Abstract
Infection with High Risk (HR) Human Papillomaviruses (HPVs) is the main aetiological agent of Cervical Squamous Cell Carcinoma (CSCC) and also associated in a subgroup of other neoplasms, including Oropharyngeal Squamous cell Carcinoma (OPSCC). HPV infection, in genital as in oral mucosa, can also be subclinical or associated with benign proliferative lesions (common warts, condylomas, papillomas) caused mostly by infection with Low Risk (LR)-HPVs. In the last decades, extensive research has resulted in growing knowledge on HPV biology and specifically viral life cycle, biochemical properties of viral proteins and their interaction with the host proteins leading to potential new targets of prophylactic or therapeutic vaccines and therapies for HPV infection. In addition, notable progresses have been made in the field of diagnostics to detect HPV DNA or RNA. The recent epidemiological data suggest the significant changes in HPV endemic, due to the changes in sexual habits especially among young generations (i.e. early sexual debuts, multiple sexual partners, oral and anal sex); this scenario has urged on the need of adequate campaigns of primary (sexual education, vaccination programs) and secondary prevention (diagnostics of HPV-related diseases). Due to the growing interest on HPV infection and HPV related cancers, the authors made a narrative review of the literature on oral HPV infection and oral-genital transmission. After this, in view of the controversies about the strategies of therapy and prevention of HPV infection, the present review focuses on the current state of art about the available tools for the therapeutic and, if any, preventive management of oral HPV infection.
Highlights
Human Papillomavirus (HPV) infection has been recognized as a necessary cause of cervical squamous cell carcinoma (CSCC) worldwide [1,2,3]
Any significant association between oral sex and carriage of HPV in the oral mucosa was established [25]. This is contradictory to the data reported by D’Souza and co-workers, who studied in a case-control setting, whether sexual behaviour that increased the odds of oropharyngeal cancer would increase the risk of oral HPV infections among their control patients [30]
The current knowledge about the natural history of oral HPV infection come from gynaecological literature about cervical infection, as recently suggested by D’Souza et al [34], oral and genital HPV infection seem to differ themselves about some aspects
Summary
Human Papillomavirus (HPV) infection has been recognized as a necessary cause of cervical squamous cell carcinoma (CSCC) worldwide [1,2,3]. Epidemiological data from last decades suggest significant changes in HPV endemic, with regard to genital and oral area This has been explained by risky sexual behaviour especially among young generations [6, 7]. This would explain the increased incidence of HPV-related SCC in head and neck region [8,9,10]. The current evidence suggests that the potential fallouts of the so called “HPV endemic” on the epidemiologic, therapeutic/preventive and socio-economic viewpoints are enormous, and in the future there is a great opportunity to design adequate strategies of prevention and management of HPV-related diseases, including SCCs of anogenital and head-neck region, to other infectious. This review focuses on oral HPV infection and oral-genital transmission and current state of art about the therapeutic and, if any, preventive management of oral HPV infection
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