Oral human papillomavirus infection in HIV-infected and HIV-uninfected MSM: the OHMAR prospective cohort study

ObjectiveWe aimed to assess incidence and clearance of oral human papillomavirus (HPV) infection and the respective risk factors in HIV-infected and uninfected men who have sex with men (MSM).MethodsOral rinse and gargles were collected semiannually from 244 MSM (103, 42.2% HIV-infected). HPV-DNA testing was performed with the Linear Array HPV Genotyping test. A Markov model was used for estimation of incidence, clearance and risk factor analysis.ResultsIncidence rates for any HPV were 21.2 and 15.0×1000 person-months in HIV-infected and uninfected MSM, respectively. The respective figures for high-risk HPVs were 10.7 and 6.5×1000 person-months. The clearance rate was 4–12 times higher than the respective incidence rate. HIV-infected MSM with >95 lifetime oral sex partners showed increased incidence of any HPV (adjusted HR, aHR: 8.46, 95% CI 1.89 to 37.92). Condomless oral sex appeared the strongest predictor for incident infection by high-risk HPVs in this group (aHR: 13.40, 95% CI 2.55 to 70.53). Those aged >46 years (aHR: 0.30, 95% CI 0.12 to 0.74) and those with nadir CD4+ T count of <200 cells/mm3 (aHR: 0.14, 95% CI 0.03 to 0.75) displayed a significantly reduced clearance of any and high-risk HPVs, respectively. HIV-uninfected MSM aged >46 years had increased risk of acquiring any HPV (aHR: 3.70, 95% CI 1.30 to 10.52) and high-risk HPV (aHR: 5.33, 95% CI 1.06 to 26.68). Any HPV clearance declined in those with more than six recent oral sex partners (aHR: 0.18, 95% CI 0.05 to 0.65).ConclusionsAcquisition of oral HPV infection in MSM seems to occur rarely, whereas clearance seems to be a frequent event. Oral HPV natural history in these at-risk subjects is differently influenced by age and sex behaviour, depending on HIV status.

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Predictors of Oral Infection by Mucosal and Cutaneous Human Papillomaviruses in HIV-Infected and Uninfected Men Who Have Sex with Men of the OHMAR Study

Journal of Clinical Medicine ◽

10.3390/jcm10132804 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2804

Author(s):

Massimo Giuliani ◽

Tarik Gheit ◽

Francesca Rollo ◽

Massimo Tommasino ◽

Alessandra Latini ◽

...

Keyword(s):

Linear Array ◽

Hpv Infection ◽

Oral Infection ◽

Human Papillomaviruses ◽

Oral Sex ◽

Sex Partners ◽

Oral Rinse ◽

Luminex Technology ◽

Oral Hpv ◽

Sex With Men

Mucosal Human Papillomaviruses (HPVs) play a role in the development of a subset of head and neck cancers. Cutaneous HPVs are abundantly present in the oral cavity. The determinants of these infections have not been extensively investigated. We assessed the correlates of oral infection by alpha and beta and/or gamma HPVs in HIV-infected and uninfected men who have sex with men (MSM). Oral rinse-and-gargles were collected with a mouthwash. Alpha and beta/gamma HPVs were detected using the Linear Array HPV genotyping test and a multiplex PCR combined with Luminex technology, respectively. Multiple logistic regression was performed to identify independent predictors of oral HPV infection. Overall, 193 HIV-uninfected and 117 HIV-infected MSM were enrolled. Among HIV-infected MSM, the only determinant of alpha HPV infection was the number of lifetime oral sex partners (AOR: 8.26, 95% CI: 2.26–30.16). The strongest determinant of beta/gamma HPV infection was represented by practicing condomless receptive oral sex (AOR: 10.76, 95% CI: 1.56–74.17). Age was independently associated with alpha HPV infection in HIV-uninfected MSM. Beta/gamma HPV infection was not associated with sexual behavior in these subjects. In conclusion, predictors of oral infection differ between HIV-infected and uninfected MSM, as well as between alpha and beta/gamma HPVs.

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The Human Papillomavirus Type 16 E7 Oncoprotein Activates the Fanconi Anemia (FA) Pathway and Causes Accelerated Chromosomal Instability in FA Cells

Journal of Virology ◽

10.1128/jvi.01121-07 ◽

2007 ◽

Vol 81 (23) ◽

pp. 13265-13270 ◽

Cited By ~ 68

Author(s):

Nicole Spardy ◽

Anette Duensing ◽

Domonique Charles ◽

Nathan Haines ◽

Tomomi Nakahara ◽

...

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Squamous Cell ◽

Fanconi Anemia ◽

Chromosomal Instability ◽

Hpv Infection ◽

Hpv 16 ◽

E7 Oncoprotein ◽

Increased Risk ◽

Frequent Event

ABSTRACT Fanconi anemia (FA) patients have an increased risk for squamous cell carcinomas (SCCs) at sites of predilection for infection with high-risk human papillomavirus (HPV) types, including the oral cavity and the anogenital tract. We show here that activation of the FA pathway is a frequent event in cervical SCCs. We found that FA pathway activation is triggered mainly by the HPV type 16 (HPV-16) E7 oncoprotein and is associated with an enhanced formation of large FANCD2 foci and recruitment of FANCD2 as well as FANCD1/BRCA2 to chromatin. Episomal expression of HPV-16 oncoproteins was sufficient to activate the FA pathway. Importantly, the expression of HPV-16 E7 in FA-deficient cells led to accelerated chromosomal instability. Taken together, our findings establish the FA pathway as an early host cell response to high-risk HPV infection and may help to explain the greatly enhanced susceptibility of FA patients to squamous cell carcinogenesis at anatomic sites that are frequently infected by high-risk HPVs.

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Prevalence and Genotype distribution of Human Papillomavirus Infection in Different Anatomical Sites among Men Who Have Sex with Men (MSM): A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-17873/v1 ◽

2020 ◽

Author(s):

Mohammad Farahmand ◽

Seyed Hamidreza Monavari ◽

Ahmad Tavakoli

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

High Risk ◽

Sexual Behaviors ◽

Meta Analysis ◽

Hpv Infection ◽

Genotype Distribution ◽

Increased Risk ◽

Pertinent Data ◽

Sex With Men

Abstract Background: Homosexual men or men who have sex with men (MSM) are at increased risk of human papillomavirus (HPV) infection because of their high-risk sexual behaviors. In this large study, a meta-analytic approach was used to systematically analyze the literature to elucidate the prevalence and genotype distribution of anal, penile, oral, and urethral HPV infection among MSM in the world.Methods: To carry out this systematic review, five electronic databases were searched for relevant studies published from January 2012 through to November 2019, and pertinent data were collected from the eligible articles. The pooled HPV prevalences were calculated for each anatomical region using random-effect model weighted by the inverse variance method. Subgroup analyses were performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the “Metaprop” function in the R package Meta.Results: The overall pooled prevalence of anal, penile, oral, and urethral HPV infection among MSM were 78.11 % (95% CI: 75.50%-80.52%), 36.26% (95% CI: 29.13%–44.05%), 17.33% (95% CI: 13.65%–21.75%), and 15.40% (95% CI: 7.86%–27.97%), respectively. Stratified analyses showed that the prevalences of HPV were significantly higher in HIV-positive than HIV-negative MSM. The most frequent HPV high-risk type detected in the anus, penis, and oral cavity was HPV-16 (20.32%, 4.96%, and 3.16%, respectively). Conclusion: HPV infection is on the dramatic rise in MSM because of high-risk sexual behaviors, strongly suggesting the increased risk of developing HPV-related diseases and malignancies in this population. Among different sexual orientations, male homosexuality is associated with the highest risk of acquiring sexually transmitted infections.

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A systematic review and meta-analysis of the association between periodontitis and oral high-risk human papillomavirus infection

Journal of Public Health ◽

10.1093/pubmed/fdaa156 ◽

2020 ◽

Author(s):

Anna Ali ◽

Zohra S Lassi ◽

Kostas Kapellas ◽

Lisa Jamieson ◽

Alice R Rumbold

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Confidence Interval ◽

Meta Analysis ◽

Positive Association ◽

Hpv Infection ◽

Eligibility Criteria ◽

Oral Hpv ◽

Meta Analyses

Abstract Background The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCCs) is increasing globally. Common oral conditions such as periodontitis may contribute. We undertook a meta-analysis to quantify the association between periodontitis, oral HPV and OPSCCs. Methods Multiple electronic databases were searched until 12 February 2020. Studies conducted in males and/or females aged ≥ 18 years that examined periodontitis, periodontal procedures, oral HPV infection, and where possible, oral cancers, were eligible. Meta-analyses were conducted and the GRADE approach was used to examine the quality of evidence. Results Of 2709 studies identified, 13 met the eligibility criteria. Five studies could be included in the meta-analyses. There was no significant increase in the odds of high-risk oral HPV infection among individuals with confirmed periodontitis (odds ratio 4.71, 95% confidence interval 0.57–38.97). Individuals with periodontitis had a 3.65 times higher odds of having any type of oral HPV infection compared with those without periodontitis (95% confidence interval 1.67–8.01). The overall body of evidence was rated as low to very-low certainty. Conclusion Meta-analysis confirms there is a positive association between periodontitis and oral HPV infection, although the overall quality of this evidence is low. Evidence for an association between periodontitis and high-risk oral HPV infection is inconclusive.

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The Relationship between Cocaine Use and Human Papillomavirus Infections in HIV-Seropositive and HIV-Seronegative Women

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2008/587082 ◽

2008 ◽

Vol 2008 ◽

pp. 1-7 ◽

Cited By ~ 11

Author(s):

Howard Minkoff ◽

Ye Zhong ◽

Howard D. Strickler ◽

D. Heather Watts ◽

Joel M. Palefsky ◽

...

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Pap Smear ◽

Crack Cocaine ◽

Hpv Infection ◽

Cocaine Use ◽

Hpv Dna ◽

Increased Risk ◽

Hiv Seropositive ◽

Oncogenic Hpv

Objective. Animal data suggest that cocaine has an immunosuppressive effect, but no human studies have been conducted to assess the relation of cocaine use with human papillomavirus (HPV) infection, the viral cause of cervical cancer. Since both cocaine use and HPV infection are common among HIV-positive women, we sought to determine whether use of cocaine and/or crack influences the natural history of HPV among women with or at high risk of HIV.Methods. Women enrolled in the Women's Interagency HIV Study (2278 HIV-seropositive and 826 high-risk seronegative women) were examined every six months for up to 9.5 years with Pap smear, collection of cervicovaginal lavage (CVL) samples, and detailed questionnaires regarding health and behavior, including use of crack and cocaine (crack/cocaine). CVLs were tested for HPV DNA by PCR, with genotyping for over forty HPV types.Results. In multivariate logistic regression models, censoring women treated for cervical neoplasia, crack/cocaine use within the last six months was associated with prevalent detection of oncogenic HPV DNA (odds ratio [OR] = 1.30 (1.09–1.55)), and with oncogenic HPV-positive squamous intraepithelial lesions (SIL) (OR = 1.70 (1.27–2.27)), following adjustment for age, race, HIV-serostatus, and CD4+ T-cell count, the number of sexual partners in the past six months, and smoking. In multivariate Cox models crack/cocaine use was also associated with a trend that approached significance in regard to incident detection of oncogenic HPV-positive SIL (HR = 1.51, 95% CI 0.99–2.30), and while the rate of oncogenic HPV clearance was not related to cocaine use, the clearance of any SIL was significantly lower in those with versus those without recent crack/cocaine use (HR = 0.57, 95% CI 0.34–0.97).Conclusions. Cocaine use is associated with an increased risk of detection of both prevalent and incident oncogenic HPV infection, as well as an increased risk of HPV-positive SIL over time.

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Prevalence of Oral Human Papillomavirus Infection among Indian HIV-Positive Men Who Have Sex With Men: A Cross-Sectional Study

10.21203/rs.3.rs-60960/v1 ◽

2020 ◽

Author(s):

Alexandra Lydia Hernandez ◽

Rajiv Karthik ◽

Murugesan Sivasubramanian ◽

Anantharam Raghavendran ◽

Shelly Lensing ◽

...

Keyword(s):

Human Papillomavirus ◽

Hpv Infection ◽

Sexual History ◽

Hiv Positive ◽

Increased Risk ◽

Oral Hpv ◽

Hpv Types ◽

Sex With Men ◽

The Impact ◽

Hiv Positive Men

Abstract Background: Oral human papillomavirus (HPV) infection has been causally linked to a subset of oropharyngeal cancers in Western populations15-20, and both oropharyngeal cancer and oral HPV infection are increased among HIV-positive individuals24,41. India has high incidences of oral and oropharyngeal cancers, and Indian HIV-positive men who have sex with men (MSM) may be at increased risk of developing oropharyngeal cancers. However, there is little information available on the prevalence of oral HPV in this population.Methods: We tested 302 HIV-positive Indian MSM for oral HPV infection using L1 HPV DNA PCR with probes specific for 29 types and a mixture of 10 additional types. CD4+ level and plasma HIV viral load (VL) were measured. Participants completed an interviewer-administered questionnaire including a sexual history.Results: The prevalence of oral HPV was 23.7% (95% CI: 19-29%) and 2.4% of participants had oncogenic HPV types. No participants had oral HPV type 16 (HPV-16) and the prevalence of other anogenital HPV types was low. Participants with higher CD4+ levels had reduced odds of having any oral HPV infection (OR: 3.1 [1.4-6.9]) in multivariable analyses.Conclusions: This is the first report of oral HPV among Indian HIV-positive MSM. Our results show a high prevalence of oral HPV infection consistent with studies from Western populations. However, oncogenic anogenital HPV types were relatively uncommon in our study population. It is unknown what the impact of this distribution of oral HPV will be on oropharyngeal cancers. HIV-positive MSM in India should be monitored closely for oral and oropharyngeal pre-cancer and cancer.

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Differences in Factors Associated With High- and Low-Risk Oral Human Papillomavirus Genotypes in Men

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa693 ◽

2020 ◽

Author(s):

Deepti Bettampadi ◽

Brittney Dickey ◽

Martha Abrahamsen ◽

Bradley Sirak ◽

Maria Luiza Baggio ◽

...

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Sexual Behaviors ◽

Hpv Infection ◽

Low Risk ◽

Factors Associated ◽

Hpv Prevalence ◽

Oral Hpv ◽

Multivariable Models ◽

High Risk Hpv

Abstract Background Human papillomavirus (HPV) causes oral warts and oropharyngeal cancer (OPC). Human papillomavirus-attributable OPC incidence among men is significantly increasing worldwide, yet few studies have reported oral HPV across multiple countries or examined factors associated with low- and high-risk HPV separately. Methods Oral gargles from 3095 men in the multinational HPV Infection in Men (HIM) Study were HPV genotyped. Multivariable models assessed factors independently associated with high-risk and low-risk HPV prevalence. Results The prevalence of high-risk and low-risk HPV was 6.0% and 2.8%, respectively. Greater number of sexual partners was only associated with high-risk HPV (1.88; 95% confidence interval [CI], 1.22–2.90) prevalence. In multivariable models, residing in Mexico (1.66; 95% CI, 1.15–2.40) and smoking (1.66; 95% CI, 1.13–2.44) were significantly associated with high-risk HPV, and history of consistent gum bleeding (2.16; 95% CI, 1.35–3.45) was significantly associated with low-risk HPV. Gender of the sexual partner did not alter the results for either high- or low-risk HPV endpoints. Conclusions Different factors were independently associated with high- and low-risk oral HPV. Oral sexual behaviors were associated with high-risk HPV, and oral health was associated with low-risk HPV. High-risk HPV prevalence differed by country of residence, highlighting the need for additional studies in multiple countries.

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High Prevalence of Anal and Oral High-Risk Human Papillomavirus in Human Immunodeficiency Virus–Uninfected French Men Who Have Sex With Men and Use Preexposure Prophylaxis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz291 ◽

2019 ◽

Vol 6 (9) ◽

Cited By ~ 4

Author(s):

Ralph-Sydney Mboumba Bouassa ◽

Laurent Bélec ◽

Camelia Gubavu ◽

Hélène Péré ◽

Mathieu Matta ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Human Papillomavirus ◽

High Risk ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Hpv Infection ◽

Preexposure Prophylaxis ◽

Immunodeficiency Virus ◽

Oral Hpv ◽

Sex With Men

Abstract Background We assessed the prevalence and risk factors of anal and oral high-risk (HR) human papillomavirus (HPV) infection in human immunodeficiency virus–uninfected men who have sex with men (MSM) and take preexposure prophylaxis (PrEP) in France. Methods Anal and oral samples were screened by multiplex real-time polymerase chain reaction (Anyplex II HPV 28; Seegene) for HPV DNA. Results A total of 61 unvaccinated MSM (mean age, 36.1 years) were enrolled. Anal HPV and HR-HPV prevalences were 93.4% and 81.9%, respectively, and oral HPV and HR-HPV prevalences, 33.9% and 19.6%, respectively. HR-HPV type 33 was the most detected genotype, in both anal and oral samples. Among MSM, 68.8% carried ≥1 anal HPV type targeted by the 9-valent Gardasil-9 vaccine; all oral HPV-positive samples carried ≥1 strain included in the vaccine. Condomless receptive anal intercourse and history of anal gonorrhea were the main factors associated with increased risk for anal HPV infection (adjusted odds ratio, 10.4) and anal infection with multiple HR-HPV genotypes (5.77), respectively. Conversely, having had <10 partners in the last 12 months was associated with decreased risk for anal carriage of both multiple HPV (adjusted odds ratio, 0.19) and HR-HPV (0.17) types. Conclusion French MSM using PrEP are at high risk for both anal and oral carriage of HR-HPV that could lead to HPV-related cancers.

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Clinical Implications of Human Papillomavirus in Head and Neck Cancers

Journal of Clinical Oncology ◽

10.1200/jco.2006.06.1291 ◽

2006 ◽

Vol 24 (17) ◽

pp. 2606-2611 ◽

Cited By ~ 317

Author(s):

Carole Fakhry ◽

Maura L. Gillison

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Head And Neck ◽

Sexual Behaviors ◽

Hpv Infection ◽

Genetic Alterations ◽

Sufficient Evidence ◽

Clinical Implications ◽

Risk Of Death ◽

Increased Risk

Human papillomavirus (HPV) is now recognized to play a role in the pathogenesis of a subset of head and neck squamous cell carcinomas (HNSCCs), particularly those that arise from the lingual and palatine tonsils within the oropharynx. High-risk HPV16 is identified in the overwhelming majority of HPV-positive tumors, which have molecular-genetic alterations indicative of viral oncogene function. Measures of HPV exposure, including sexual behaviors, seropositivity to HPV16, and oral, high-risk HPV infection, are associated with increased risk for oropharyngeal cancer. HPV infection may be altering the demographics of HNSCC patients, as these patients tend to be younger, nonsmokers, and nondrinkers. There is sufficient evidence to conclude that a diagnosis of HPV-positive HNSCC has significant prognostic implications; these patients have at least half the risk of death from HNSCC when compared with the HPV-negative patient. The HPV etiology of these tumors may have future clinical implications for the diagnosis, therapy, screening, and prevention of HNSCC.

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Prevalence of Oral Human Papillomavirus Infection among Indian HIV-positive Men who have Sex with Men: A Cross-Sectional Study

10.21203/rs.3.rs-60960/v2 ◽

2021 ◽

Author(s):

Alexandra Lydia Hernandez ◽

Rajiv Karthik ◽

Murugesan Sivasubramanian ◽

Anantharam Raghavendran ◽

Shelly Lensing ◽

...

Keyword(s):

Human Papillomavirus ◽

Hpv Infection ◽

Sexual History ◽

Hiv Positive ◽

Increased Risk ◽

Oral Hpv ◽

Hpv Types ◽

Sex With Men ◽

The Impact ◽

Hiv Positive Men

Abstract Background: Oral human papillomavirus (HPV) infection has been causally linked to a subset of oropharyngeal cancers in Western populations15-20, and both oropharyngeal cancer and oral HPV infection are increased among HIV-positive individuals24,41. India has high incidences of oral and oropharyngeal cancers, and Indian HIV-positive men who have sex with men (MSM) may be at increased risk of developing oropharyngeal cancers. However, there is little information available on the prevalence of oral HPV in this population.Methods: We tested 302 HIV-positive Indian MSM for oral HPV infection using L1 HPV DNA PCR with probes specific for 29 types and a mixture of 10 additional types. CD4+ level and plasma HIV viral load (VL) were measured. Participants completed an interviewer-administered questionnaire including a sexual history.Results: The prevalence of oral HPV was 23.7% (95% CI: 19-29%) and 2.4% of participants had oncogenic HPV types. No participants had oral HPV type 16 (HPV-16) and the prevalence of other anogenital HPV types was low. Participants with higher CD4+ levels had reduced odds of having any oral HPV infection (OR: 3.1 [1.4-6.9]) in multivariable analyses. Conclusions: This is the first report of oral HPV among Indian HIV-positive MSM. Our results show a high prevalence of oral HPV infection consistent with studies from Western populations. However, oncogenic anogenital HPV types were relatively uncommon in our study population. It is unknown what the impact of this distribution of oral HPV will be on oropharyngeal cancers. HIV-positive MSM in India should be monitored closely for oral and oropharyngeal pre-cancer and cancer.

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