Abstract
BackgroundIncidence of anal and oral infections with Human Papillomavirus (HPV) is increasing, particularly among Human Immunodeficiency Virus-positive (HIV+) men. HPV type 16 has exhibited the highest incidence and only limited data is available on other prevalent types, variants of HPV16, as well as associated factors. We were interested in identifying prevalent HPV types, variants of type 16, as well as factors associated with HPV16 infections in the oral cavity of HIV+ men who have sex with men (MSM).MethodsA cross-sectional study of oral cavity samples from HIV+ MSM, that in a previous study were identified as positive for HPV16 in the anal canal. Cells from the oral cavity (102 samples, paired with 102 from the anal canal of same patient) were used to extract DNA and detect HPV infections using INNO-LiPA HPV Genotyping Extra II, and PCR. From these, 80 samples (paired, 40 anal and 40 oral) were used to identify variants of type 16 by sequencing. Statistical differences were estimated by the X2 test, and p values equal to or less than 0.05 were considered significant. SPSS ver. Twenty-four statistical software (IBM Corp) was used.ResultsWe found a high prevalence of High-Risk HPV (HR-HPV) and Low-Risk HPV (LR-HPV). Patients were positive in the oral cavity for HR types; 16, 39 and 18 (80.4, 61.8 and 52.9% respectively) and LR types 11 and 6 (53.9 and 34.3% respectively). Surprisingly, only European variants of type 16 were found in the oral cavity, although American Asian (22.5%) and African (2.5%) variants were identified in the anal canal. The analysis showed that CD4 counts could be the most important risk factor associated with HR-HPV infections in the oral cavity, anal canal or both anatomical regions. The risk of infection of the oral cavity with type 18 increased in men diagnosed with HIV for more than 6 years.ConclusionsPrevalence of both HR and LR HPV’s in the oral cavity of Mexican HIV+ MSM is very high. The fact that only European variants of HPV16 were found in the oral cavity suggest a possible tropism not previously described.
Highlights
Incidence of anal and oral infections with Human Papillomavirus (HPV) is increasing, among Human Immunodeficiency Virus-positive (HIV+) men
Recently is suggested that HPV infections in the oral cavity are associated with sexual practices, evidences show that vertical transmission is present in newborns from HPV + mothers, indicating that HPV can be acquired at an early age and may remain latent for years, and has been report that exists horizontal transmission, which can mediated by saliva [46]
Risk factors analysis showed that CD4 (201–499) count could be the most important risk factor associated with infection of oncogenic HPV types, in the oral cavity, anal region or both anatomical regions, (e.g. HPV66, 52 and 51), we found that anal and oral infection with oncogenic HPV types were significantly associated with decreased CD4 counts and short Highly Active Antiretroviral therapy (HAART) durations
Summary
Incidence of anal and oral infections with Human Papillomavirus (HPV) is increasing, among Human Immunodeficiency Virus-positive (HIV+) men. We were interested in identifying prevalent HPV types, variants of type 16, as well as factors associated with HPV16 infections in the oral cavity of HIV+ men who have sex with men (MSM). HPV’s are recognized as one of the major causes of sexually transmitted infections related to cancer worldwide, and have been detected in cervical, anal and oral high-grade intraepithelial lesions [1,2,3]. The persistent oral infection of these patients have with HRHPV can lead to development of head and neck cancer (HNC), with a minor association with oral cancer and a major role with OPC [21,22,23]
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