Abstract
ObjectivesTo estimate the prevalence of oral detectable human papillomavirus (HPV) DNA in HIV-negative men who have sex with men (MSM) attending a sexual health clinic in London and concordance with anogenital HPV infection. Such data are important to improve our understanding of the epidemiology of oral HPV and the potential use of vaccines to prevent oropharyngeal cancers.MethodsPaired oral rinse samples and anogenital samples were available from 151 HIV-negative MSM within a larger cross-sectional survey. All samples were tested in parallel for 21 types of HPV DNA using an in-house assay.ResultsThe median age of participants was 30 (IQR 25–35). The prevalence of any oral HPV and of high-risk HPV (HR-HPV) was 13.7% (n=21; 95% CI 8.7 to 20.2) and 5.9% (n=9; 95% CI 2.7 to 10.9) compared with 64.9% (n=98; 95% CI 56.7 to 72.5) and 34.4% (n=52; 95% CI 26.9 to 42.6) in any anogenital sample, respectively. The prevalence of types prevented by the bivalent (HPV16/18), quadrivalent (HPV6/11/16/18) and nonavalent (HPV6/11/16/18/31/33/45/52/58) vaccines was 1.3% (95% CI 0.2 to 4.7), 2.6% (95% CI 0.7 to 6.6) and 4.6% (95% CI 1.9 to 9.3), respectively. There was no concordance between HPV genotypes detected in oral and anogenital sites.ConclusionsHR-HPV DNA, including HPV 16/18, was detected in oral specimens from HIV-negative MSM attending sexual health clinics, suggesting a potential role for vaccination, but is far less common than anogenital infection. How this relates to the risk and natural history of HPV-related head and neck cancers warrants further study. Lack of concordance with anogenital infection also suggests that oral HPV infection should be considered separately when estimating potential vaccine impact.
Highlights
Human papillomavirus (HPV) infection is associated with cancers at a number of sites in the head and neck, most importantly oropharyngeal cancer, which has been rising in incidence in recent decades.[1]
Only three studies involving a total of 877 HIV-negative men who have sex with men (MSM) have been conducted to estimate oral high-risk HPV (HR-HPV) prevalence, and results are not consistent (2%,7 9%,4 17%8)
We describe age-specific oral HPV prevalence and the concordance between detection of typespecific HPV DNA in oral and anogenital specimens from HIV-negative MSM attending a sexual health clinic in central London
Summary
Human papillomavirus (HPV) infection is associated with cancers at a number of sites in the head and neck, most importantly oropharyngeal cancer, which has been rising in incidence in recent decades.[1] The global estimate of oral HPV prevalence in men was 5%2 and estimates in men who have sex with men (MSM) outside the UK range from 3% to 57%,3 4 yet few studies have compared oral HPV prevalence in heterosexual and MSM populations.[3] the natural history of oral HPV infection and its role in the development of head and neck cancers is not well understood.[5] HPV infection and related disease in MSM is of particular interest, given the potential for prevention by vaccination.[6]. Estimating the potential benefit of vaccinating MSM requires knowledge of the epidemiology of oral HPV infection. Only three studies involving a total of 877 HIV-negative MSM have been conducted to estimate oral high-risk HPV (HR-HPV) prevalence, and results are not consistent (2%,7 9%,4 17%8). The relationship between oral and anogenital HPV infection in MSM is not well understood
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