Oral human papillomavirus (HPV) infection is associated with partner's genital HPV infection

Abstract

Background: Human papillomavirus (HPV) is the causal agent of cancer of the oral cavity and oropharynx. Approximately 30% of cases of oral cancer cases are associated with HPV. Worldwide, the incidence of oral warts and cancer related to HPV is increasing, especially among human immunodeficiency virus (HIV) infected individuals, despite the use of highly active antiretroviral therapy. The objectives of the studywere to investigate oral HPV prevalence and factors associatedwith oral HPV infection in an African setting. Methods &Materials: Cervical, penile and oral HPV types were determined in 221heterosexual couples byRoche Linear ArrayHPV genotyping assay. Results: Oral HPV infectionwas observed in 8.4% (37/442) study participants. A total of 6.8% (15/221) women and 13.5% (22/221) men were oral HPV positive compared to 55% (121/219) of the cervical and 57% (120/210) of the penile specimens, with neither sex difference being statistically significant (P =0.23 and P=0.69 respectively). 13.5% (5/37) of study participants who were orally infected were infected with multiple HPV types (2-4 HPV types). In women, the risk of oral HPV infection were nearly significantly associatedwith oral sex (odd ratio (OR): 4.54, 95% confidence interval (CI): 0.94-21.93, P =0.060). The risk of oral infection with a specificHPV type inwomenwas increasedwhen the same typewas detected in their genital tract (OR:3.65, 95%CI:1.62-8.25, P =0.002), the genital tract of their male partner (OR: 6.08, 95% CI: 2.90-12.73, P <0.001) or themouthof theirmalepartner (OR: 8.30, 95%CI: 1.5843.50, P =0.012). In men, the risk of oral infection with a specific HPV type was increased when the same type was detected in the genital tract of their female partner (OR: 7.28, 95% CI: 1.45-36.58, P =0.016) or the mouth of their female partner (OR: 5.43, 95% CI: 0.79-37.06, P =0.084) but not when the same type was present in their own genital tract Conclusion: These findings suggest that in African settings oral HPV infection is acquired from sexual partners, and that in women it may also be the result of self-inoculation