODS A longitudinal, observational and analytical study was performed with an ongoing cohort of HIV/AIDS subjects in Mexico City (September 2013-February 2015). The study was approved by institutional committees, and demographic and clinical data were registered. At the baseline and three-month visits, oral examinations and cytobrush samples were obtained. DNA was purified, quantified and used to detect an HPV-L1 gene fragment by nested PCR, using MY09/MY11 and GP5 + /GP6 + primers. HPV DNA products were purified, sequenced and typed according to HPV databases. Risk factors were assessed, and a multivariate modelling approach was used to determine independent effects. RESULTS This study included 97 HIV/AIDS individuals (91% men [86.4% of which are men who have sex with men], median age: 36 years, 72.2% under HAART). From the baseline visit, HPV was observed in 55.7% (HR-HPV: 26.8%; HPV-18: 24.1%), with a higher HPV-positive samples for smokers (61.1 vs 32.6%, P = .005). The three-month overall HPV incidence was 33.9%; type-specific HPV persistence was 33.3% (HR-HPV: 13.3%); and 13 of the 33 (39.4%) baseline HPV-positive individuals cleared the infection (HR-HPV: 53.8%). CONCLUSIONS Although HR-HPV persistence was low, and clearance of the infection was observed in most cases, a close follow-up is necessary, given the increase in HNC among HIV-subjects, particularly HPV-related cancer.
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Affiliation(s)
- Itzel Castillejos-García
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Velia A Ramírez-Amador
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Adela Carrillo-García
- Biomedical Research Unit, Instituto Nacional de Cancerología (INCan)/Instituto de Investigaciones Biomédicas, UNAM, México City, Mexico
| | - Alejandro García-Carrancá
- Biomedical Research Unit, Instituto Nacional de Cancerología (INCan)/Instituto de Investigaciones Biomédicas, UNAM, México City, Mexico
| | - Marcela Lizano
- Biomedical Research Unit, Instituto Nacional de Cancerología (INCan)/Instituto de Investigaciones Biomédicas, UNAM, México City, Mexico
| | - Gabriela Anaya-Saavedra
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana, Mexico City, Mexico
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Criscuolo MI, Belardinelli PA, Morelatto RA, Mosmann J, Venezuela RF, Kiguen AX, Cuffini C, Lopez de Blanc S. Prevalence of oral human papillomavirus (HPV) in the adult population of Córdoba, Argentina. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2018. [DOI: 10.1177/2057178x18757334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To determine the prevalence of oral human papillomavirus (HPV) in the population of Córdoba, Argentina and its association with other risk factors. Methods: A sample of 401 volunteers over 18 years, representative of Cordoba city population, was selected. Using a questionnaire, we collected sociodemographic data including the use of tobacco, alcohol, and mate consumption. Two biological samples were taken from each individual, whole mouth saliva and a scraping of the posterior border of the tongue. HPV was determined by polymerase chain reaction using MY09/11 primers. Statistical associations were analyzed using χ2 test. Results: Prevalence of HPV in the population was of 3% (13/401). The mean age of HPV-positive cases was 42 years with a range of 20–85; 54% were females. Among the 13 cases whose saliva was positive for HPV, only 7 (54%) had HPV-DNA in the tongue scraping. All identified genotypes were of low risk and HPV11 was the most frequent type in 62% of positive cases. None of the positive subjects exhibited oral lesions compatible with HPV infection. Ten (77%) of the HPV-positive subjects exhibited lesions in the oral mucosa, mostly related to chronic mechanical irritation (CMI) (odds ratio 3, 95% confidence interval: 1.01–8.97, p < 0.05). Fifty-four percent of HPV-positive individuals were light smokers and consumed alcohol moderately. The combination of both habits was observed in 31%. Sixty-two percent drank mate at high water temperatures. No differences were detected in the sexual behavior or in the reported number of sexual partners between HPV-positive and -negative subjects. Conclusion: The overall prevalence of oral HPV in adults was 3%; only the low-risk genotypes were detected and no association with other risk factors for oral cancer was found. However, an association with CMI of the oral mucosa was noted. The saliva sample proved to be a simple, efficient, and well-tolerated method suitable for screening for HPV, and more cases were detected in saliva compared with tissue scrapings.
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Affiliation(s)
- MI Criscuolo
- Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - PA Belardinelli
- Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - RA Morelatto
- Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - J Mosmann
- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - RF Venezuela
- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - AX Kiguen
- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - C Cuffini
- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - S Lopez de Blanc
- Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
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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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12
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Lupato V, Holzinger D, Höfler D, Menegaldo A, Giorgi Rossi P, Del Mistro A, Da Mosto MC, Pawlita M, Boscolo-Rizzo P. Prevalence and Determinants of Oral Human Papillomavirus Infection in 500 Young Adults from Italy. PLoS One 2017; 12:e0170091. [PMID: 28103272 PMCID: PMC5245874 DOI: 10.1371/journal.pone.0170091] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/28/2016] [Indexed: 01/05/2023] Open
Abstract
Although the prevalence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is increasing in developed countries and becoming a relevant health issue, the natural history of oral HPV infection is still unclear. Estimating the infection's prevalence in specific populations and identifying risk factors can widen our understanding of its natural history and help to delineate appropriate prevention strategies. This study sought to (i) determine oral HPV prevalence and genotype distribution in a large series of young Italian adults, (ii) validate an oral rinse sampling/storage protocol, and (iii) pinpoint factors associated with oral HPV infection. Five hundred students, nurses, and technicians (19-35 years-old) studying and working at/for the University of Padua were recruited. Each participant was provided with an oral rinse sampling kit and instructions for use. They were also asked to complete an anonymous questionnaire concerning their demographic characteristics and behaviors. The questionnaires and oral rinse containers were labeled with the same identification code number. The oral rinse samples were tested using a bead-based multiplex BSGP5+/6+-MPG genotyping assay which amplifies the L1 region of 51 mucosal HPV types. The prevalence of oral HPV infection was 4.0% (95% confidence interval (CI), 2.5%-6.1%); those of 14 high-risk HPV types and of HPV-type 16 (HPV16) infection were 2.2% (95% CI, 1.1%-3.9%) and 1.6% (95% CI, 0.6%-3.1%), respectively. HPV16 was the most frequent genotype (40.0% of oral HPV infections). No association was found between oral infection and the co-variables studied (gender, tobacco, alcohol and illegal drug use, number of sex and oral sex partners, HPV vaccination status, history of HPV and sexually transmitted infections, abnormal pap smears, recurrent tonsillitis and tonsillectomy). The oral rinse sampling protocol outlined here proved to be simple, efficient and well tolerated, and the prevalence rate can be considered reliable and thus useful to guide future research. Determinants of oral HPV infection are still unclear and further studies are certainly warranted.
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Affiliation(s)
- Valentina Lupato
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
- Unit of Otolaryngology, Azienda Ospedaliera “S. Maria degli Angeli”, Pordenone, Italy
| | - Dana Holzinger
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniela Höfler
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anna Menegaldo
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
| | - Paolo Giorgi Rossi
- Interinstitutional Epidemiology Unit, Local Health Authority, Reggio Emilia, Italy
- Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Annarosa Del Mistro
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto—IRCCS, Padova, Italy
| | - Maria Cristina Da Mosto
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
| | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paolo Boscolo-Rizzo
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
- * E-mail:
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13
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Taylor S, Bunge E, Bakker M, Castellsagué X. The incidence, clearance and persistence of non-cervical human papillomavirus infections: a systematic review of the literature. BMC Infect Dis 2016; 16:293. [PMID: 27301867 PMCID: PMC4908763 DOI: 10.1186/s12879-016-1633-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 06/07/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccines were designed to prevent cervical cancer in women and their provision remains a major public health need. However, HPV is also a major cause of non-cervical anogenital and oropharyngeal cancers and the potential benefit of vaccination likely extends beyond cervical cancer. METHODS A systematic literature search of PubMed (1995-2014) identified publications assessing the incidence, persistence, and clearance of non-cervical anogenital/oral HPV infections. Comparability with cervical HPV was assessed by identifying articles assessing the same or similar populations. RESULTS Available data suggest high incidence rates of non-cervical HPV infection in men and women, with HPV-16 predominating in all sites. The incidence of high risk HPV per 100 person-years ranged from 11.4 to 72.9 for penile infections, 6.7-47.9 at other male genital sites, and 4.4-36.7 and 5.3-23.4 for anal infections in men and women, respectively. The incidence per 100 person-years of oral infection with any HPV type ranged from 5.7 to 6.7 in men and 6.8-39.6 in women. Within the limitations of the data, there was a general pattern of higher incidence and clearance of non-cervical genital HPV infections, compared to cervical infections. HIV status, circumcision, number of sex partners and partner HPV status significantly influenced high-risk HPV incidence/clearance at male anogenital sites. Few studies assessed risk factors for oral HPV. CONCLUSIONS Parallels appear to exist between the epidemiology of cervical and non-cervical HPV infections in terms of incidence, HPV-type distribution, and risk factors for infection. Available data suggest that non-cervical genital HPV infections may occur more frequently, with higher clearance rates, than cervical infections. More extensive studies could provide useful information for estimating vaccine impact, the wider cost-benefit of HPV vaccination, and guiding vaccination policy. TRIAL REGISTRATION Not applicable, as systematic review of the literature.
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Affiliation(s)
- Sylvia Taylor
- GSK Vaccines, 20, Avenue Fleming, Parc de la Noire Epine, B-1300, Wavre, Belgium.
| | - Eveline Bunge
- Pallas Health Research and Consultancy BV, Rotterdam, The Netherlands
| | - Marina Bakker
- Pallas Health Research and Consultancy BV, Rotterdam, The Netherlands
| | - Xavier Castellsagué
- Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, Catalonia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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14
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Gooi Z, Chan JYK, Fakhry C. The epidemiology of the human papillomavirus related to oropharyngeal head and neck cancer. Laryngoscope 2016; 126:894-900. [DOI: 10.1002/lary.25767] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Zhen Gooi
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University; Baltimore Maryland U.S.A
| | - Jason Y. K. Chan
- Department of Otorhinolaryngology-Head and Neck Surgery; The Chinese University of Hong Kong; Prince of Wales Hospital Shatin Hong Kong SAR
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University; Baltimore Maryland U.S.A
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15
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Carcinomes oropharyngés HPV induits. ONCOLOGIE 2015. [DOI: 10.1007/s10269-015-2522-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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TESTI D, NARDONE M, MELONE P, CARDELLI P, OTTRIA L, ARCURI C. HPV and oral lesions: preventive possibilities, vaccines and early diagnosis of malignant lesions. ORAL & IMPLANTOLOGY 2015; 8:45-51. [PMID: 27555904 PMCID: PMC4969729 DOI: 10.11138/orl/2015.8.2.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The importance of HPV in world healthy is high, in fact high-risk HPV types contribute significantly to viral associated neoplasms. In this article we will analyze vary expression of HPV in oral cavity both benign and malignant, their prevalence and the importance in early diagnosis and prevention. The classical oral lesions associated with human papillomavirus are squamous cell papilloma, condyloma acuminatum, verruca vulgaris and focal epithelial hyperplasia. Overall, HPV types 2, 4, 6, 11, 13 and 32 have been associated with benign oral lesions while HPV types 16 and 18 have been associated with malignant lesions, especially in cancers of the tonsils and elsewhere in the oropharynx. Transmission of the virus can occur with direct contact, genital contact, anal and oral sex; latest studies suggest a salivary transmission and from mother to child during delivery. The number of lifetime sexual partners is an important risk factor for the development of HPV-positive head-neck cancer. Oral/oropharyngeal cancer etiologically associated with HPV having an increased survival and a better prognostic (85%-90% to five years). There is no cure for the virus. There are two commercially available prophylactic vaccines against HPV today: the bivalent (16 and 18) Cervarix® and the tetravalent (6, 11, 16 and 18) Gardasil® and new vaccine Gardasil 9 (6, 11, 16, 18, 31, 33, 45, 52, 58) was approved in the United States. To be effective, such vaccination should start before "sexual puberty". The vaccine could be an important preventive strategy, in fact the scientific community is in agreement on hypothesis that blocking the contagion it may also limit the distance complications as the oropharyngeal cancer.
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Affiliation(s)
- D. TESTI
- Graduate School in Materials for Health, Environment and Energy, University of Rome “Tor Vergata”, Rome, Italy
| | - M. NARDONE
- Medical Director of the Health Professions, Ministry of Health, Rome, Italy
| | - P. MELONE
- Graduate School in Materials for Health, Environment and Energy, University of Rome “Tor Vergata”, Rome, Italy
| | - P. CARDELLI
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - L. OTTRIA
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - C. ARCURI
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, Rome, Italy
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17
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Gonzalez-Losa MDR, Barrera ES, Herrera-Pech V, Conde-Ferráez L, Puerto-Solís M, Ayora-Talavera G. Epidemiology of oral HPV in the oral mucosa in women without signs of oral disease from Yucatan, Mexico. Braz J Microbiol 2015. [PMID: 26221121 PMCID: PMC4512083 DOI: 10.1590/s1517-838246120130976] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
High-risk human papillomaviruses (HR-HPV) are considered necessary for the development of cervical cancer. Furthermore, there is no doubt that some types of oral squamous cell carcinoma are associated with HR-HPV. The epidemiology of oral HPV infections in healthy subjects remains unclear due to a lack of knowledge. The objective of this study was to investigate the epidemiology of human papillomavirus infections of the oral mucosa without pathology. A cross-sectional study was performed; samples from 390 women seeking prenatal care, Pap smears, family planning or gynecological diseases were studied. Oral cells were collected by direct swab sampling. Information regarding sociodemographic status, sexual behavior, infectious diseases, contraceptive history and tobacco and alcohol consumption were obtained through direct interviews. HPV and genotypes were detected by type-specific polymerase chain reaction. Our results revealed that 14% of the women studied had an oral HPV infection. Women ≤ 20 years of age had the highest HPV prevalence (24.5%). In total, seven genotypes were identified, including the high-risk genotypes 16, 18, 58 and 59 and the low-risk genotypes 6, 81 and 13, the latter of which is a type exclusive to oral mucosa. Sexual behavior was not associated with the presence of genital HPV types in the oral mucosa. Genital HPV types were present in the oral mucosa of women without associated clinical manifestations; however, sexual behavior was not associated with infection, and therefore others routes of transmission should be explored.
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Affiliation(s)
- María Del Refugio Gonzalez-Losa
- Laboratorio de Virología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Yucatán, México
| | | | - Verónica Herrera-Pech
- Laboratorio de Virología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Yucatán, México
| | - Laura Conde-Ferráez
- Laboratorio de Virología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Yucatán, México
| | - Marylin Puerto-Solís
- Laboratorio de Virología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Yucatán, México
| | - Guadalupe Ayora-Talavera
- Laboratorio de Virología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Yucatán, México
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18
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Chai RC, Lambie D, Verma M, Punyadeera C. Current trends in the etiology and diagnosis of HPV-related head and neck cancers. Cancer Med 2015; 4:596-607. [PMID: 25644715 PMCID: PMC4402074 DOI: 10.1002/cam4.424] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/18/2014] [Accepted: 12/18/2014] [Indexed: 12/15/2022] Open
Abstract
Human papilloma virus (HPV) infection is a major risk factor for a distinct subset of head and neck squamous cell carcinoma (HNSCC). The current review summarizes the epidemiology of HNSCC and the disease burden, the infectious cycle of HPV, the roles of viral oncoproteins, E6 and E7, and the downstream cellular events that lead to malignant transformation. Current techniques for the clinical diagnosis of HPV-associated HNSCC will also be discussed, that is, the detection of HPV DNA, RNA, and the HPV surrogate marker, p16 in tumor tissues, as well as HPV-specific antibodies in serum. Such methods do not allow for the early detection of HPV-associated HNSCC and most cases are at an advanced stage upon diagnosis. Novel noninvasive approaches using oral fluid, a clinically relevant biological fluid, allow for the detection of HPV and cellular alterations in infected cells, which may aid in the early detection and HPV-typing of HNSCC tumors. Noninvasive diagnostic methods will enable early detection and intervention, leading to a significant reduction in mortality and morbidity associated with HNSCC.
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Affiliation(s)
- Ryan C Chai
- The University of Queensland Diamantina Institute, The University of Queensland, The Translational Research Institute, Woolloongabba, Queensland, 4102, Australia
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19
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Pattanshetty S, Kotrashetti VS, Nayak R, Bhat K, Somannavar P, Babji D. PCR based detection of HPV 16 and 18 genotypes in normal oral mucosa of tobacco users and non-users. Biotech Histochem 2014; 89:433-9. [PMID: 24588599 DOI: 10.3109/10520295.2014.887143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
There is increasing evidence of a causal association between human papillomavirus (HPV) and oral squamous cell carcinoma (OSCC). Several studies have shown that HPV is associated with increased risk of oral cancer independent of exposure to tobacco and alcohol. The association is valid for HPVs 16 and 18, which generally are considered high risk types, because they have been detected in oral dysplastic lesions and cancers. We determined the baseline prevalence of HPVs 16 and 18 in normal oral mucosa of individuals with and without tobacco habit. PCR was used for DNA collected by oral smears to detect HPV 16/18 DNA in normal oral mucosa of 60 healthy individuals who were assigned to two groups of 30 subjects each. One group had a tobacco habit, the other did not. The tobacco user group comprised individuals who were tobacco chewers only. Sixty-five percent of individuals were positive for HPV 16/18 DNA, but HPV 16/18 positivity was less in individuals with tobacco habit than in those without tobacco habit. No significant association was found between the presence of HPVs and gender, age or duration of chewing habit, or between groups with and without a tobacco habit. We propose that HPVs16 and 18 commonly are present in normal oral mucosa and emphasize the importance of distinguishing clinical, subclinical and latent HPV infections when investigating HPVs and OSCC.
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Affiliation(s)
- S Pattanshetty
- Departments of Oral Pathology and Microbiology, Maratha Mandal's NGH Institute of Dental Sciences , Belgaum 590010 Karnataka , India
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20
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Canuti M, Deijs M, Jazaeri Farsani SM, Holwerda M, Jebbink MF, de Vries M, van Vugt S, Brugman C, Verheij T, Lammens C, Goossens H, Loens K, Ieven M, van der Hoek L. Metagenomic analysis of a sample from a patient with respiratory tract infection reveals the presence of a γ-papillomavirus. Front Microbiol 2014; 5:347. [PMID: 25071755 PMCID: PMC4086198 DOI: 10.3389/fmicb.2014.00347] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 06/23/2014] [Indexed: 01/19/2023] Open
Abstract
Previously unknown or unexpected pathogens may be responsible for that proportion of respiratory diseases in which a causative agent cannot be identified. The application of broad-spectrum, sequence independent virus discovery techniques may be useful to reduce this proportion and widen our knowledge about respiratory pathogens. Thanks to the availability of high-throughput sequencing (HTS) technology, it became today possible to detect viruses which are present at a very low load, but the clinical relevance of those viruses must be investigated. In this study we used VIDISCA-454, a restriction enzyme based virus discovery method that utilizes Roche 454 HTS system, on a nasal swab collected from a subject with respiratory complaints. A γ-papillomavirus was detected (complete genome: 7142 bp) and its role in disease was investigated. Respiratory samples collected both during the acute phase of the illness and 2 weeks after full recovery contained the virus. The patient presented antibodies directed against the virus but there was no difference between IgG levels in blood samples collected during the acute phase and 2 weeks after full recovery. We therefore concluded that the detected γ-papillomavirus is unlikely to be the causative agent of the respiratory complaints and its presence in the nose of the patient is not related to the disease. Although HTS based virus discovery techniques proved their great potential as a tool to clarify the etiology of some infectious diseases, the obtained information must be subjected to cautious interpretations. This study underlines the crucial importance of performing careful investigations on viruses identified when applying sensitive virus discovery techniques, since the mere identification of a virus and its presence in a clinical sample are not satisfactory proofs to establish a causative link with a disease.
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Affiliation(s)
- Marta Canuti
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands
| | - Martin Deijs
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands
| | - Seyed M Jazaeri Farsani
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands
| | - Melle Holwerda
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands
| | - Maarten F Jebbink
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands
| | - Michel de Vries
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands
| | - Saskia van Vugt
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht Utrecht, Netherlands
| | - Curt Brugman
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht Utrecht, Netherlands
| | - Theo Verheij
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht Utrecht, Netherlands
| | - Christine Lammens
- Department of Medical Microbiology, Vaccine and Infectious Disease Institute, Universiteit Antwerpen-University Hospital Antwerp Antwerp, Belgium
| | - Herman Goossens
- Department of Medical Microbiology, Vaccine and Infectious Disease Institute, Universiteit Antwerpen-University Hospital Antwerp Antwerp, Belgium
| | - Katherine Loens
- Department of Medical Microbiology, Vaccine and Infectious Disease Institute, Universiteit Antwerpen-University Hospital Antwerp Antwerp, Belgium
| | - Margareta Ieven
- Department of Medical Microbiology, Vaccine and Infectious Disease Institute, Universiteit Antwerpen-University Hospital Antwerp Antwerp, Belgium
| | - Lia van der Hoek
- Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands
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21
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Morbini P, Dal Bello B, Alberizzi P, Mannarini L, Mevio N, Garotta M, Mura F, Tinelli C, Bertino G, Benazzo M. Oral HPV infection and persistence in patients with head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 116:474-84. [PMID: 24035114 DOI: 10.1016/j.oooo.2013.06.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 06/04/2013] [Accepted: 06/14/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate the presence and persistence of human papillomavirus (HPV) infection in the oral mucosa of patients with head and neck squamous cell carcinoma (HNSCC), and its correlation with prognosis. STUDY DESIGN HPV infection was characterized in tumors and pre and posttreatment oral scrapings in 51 patients with HNSCC and matched controls using the SPF10 LiPA Extra assay. p16INK4A immunostain and in situ hybridization for high-risk HPV genotypes recognized transcriptionally active infection in tumor samples. The risk of infection was compared in patients and controls. The association of pretreatment HPV status with recurrence and survival and with posttreatment HPV persistence was assessed. RESULTS Oral HPV infection risk was significantly higher in patients with HNSCC than in controls (P < .001). Oral HPV infection was associated with infection in the first posttreatment scrapings (P = .015), but did not affect recurrence or prognosis. CONCLUSION Oral HPV infection is frequent in patients with HNSCC and has no prognostic implications, suggesting that posttreatment polymerase chain reaction monitoring on oral cells is not effective to monitor patient recurrence risk.
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Affiliation(s)
- Patrizia Morbini
- Department of Molecular Medicine, Unit of Pathology, University of Pavia, Pavia, Italy; Department of Pathology IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
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22
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Antonsson A, Cornford M, Perry S, Davis M, Dunne MP, Whiteman DC. Prevalence and risk factors for oral HPV infection in young Australians. PLoS One 2014; 9:e91761. [PMID: 24637512 PMCID: PMC3956721 DOI: 10.1371/journal.pone.0091761] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 02/13/2014] [Indexed: 01/22/2023] Open
Abstract
The prevalence of human papillomavirus (HPV)–associated head and neck cancers is increasing, but the prevalence of oral HPV infection in the wider community remains unknown. We sought to determine the prevalence of, and identify risk factors for, oral HPV infection in a sample of young, healthy Australians. For this study, we recruited 307 Australian university students (18–35 years). Participants reported anonymously about basic characteristics, sexual behaviour, and alcohol, tobacco and illicit drugs use. We collected oral rinse samples from all participants for HPV testing and typing. Seven of 307 (2.3%) students tested positive for oral HPV infection (3 HPV-18, one each of HPV-16, -67, -69, -90), and six of them were males (p = 0.008). Compared to HPV negative students, those with oral HPV infection were more likely to have received oral sex from more partners in their lifetime (p = 0.0004) and in the last year (p = 0.008). We found no statistically significant associations with alcohol consumption, smoking or numbers of partners for passionate kissing or sexual intercourse. In conclusion, oral HPV infection was associated with male gender and receiving oral sex in our sample of young Australians.
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Affiliation(s)
- Annika Antonsson
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- * E-mail:
| | - Michelle Cornford
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Susan Perry
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Marcia Davis
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Michael P. Dunne
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - David C. Whiteman
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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Smoking increases oral HPV persistence among men: 7-year follow-up study. Eur J Clin Microbiol Infect Dis 2013; 33:123-33. [PMID: 24026862 DOI: 10.1007/s10096-013-1938-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 07/18/2013] [Indexed: 10/26/2022]
Abstract
Persistent high-risk human papillomavirus (HR-HPV) infection is the key event in the progression of HPV lesions, and more data are urgently needed on asymptomatic oral HPV infections in men. Asymptomatic fathers-to-be (n = 131, mean age 28.9 years) were enrolled in the cohort, sampled by serial oral scrapings at baseline and at 2-month, 6-month, 12-month, 24-month, 36-month, and 7-year follow-up visits to accomplish persistent and cleared HPV infections. HPV genotyping was performed using nested PCR and Multimetrix® assay. Covariates of persistent and cleared oral HPV infections were analysed using generalised estimating equation (GEE) and Poisson regression. Altogether, 17 HPV genotypes were detected in male oral mucosa point prevalence, varying from 15.1 % to 31.1 %. Genotype-specific HPV persistence was detected in 18/129 men the mean persistence time ranging from 6.0 to 30.7 months. History of genital warts decreased (p = 0.0001; OR = 0.41, 95 % CI 0.33-0.51) and smoking increased (p = 0.033, OR = 1.92, 95 % CI 1.05-3.50) the risk of persistent species 7/9 HPV infections. Of the 74 HPV-positive men, 71.6 % cleared their infection actuarial and crude clearance times, varying between 1.4 and 79.6 months. No independent predictors were identified for species 7/9 clearance. At the last follow-up-visit, 50.1 % of the fathers had oral mucosal changes, correlating only with smoking (p = 0.046). To conclude, most of the persisting oral infections in males were caused by HPV16. Smoking increased while previous genital warts decreased oral HR-HPV persistence. No predictors of HR-HPV clearance were disclosed.
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Lang Kuhs KA, Gonzalez P, Struijk L, Castro F, Hildesheim A, van Doorn LJ, Rodriguez AC, Schiffman M, Quint W, Lowy DR, Porras C, Delvecchio C, Katki HA, Jimenez S, Safaeian M, Schiller J, Solomon D, Wacholder S, Herrero R, Kreimer AR. Prevalence of and risk factors for oral human papillomavirus among young women in Costa Rica. J Infect Dis 2013; 208:1643-52. [PMID: 24014882 DOI: 10.1093/infdis/jit369] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Little is known about the epidemiology of oral human papillomavirus (HPV) in Latin America. METHODS Women (N = 5838) aged 22-29 in the control and vaccine arms of an HPV-16/18 vaccine trial in Costa Rica had oral, cervical, and anal specimens collected. Samples were tested for alpha mucosal HPV types (SPF10/LiPA25 version 1); a subset of oral samples (n = 500) was tested for cutaneous HPV types in the genera alpha, beta, gamma, mu, and nu. RESULTS In the control arm (n = 2926), 1.9% of women had an oral alpha mucosal HPV detected, 1.3% had carcinogenic HPV, and 0.4% had HPV-16; similar patterns for non-16/18 HPV types were observed in the vaccine arm. Independent risk factors for any oral alpha mucosal HPV among women in the control arm included marital status (adjusted odds ratio [AOR], 3.2; 95% confidence interval [CI], 1.8-5.7 for single compared to married/living as married), number of sexual partners (AOR, 2.4; 95% CI, 1.0-6.1 for ≥4 partners compared to 0-1 partners), chronic sinusitis (AOR, 3.1; 95% CI, 1.5-6.7), and cervical HPV infection (AOR, 2.6; 95% CI, 1.4-4.6). Detection of beta HPV was common (18.6%) and not associated with sexual activity. CONCLUSIONS Unlike cutaneous HPV types, alpha mucosal HPV types were uncommon in the oral region and were predominately associated with sexual behavior. Clinical Trials Registration. NCT00128661.
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Affiliation(s)
- Krystle A Lang Kuhs
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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25
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Role of HPV-16 in Pathogenesis of Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma and Correlation of p16INK4A Expression in HPV-16 Positive Cases: An Immunohistochemical Study. ACTA ACUST UNITED AC 2013. [DOI: 10.1155/2013/807095] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of current study is to evaluate the role of HPV-16 in the pathogenesis of oral epithelial dysplasias (OED) and oral squamous cell carcinoma (OSCC) by immunohistochemistry (IHC) and to know whether HPV-16 participates in disruption of the regulation of p16 INK4A suppressor protein in OED and OSCC by IHC. Histopathologically diagnosed 20 cases of OED and 20 cases of OSCC were selected from amongst the patients attending the OPD of Vasantdada Patil Dental College and Hospital, Sangli. Biopsy tissue section were then tested for HPV-16 by IHC. HPV-16 positive tissue sections were then again tested by p16 by IHC. Overall 22.5% of cases in our study were found to be positive for HPV 16 which includes 10% of cases of OED and 35% cases of OSCC. Amongst the HPV 16 positive cases, more than 60% of cells were positive for p16INK4A IHC in OED (50%) and OSCC (85.71%). Thus, HPV 16 participates in disruption of the regulation of p16INK4A suppressor protein and can be used as surrogate biomarker for detection of HPV infection in OED and OSCC.
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Paolini F, Rizzo C, Sperduti I, Pichi B, Mafera B, Rahimi SS, Vigili MG, Venuti A. Both mucosal and cutaneous papillomaviruses are in the oral cavity but only alpha genus seems to be associated with cancer. J Clin Virol 2012; 56:72-6. [PMID: 23092620 DOI: 10.1016/j.jcv.2012.09.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 09/28/2012] [Accepted: 09/30/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Human papillomaviruses are associated with invasive cancers in the cervical, anogenital, and oropharyngeal areas. Persistent HPV infections, particularly with high-risk HPV such as HPV 16, are involved in the carcinogenesis of a subset of oropharyngeal cancers. The majority of published studies on HPV prevalence in these tumors concentrated on identifying high-risk mucosal types. OBJECTIVES To determine the HPV type specific prevalence in different samples collected from the oral cavity of three groups of patients: (A) healthy (n=25); (B) non-malignant lesions (n=47); and (C) cancers (n=78). STUDY DESIGN To evaluate the prevalence of HPV genotypes in the oral cavity, samples were analyzed by PCR with: MY09/MY11 followed by GP5+/GP6+, CP65/CP70 followed by CP66/CP69, and FAP59/FAP64 primers. The presence of viral transcripts was ascertained by RT-PCR with specific primers for the E7 region. RESULTS Mucosal HPV types were associated with the presence of cancers. This trend was statistically significant if the analysis was performed for HPV 16 (p=0.04), which is the most prevalent type detected in oropharyngeal cancers. Conversely, cutaneous HPVs were associated with non-malignant lesions (p=0.007). The multiple correspondence analysis confirmed these data. Viral transcripts of only mucosal HPVs were detected in non-malignant lesions and cancers. CONCLUSIONS Different types of HPVs infect the oral epithelium, but only the mucosal types, particularly HPV 16, are clearly associated with tumors. The discovery that cutaneous HPVs are associated with potential malignant oral disorders brings other data to understand the significance of their presence in the oral cavity.
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Affiliation(s)
- Francesca Paolini
- Laboratory of Virology, Regina Elena National Cancer Institute, Rome, Italy
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27
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The prevalence and incidence of oral human papillomavirus infection among young men and women, aged 18-30 years. Sex Transm Dis 2012; 39:559-66. [PMID: 22706220 DOI: 10.1097/olq.0b013e31824f1c65] [Citation(s) in RCA: 132] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Oral human papillomavirus (HPV) infection is a cause of oropharyngeal squamous cell carcinoma, yet little is known about the epidemiology and natural history of infection. METHODS At a baseline and 3-month follow-up visit, 1000 young adults aged 18 to 30 years provided an oral rinse sample and completed a survey assessing demographic and behavioral risk factors. The oral rinse sample was analyzed for 37 types of HPV by use of a multiplex polymerase chain reaction assay. Factors associated with oral HPV detection were analyzed using univariate and bivariate logistic regression. RESULTS The prevalence of oral HPV infection was 2.4% (95% CI: 1.4-3.4). Ever having consumed alcohol (OR, 0.2; 95% CI: 0.1-0.8), 5 or more lifetime open-mouth kissing (OR, 4.0; 95% CI: 1.1-14.8) or lifetime oral sex (OR, 4.0; 95% CI: 1.3-11.9) partners were associated with infection, controlling for lifetime vaginal sex partners. The incidence rate for oral HPV infection was 5.67 (95% CI: 3.12-8.16) per 1000 person-months. Incident infection was associated in univariate analysis with black race (OR, 4.7; 95% CI: 1.7-13.5) and having open-mouth kissed a new partner in the previous 3 months (OR, 2.6; 95% CI: 1.0-6.4). CONCLUSIONS This study provides further evidence that oral sexual contact in the form of both oral-oral and oral-genital contact could play a role in the transmission of oral HPV.
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Rautava J, Willberg J, Louvanto K, Wideman L, Syrjänen K, Grénman S, Syrjänen S. Prevalence, genotype distribution and persistence of human papillomavirus in oral mucosa of women: a six-year follow-up study. PLoS One 2012; 7:e42171. [PMID: 22952591 PMCID: PMC3431392 DOI: 10.1371/journal.pone.0042171] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 07/04/2012] [Indexed: 01/22/2023] Open
Abstract
Background Human papillomavirus (HPV) infections have been linked to a subset of oral and oropharyngeal cancers. However, little is known on the natural history of oral HPV infections. We designed the prospective Finnish HPV Family Study to assess the dynamics of HPV infections in parents and their infants. This study reports HPV genotype distribution and virus persistence in oral mucosa of the mothers. Materials and Methods Totally, 324 pregnant women were enrolled at the 3rd trimester of pregnancy and followed-up for 6 years. Oral scrapings taken with a brush were collected and HPV-genotyping was performed with nested PCR and Multimetrix® test (Progen, Heidelberg, Germany). The predictors of persistent oral HPV species 7/9 infections were analyzed using generalized estimating equation models. Results The point prevalence of oral HPV varied from 15% to 24% during the 6-year follow-up. Altogether, 18 HPV genotypes were identified either as single or multiple-type oral infections. HPV16 was the most prevalent type at 9.7%–18.4%, followed by HPV18, HPV6, and multiple infections. Altogether, 74 women had persistent oral HPV infection determined as at least two consecutive samples positive with the same HPV genotype. HPV16 and HPV6 were the two most frequent types to persist (76% and 9%) for a mean of 18.6 and 20.2 months, respectively, followed by multiple infections (8%) for 18.3 months. An increased risk for persistent oral HPV infection with species 7/9 was associated with being seropositive for low-risk (LR)-HPV-types at baseline, whereas the use of oral contraceptives and a second pregnancy during follow-up were protective. Clinical oral lesions were detected in 17% of these women, one-third of whom had persistent oral HPV-infections. Conclusion HPV16 and HPV6 were the most common genotypes in oral HPV-infections and were also most likely to persist. Use of oral contraceptives and a second pregnancy protected against oral HPV persistence.
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Affiliation(s)
- Jaana Rautava
- Department of Oral Pathology, Institute of Dentistry, and Medicity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland
| | - Jaana Willberg
- Department of Oral Pathology, Institute of Dentistry, and Medicity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland
| | - Karolina Louvanto
- Department of Oral Pathology, Institute of Dentistry, and Medicity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland
| | - Lilli Wideman
- Department of Oral Pathology, Institute of Dentistry, and Medicity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland
| | - Kari Syrjänen
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - Seija Grénman
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
| | - Stina Syrjänen
- Department of Oral Pathology, Institute of Dentistry, and Medicity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland
- * E-mail:
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Martinelli M, Zappa A, Bianchi S, Frati E, Colzani D, Amendola A, Tanzi E. Human papillomavirus (HPV) infection and genotype frequency in the oral mucosa of newborns in Milan, Italy. Clin Microbiol Infect 2012; 18:E197-9. [DOI: 10.1111/j.1469-0691.2012.03839.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Joseph AW, D'Souza G. Epidemiology of human papillomavirus-related head and neck cancer. Otolaryngol Clin North Am 2012; 45:739-64. [PMID: 22793850 DOI: 10.1016/j.otc.2012.04.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Human papillomavirus (HPV) is now recognized to cause a subset of head and neck squamous cell carcinomas (HNSCC). Although excessive tobacco and alcohol use continue to be important risk factors for HNSCC, epidemiologic studies suggest that more than 25% of HNSCC are now caused by HPV. The incidence of HPV-related HNSCC is increasing, highlighting the need to understand the oral HPV infections causing these cancers. This article reviews the evidence for a causal association between HPV and HNSCC, examines the changing epidemiologic trends of HNSCC, and discusses what is currently known about oral HPV infection, natural history, and transmission.
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Affiliation(s)
- Andrew W Joseph
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, JHOC 6th Floor, 601 North Caroline Street, Baltimore, MD 21287, USA
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Sanders AE, Slade GD, Patton LL. National prevalence of oral HPV infection and related risk factors in the U.S. adult population. Oral Dis 2012; 18:430-41. [PMID: 22251072 DOI: 10.1111/j.1601-0825.2011.01892.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This article reviews the rapidly growing evidence that oral human papilloma viruses (HPV) infection contributes to the risk of oral squamous cell carcinoma. It also reports the first nationally representative estimates of oral HPV prevalence in the United States adult population. An estimated 7.3% (95% CI: 6.0, 8.9) of the U.S. population had one or more oral HPV types detected in oral rinse; 3.1% (95%CI: 2.4, 3.9) of the U.S. population had one or more oncogenic HPV types. A substantial excess risk of HPV infection in men is not explained by education, smoking, age of sexual debut, or number of lifetime sex partners. Based on the published finding from a case-control study, where there was an odds ratio of 2.6 (95% CI: 1.5, 4.2) for the association of head and neck cancer oncogenic oral HPV infection, the estimated population attributable risk for head and neck cancer in the U.S. population was 4.7%. In other words, there would be a 4.7% reduction in incidence rate of head and neck cancer in the United States if oncogenic HPV infection could be prevented. The results also provide population data that help evaluate the likely public health benefits of prophylactic vaccination against oral HPV acquisition.
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Affiliation(s)
- A E Sanders
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA.
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Bottalico D, Chen Z, Dunne A, Ostoloza J, McKinney S, Sun C, Schlecht NF, Fatahzadeh M, Herrero R, Schiffman M, Burk RD. The oral cavity contains abundant known and novel human papillomaviruses from the Betapapillomavirus and Gammapapillomavirus genera. J Infect Dis 2011; 204:787-92. [PMID: 21844305 DOI: 10.1093/infdis/jir383] [Citation(s) in RCA: 136] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Human papillomaviruses (HPVs) primarily sort into 3 genera: Alphapapillomavirus (α-HPV), predominantly isolated from mucosa, and Betapapillomavirus (β-HPV) and Gammapapillomavirus (γ-HPV), predominantly isolated from skin. HPV types might infect body sites that are different from those from which they were originally isolated. METHODS We investigated the spectrum of HPV type distribution in oral rinse samples from 2 populations: 52 human immunodeficiency virus (HIV)-positive men and women and 317 men who provided a sample for genomic DNA for a prostate cancer study. HPV types were detected with the MY09/MY11 and FAP59/64 primer systems and identified by dot blot hybridization and/or direct sequencing. RESULTS Oral rinse specimens from 35 (67%) of 52 HIV-positive individuals and 117 (37%) of 317 older male participants tested positive for HPV DNA. We found 117 type-specific HPV infections from the HIV-positive individuals, including 73 α-HPV, 33 β-HPV, and 11 γ-HPV infections; whereas, the distribution was 46 α-HPV, 108 β-HPV, and 14 γ-HPV infections from 168 type-specific infections from the 317 male participants. CONCLUSIONS The oral cavity contains a wide spectrum of HPV types predominantly from the β-HPV and γ-HPV genera, which were previously considered to be cutaneous types. These results could have significant implications for understanding the biology of HPV and the epidemiological associations of HPV with oral and skin neoplasia.
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Affiliation(s)
- Danielle Bottalico
- Department of Pediatrics, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
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Human papillomavirus types 16 and 18 in epithelial dysplasia of oral cavity and oropharynx: a meta-analysis, 1985-2010. Oral Oncol 2011; 47:1048-54. [PMID: 21816661 DOI: 10.1016/j.oraloncology.2011.07.009] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 07/01/2011] [Accepted: 07/09/2011] [Indexed: 12/20/2022]
Abstract
Human papillomavirus (HPV) types 16 and 18 are causally related to a sub-set of oral cavity and oropharyngeal squamous cell cancers. However, a clear estimate of the prevalence of HPV-16/18 in oral cavity and oropharyngeal dysplasia (OOPD) is not available. This literature review and meta-analysis was conducted to provide a prevalence estimate for HPV-16/18 in OOPD. Twenty-two studies that reported prevalence of HPV-16 and/or 18 in 458 OOPD lesions were analyzed. Meta-analysis was used to evaluate the prevalence of HPV-16/18 and logistic regression was used for stratified analysis by age, gender, and histological grade. The overall prevalence of HPV-16/18 in OOPD lesions was 24.5% [95% confidence interval (CI), 16.4-36.7%)]. The individual prevalence for HPV-16 alone was 24.4%. The prevalence of HPV-16/18 in oral cavity lesions alone was 25.3% (95% CI, 14.2-45.2%). The odds of detection of HPV-16/18 in dysplastic lesions in males were twice that of females [odds ratio (OR), 2.44]. HPV-16/18 were 3 times more common in dysplastic lesions (OR, 3.29; 95% CI, 1.95-5.53%) and invasive cancers (OR, 3.43; 95% CI, 2.07-5.69%), when compared to normal biopsies. There was no significant difference in HPV-16/18 rates between dysplastic lesions and cancers or between mild, moderate or severe dysplastic lesions. This meta-analysis provides a quantification of the prevalence of HPV types 16/18 in OOPD lesions. These results also support the assumption that HPV-16/18 infection occurs during the early phase of the oral cavity and oropharyngeal carcinogenesis.
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Migaldi M, Pecorari M, Forbicini G, Nanni N, Grottola A, Grandi T, Delle Donne G, Leocata P, Trovato D, Sgambato A. Low prevalence of human papillomavirus infection in the healthy oral mucosa of a Northern Italian population. J Oral Pathol Med 2011; 41:16-20. [PMID: 21762429 DOI: 10.1111/j.1600-0714.2011.01062.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Oral cancer is the sixth most common malignancy in developed countries, representing almost 3% of malignant tumors. Tobacco use and alcohol consumption are well-established risk factors. However, the observation that most patients with oral cancer have not been exposed to these risk factors suggests that additional causes may promote oral carcinogenesis. A link has been suggested between human papillomavirus (HPV) and oral cavity cancer but the significance of HPV contribution to oral carcinogenesis as well as the prevalence of HPV infection in normal oral cavity mucosa remains debated. METHODS In this study, the prevalence of oral HPV infection was evaluated in 81 randomly selected Northern Italian subjects with clinically normal oral mucosa using a nested PCR on DNA extracted by oral smears. RESULTS AND CONCLUSIONS No HPV-related lesions were detectable in any of the smears analyzed by cytological approach. nPCR identified HPV DNA in only one (1.2%) of the specimens obtained from clinically healthy oral mucosa and subsequent characterization assigned the positive case to HPV type 90. These data suggest that the incidence of HPV infection in the healthy population might be very low and that other risk factors are likely responsible to promote oral carcinogenesis.
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Affiliation(s)
- M Migaldi
- Section of Pathology, Azienda Ospedaliero-Universitaria Policlinico, University of Modena-Reggio Emilia, Modena, Italy
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Oral HPV infection and sexuality: a cross-sectional study in women. Int J Mol Sci 2011; 12:3928-40. [PMID: 21747715 PMCID: PMC3131599 DOI: 10.3390/ijms12063928] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 04/12/2011] [Accepted: 06/03/2011] [Indexed: 01/22/2023] Open
Abstract
Human Papillomavirus (HPV) is the main risk factor for cervical cancers and is associated with close to 36% of oropharyngeal cancers. There is increasing evidence that oral HPV transmission is related to sexual behavior but to our knowledge studies that involve women who have sex with women have not been performed. We examined the prevalence of oral HPV according to sexual behavior among a population-based sample of 118 women and have made some inferences of possible predictors of oral HPV infection. Women were categorized as heterosexual (history of vaginal sex and/or oral sex with males only, n = 75), bisexual (history of vaginal sex and oral sex with females, n = 32) and other (no history of vaginal sex but oral sex with females [homosexuals], virgins and women with incomplete sexual exposure data, n = 11) The prevalence of oral HPV infection was 12/118 (10.2%) for the overall study population and was not significantly different between heterosexual and bisexual women (10.7% (8/75) vs. 12.5% (4/32), p = 0.784). There was no oral HPV detected among homosexual women, virgins or among women where sexual exposure was unknown. Never smokers were more likely to be oral HPV+ compared to former smokers (Adjusted Odds Ratio (Adj OR) = 0.1, 95% CI, 0.0–1.1) and there was no difference in risk between never smokers and current smokers (Adj OR = 0.7, 95% CI, 0.1–4.6). Twenty-five percent (3/12) of oral HPV+ women had a history of HPV and/or genital warts compared to 9% (10/106) of oral HPV-women (p = 0.104). For the women with a history of vaginal sex (n = 110), oral HPV status was statistically significantly different according to oral sex exposure (p = 0.039). A higher proportion of oral HPV-positive women reported that they had no history of oral sex exposure compared to oral HPV-negative women (4/12, 33% vs. 7/98, 8%). The prevalence of cervical HPV infection did not vary between heterosexuals and bisexuals (35.7% (25/70) vs. 35.5% (11/31), p-value 0.411) and for all other women the cervical HPV prevalence was significantly lower (11.1%, 1/9). Our study suggests that smoking and sexual behavior involving males rather than female partners may be possible predictors of oral HPV infection in women. Further studies with larger sample size are needed to confirm these findings.
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Durzyńska J, Pacholska-Bogalska J, Kaczmarek M, Hanć T, Durda M, Skrzypczak M, Goździcka-Józefiak A. HPV genotypes in the oral cavity/oropharynx of children and adolescents: cross-sectional survey in Poland. Eur J Pediatr 2011; 170:757-61. [PMID: 21107606 PMCID: PMC3098990 DOI: 10.1007/s00431-010-1345-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 11/03/2010] [Indexed: 01/11/2023]
Abstract
UNLABELLED Human papillomaviruses (HPVs) are a very complex group of pathogenic viruses, with more than 80 types, causing human infection. Given the prevalence of HPV infection and its relationship with the development of cervical and many other cancers, HPV vaccine development has been a major public health initiative worldwide in the last decade. The aim of the presented study was to identify HPV DNA by MY-PCR in 4,150 school children and adolescents, aged 10-18 years in the Wielkopolska region, Poland. All individuals were asked to fill in extensive questionnaires; further normal, oral squamous cells were collected from each pupil. Cellular DNA was isolated and used as a MY-PCR template to estimate the incidence of HPV-active infection. Forty five subjects (1.08% of the sample) were carriers of oropharyngeal HPVs. HPV status and variables of interest, such as age, gender, socioeconomical status, and risk factors (smoking and sexual intercourse history, alcohol consumption) were not correlated. The presence of HPVs in the oral cavity was cumulated in several schools of the region. DNA sequencing of MY-PCR products revealed only four HPV genotypes. The most frequent genotype was HPV11 (38/45 HPV-positive cases), while other more rare genotypes were HPV6 (3/45), HPV12 (3/45), and HPV57 (1/45). CONCLUSION Our findings presented herein, reveal a relatively low prevalance of oropharyngeal HPVs in Polish adolescents and fill an important gap in the knowledge of oral HPV infections of children above 10 years and adolescents.
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Affiliation(s)
- Julia Durzyńska
- Department of Molecular Virology, Faculty of Biology, Adam Mickiewicz University, Poland.
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Sánchez-Vargas LO, Díaz-Hernández C, Martinez-Martinez A. Detection of Human Papilloma Virus (HPV) in oral mucosa of women with cervical lesions and their relation to oral sex practices. Infect Agent Cancer 2010; 5:25. [PMID: 21129222 PMCID: PMC3014881 DOI: 10.1186/1750-9378-5-25] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 12/04/2010] [Indexed: 12/01/2022] Open
Abstract
Background Previous studies have either investigated the relationship of HPV with oral cancer or the prevalence of HPV on the oral cavity. The purpose of this investigation was to study the prevalence of HPV in oral cavity of women with oral sex practices and cervical lesions. Methods Forty six (46) non-smokers and non-alcoholic patients attended the "Clínica de Displasias" of "Ciudad Juarez" were sampled. This population had a CIN diagnosis sometime between the previous six months. On previous consent they filled out a questionnaire related to their oral sex practices. Afterwards one swab from cheeks and another from palate/gum were taken; PCR was used to determine generic HPV, HPV16 and HPV18. Results Seventy two percent (72%) of the patients stated to have oral sex practices regularly which all of them were positive to HPV either in oral mucus, palate/gum or both. The total of the given results showed that 35% had HPV16; among those distributed in 26% with regular oral sex practices and 9% stated as never practiced oral sex. An association was found between oral HPV16 positivity and progression to cervical CIN advanced lesions. On the other hand HPV18 was not detected. The frequency of HPV16 was higher in buccal mucosa (23%) versus palate/gum (16%). Conclusions This study suggests that buccal HPV16 infection is associated with CIN progression.
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Affiliation(s)
- Luis O Sánchez-Vargas
- Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez, Chihuahua, México.
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Abstract
BACKGROUND Human papillomavirus type 16 (HPV16) is a common infection in the anogenital tract. HPV16 DNA detected in oral specimens has recently been identified as a risk factor for some oropharyngeal cancers. The reported prevalence of oral HPV infection from individual studies is highly variable. METHODS We systematically reviewed and abstracted data from published studies (n = 18) that detected oral HPV DNA in 4581 cancer-free subjects to determine the pooled prevalence (and 95% confidence intervals [CI]) of HPV16, carcinogenic HPV, and any HPV. RESULTS 1.3% (95% CI: 1.0-1.7%) of 3977 healthy subjects had oral HPV16, 3.5% (95% CI: 3.0-4.1) of 4441 subjects had carcinogenic HPV, and 4.5% (95% CI: 3.9-5.1) of 4070 subjects were positive for any HPV. Oral HPV16 accounted for 28% of all HPV detected in the oral region. Men (47 of 1017) and women (117 of 3690) had nearly exactly the same prevalence of any oral HPV detected (4.6% vs. 4.4%, respectively). CONCLUSIONS HPV-16, a common anogenital infection, was rarely detected in oral specimens. However, a small but noteworthy proportion of healthy individuals have oral HPV infections with types known to cause cancer in the oral region.
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Durzyńska J, Błażejewska P, Szydłowski J, Goździcka-Józefiak A. Detection of Anti-HPV11-L1 Antibodies in Immune Sera from Patients Suffering from Recurrent Respiratory Papillomatosis Using ELISA. Viral Immunol 2010; 23:415-23. [DOI: 10.1089/vim.2010.0014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Julia Durzyńska
- Department of Molecular Virology, Faculty of Biology, University of A. Mickiewicz, Poznan, Poznan
| | - Paulina Błażejewska
- Department of Infection Genetics, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Jarosław Szydłowski
- Department of Pediatric Otolaryngology, Institute of Pediatrics, University of Medical Sciences, Poland
| | - Anna Goździcka-Józefiak
- Department of Molecular Virology, Faculty of Biology, University of A. Mickiewicz, Poznan, Poznan
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Horewicz VV, Feres M, Rapp GE, Yasuda V, Cury PR. Human papillomavirus-16 prevalence in gingival tissue and its association with periodontal destruction: a case-control study. J Periodontol 2010; 81:562-8. [PMID: 20367098 DOI: 10.1902/jop.2009.090571] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Human papillomavirus (HPV)-16 is detected in normal oral mucosa and several oral lesions, including squamous cell carcinoma, condyloma acuminatum, verruca vulgaris, focal epithelial hyperplasia, and periodontal diseases. It was hypothesized that HPV may be involved in periodontal breakdown and that periodontal tissue acts as a reservoir for the virus. Therefore, in this study, the prevalence of HPV-16 in the gingival tissue of Brazilians with periodontal health or disease is investigated. METHODS Fifty-six gingival samples from subjects with chronic periodontitis, 26 samples from subjects with gingivitis, and 22 samples from subjects with healthy peridontium were analyzed. Total DNA was extracted, and the presence of HPV-16 was assessed using a real-time polymerase chain reaction. Positive and negative controls were included in the reactions. RESULTS HPV-16 was not detected in any of the 104 gingival samples evaluated; therefore, this virus showed no association with periodontal disease in this study. CONCLUSION In the population studied, HPV-16 may not have participated in the pathogenesis of chronic periodontitis, and the gingival tissue did not act as a reservoir for this virus.
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Affiliation(s)
- Verônica V Horewicz
- Research Group on Periodontal Disease, Department of Periodontics, School of Dentistry, Federal University of Bahia, Salvador, BA, Brazil
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Winder DM, Ball SLR, Vaughan K, Hanna N, Woo YL, Fränzer JT, Sterling JC, Stanley MA, Sudhoff H, Goon PKC. Sensitive HPV detection in oropharyngeal cancers. BMC Cancer 2009; 9:440. [PMID: 20003490 PMCID: PMC2803197 DOI: 10.1186/1471-2407-9-440] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Accepted: 12/15/2009] [Indexed: 11/20/2022] Open
Abstract
Background Human papillomaviruses (HPV) are the aetiological agents of certain benign and malignant tumours of skin and mucosae; the most important of which is cervical cancer. Also, the incidence of ano-genital warts, HPV-anal cancer and oropharyngeal cancers are rising. To help ascertain a useful PCR detection protocol for oropharyngeal cancers, we directly compared three commonly used primer sets in detection of HPV from different clinical samples. Methods We compared PGMY09/11, MY09/11 and GP5+/6+ primers sets in PCRs of 34 clinically diagnosed samples of genital warts, cervical brushings (with associated histological diagnosis) and vulval biopsies. All negative samples were subsequently tested using the previously reported PGMY/GP PCR method and amplicons directly sequenced for confirmation and typing. An optimised PCR protocol was then compared to a line blot assay for detection of HPV in 15 oropharyngeal cancer samples. Results PGMY09/11 primers detected HPV presence in more cervical brushing (100%) and genital wart (92.9%) samples compared to MY09/11 (90% and 64.3%) and GP5+/6+ (80% and 64.3%) primer sets, respectively. From vulval biopsies, HPV detection rates were: MY09/11 (63.6%), GP5+/6+ (54.5%) and PGMY09/11 (54.5%). PGMY/GP nested PCR demonstrated that HPV was present, and direct sequencing confirmed genotypes. This nested PCR protocol showed detection of HPV in 10/15 (66.7%) of oropharyngeal cancer samples. Conclusions PGMY09/11 primers are the preferred primer set among these three for primary PCR screening with different clinical samples. MY09/11 and GP5+/6+ may be used (particularly for cervical samples) but demonstrate lower detection rates. A nested PCR approach (i.e. a PGMY-GP system) may be required to confirm negativity or to detect low levels of HPV, undetectable using current primary PCR methods, as demonstrated using oropharyngeal cancer samples.
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Affiliation(s)
- David M Winder
- Dept of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, UK.
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Richter KL, Van Rensburg EJ, Van Heerden WFP, Boy SC. Human papilloma virus types in the oral and cervical mucosa of HIV-positive South African women prior to antiretroviral therapy. J Oral Pathol Med 2008; 37:555-9. [DOI: 10.1111/j.1600-0714.2008.00670.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Anaya-Saavedra G, Ramírez-Amador V, Irigoyen-Camacho ME, García-Cuellar CM, Guido-Jiménez M, Méndez-Martínez R, García-Carrancá A. High association of human papillomavirus infection with oral cancer: a case-control study. Arch Med Res 2007; 39:189-97. [PMID: 18164962 DOI: 10.1016/j.arcmed.2007.08.003] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Accepted: 08/08/2007] [Indexed: 12/23/2022]
Abstract
BACKGROUND The aim of the present study was to determine the association of high-risk human papillomavirus (HR-HPV) in Mexican individuals with oral squamous cell carcinoma (OSCC) and their association with various risk factors. METHODS We designed a matched case-control study. Cases were individuals with newly diagnosed OSCC, age- and sex-matched with controls (1:4). Demographic and clinical data were obtained; also a self-administered questionnaire about sexual behavior was included. DNA from oral brushing was purified to amplify HPV-DNA through MY09/MY11 and GP5+/GP6+ primers and subsequently subjected to sequencing. Conditional regression models were built to calculate odds ratios (ORs) and 95% confidence intervals (CI). RESULTS Sixty two cases and 248 controls (53.2% males), median age 62 years (Q1-Q3=54-72 years) were included. HPV prevalence was 43.5% in cases and 17.3% in controls (HR-HPV: 37.1% cases, 9.7% controls). The most frequent types in cases were HPV-16 and HPV-18 (55.6 and 18.5%). The presence of HR-HPV was associated with OSCC (OR=6.2; 95% CI: 2.98-12.97) controlling for the most common risk factors. An interaction between smoking and drinking was detected, and family history of cancer was also significant (OR: 3.61; 95% CI=1.44-8.99). Early age at first sexual intercourse and large number of lifetime sexual partners showed an association with HR-HPV (p=0.019 and p=0.033, respectively). CONCLUSIONS Oral HR-HPV was strongly associated with OSCC, suggesting that HPV-16 and -18 are risk factors for oral cancer in Mexican patients. A significant association of tobacco and alcohol was confirmed. In addition, family history of cancer was associated with OSCC. The results underline the role of HPV in OSCC and its multifactorial etiology.
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Marini A, Wagenmann M, Ting E, Hengge UR. Squamous cell cancer and human papillomavirus infection in oral lichen planus: case report and literature review. Dermatol Surg 2007; 33:756-60. [PMID: 17550459 DOI: 10.1111/j.1524-4725.2007.33157.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alessandra Marini
- Department of Dermatology, Heirich-Heine University, Düsseldorf, Germany
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D'Souza G, Fakhry C, Sugar EA, Seaberg EC, Weber K, Minkoff HL, Anastos K, Palefsky JM, Gillison ML. Six-month natural history of oral versus cervical human papillomavirus infection. Int J Cancer 2007; 121:143-50. [PMID: 17354235 DOI: 10.1002/ijc.22667] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Human papillomavirus (HPV) infection is etiologically associated with a subset of oral cancers, and yet, the natural history of oral HPV infection remains unexplored. The feasibility of studying oral HPV natural history was evaluated by collecting oral rinse samples on 2 occasions at a 6-month interval from 136 HIV-positive and 63 HIV-negative participants. Cervical vaginal lavage samples were concurrently collected for comparison. HPV genomic DNA was detected in oral and cervical samples by consensus primer PCR and type-specified for 37 HPV types. The six-month cumulative prevalence of oral HPV infection was significantly less than for cervical infection (p < 0.0001). HIV-positive women were more likely than HIV-negative women to have an oral (33 vs. 15%, p = 0.016) or cervical (78 vs. 51%, p < 0.001) infection detected. Oral HPV infections detected at baseline were as likely as cervical infections to persist to 6 months among HIV-negative (60% vs. 51%, p = 0.70) and HIV-positive (55% vs. 63%, p = 0.27) women. Factors that independently elevated odds for oral HPV persistence differed from cervical infection and included current smoking (OR = 8, 95% CI = 1.3-53), age above 44 years (OR = 20, 95% CI = 4.1-83), CD4 < 500 (OR = 6, 95% CI = 1.1-26), use of HAART therapy (OR = 12, 95% CI = 1.0-156), and time on HAART therapy (trend p = 0.04). The rate of oral HPV infections newly detected at follow-up was significantly lower than cervical infection among HIV-positive (p < 0.001) and HIV-negative women (p < 0.001). Our study not only demonstrates that it is feasible to study the natural history of oral HPV infection with oral rinse sampling, but also indicates that oral and cervical HPV natural history may differ.
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Affiliation(s)
- Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21231, USA
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Rose B, Wilkins D, Li W, Tran N, Thompson C, Cossart Y, McGeechan K, O'Brien C, Eris J. Human Papillomavirus in the Oral Cavity of Patients with and without Renal Transplantation. Transplantation 2006; 82:570-3. [PMID: 16926603 DOI: 10.1097/01.tp.0000231706.79165.e5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study investigates human papillomavirus (HPV) infection in the oral cavities of 88 Australian renal transplant recipients and 88 immunocompetent controls. Oral cavities were examined for lesions and brushings collected for HPV analysis by consensus PCR. No warts were identified; HPV DNA was detected in 18% of transplant versus 1% control samples (P<0.001). Cutaneous HPVs predominated. One patient had HPV16 in samples taken four years apart without evidence of associated lesions or malignancy. Transplant recipients were more likely than controls to have current cutaneous warts (P<0.001), fewer sexual partners (P=0.001), and to have never consumed alcohol (P=0.01). Among the transplant group, the risk of an HPV-positive sample was higher among older patients (P=0.05), and those with past cutaneous warts (P=0.04). This study extends previous surveys by encompassing overt and asymptomatic infection, a broad spectrum of cutaneous and genital HPVs, and by providing new data on risk factors for oral HPV infection.
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Affiliation(s)
- Barbara Rose
- Sydney Head & Neck Cancer Institute and Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia.
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do Sacramento PR, Babeto E, Colombo J, Cabral Ruback MJ, Bonilha JL, Fernandes AM, Pereira Sobrinho JS, de Souza FP, Villa LL, Rahal P. The prevalence of human papillomavirus in the oropharynx in healthy individuals in a Brazilian population. J Med Virol 2006; 78:614-8. [PMID: 16555270 DOI: 10.1002/jmv.20583] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Oncogenic human papillomavirus (HPV), a causative agent of uterine cervical cancer, has also been detected in head and neck squamous cell cancers, especially in squamous cell carcinomas of the tonsils. However, the true HPV prevalence in normal and neoplasic oropharyngeal mucosa remains uncertain. To determine the prevalence of HPV DNA in normal oropharyngeal mucosa of cancer-free individuals, a study was carried out on 50 Brazilian subjects. PCR was performed to identify HPV DNA in samples from four sites in the oropharynx (tonsils, soft palate, base of the tongue, and back wall of the pharynx). For amplification of the HPV DNA, MY09/11 consensus primers were used, and specific genotypes were identified by dot-blot hybridization or cloning and sequencing. HPV DNA was present in 14.0% of the individuals, and the identified genotypes were 16, 18, 52, and 61. All these types are considered high-risk (HR) HPV. The tonsils and the soft palate were the sites with the highest HPV prevalence. This study shows the prevalence of HR HPV in the oropharynx of normal individuals. However, the prevalence of HPV is still unclear, and if HPV infection in a healthy it is not known individual predisposes to HPV-associated disease such as oropharyngeal cancer. Thus, it is important to assess the prevalence of HPV in cancer-free individuals, in order to compare it with the HPV prevalence in oropharyngeal carcinomas and to attempt to determine the true role of HPV in the development of head and neck squamous cell cancers.
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Boy S, Van Rensburg EJV, Engelbrecht S, Dreyer L, van Heerden M, van Heerden W. HPV detection in primary intra-oral squamous cell carcinomas--commensal, aetiological agent or contamination? J Oral Pathol Med 2006; 35:86-90. [PMID: 16430738 DOI: 10.1111/j.1600-0714.2006.00385.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND High-risk human papilloma viruses (HPV) are reported to be significant independent risk factors for oral squamous cell carcinoma (OSCC). The prevalence of HPV in OSCC in a South African population sample was evaluated comparing three different HPV detection methods. METHODS Tumour and adjacent morphologically normal oral mucosa of 59 resections of primary OSCC were evaluated for the presence of HPV using real-time polymerase chain reaction (PCR), conventional in situ hybridization (ISH), and a signal amplification ISH technique (Dako GenPoint). RESULTS HPV18 DNA was detected in seven cases using real-time PCR. No positivity was found with the other two ISH techniques. CONCLUSIONS We support the view that HPV is probably unimportant in the pathogenesis of OSCC and hypothesize HPV detection techniques as the main reason for the positive results in many studies. Real-time PCR was confirmed as the most sensitive technique, but researchers are urged to incorporate strict internal controls when using this detection method.
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Affiliation(s)
- Sonja Boy
- Department of Oral Pathology and Oral Biology, University of Pretoria, Pretoria, South Africa.
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