Abstract

Worldwide, 96,000 cases of oropharyngeal cancer (OPC) occurred in 2012. Human papillomavirus (HPV) is a risk factor for OPC. Data on oropharyngeal HPV infection are limited. There is no consensus on the best sampling method for detecting the infection. We describe the prevalence of oropharyngeal HPV infection among HIV-infected men and compare the performance of oral rinses and swabs in detecting oropharyngeal HPV infection. Paired oral rinses and swabs for 181 men were tested for HPV DNA using the Roche Linear Array. Performance was determined by the number of infections detected and the percentage of samples with adequate DNA extraction. Agreement between sampling methods was assessed by the kappa statistic. Prevalence of oropharyngeal HPV infection with rinse samples was 1.8% (three infections) and 0.6% (one infection) with swabs (p = 0.06). Adequate cellular DNA extraction was more likely with rinse (93.4%) than swab samples (89.0%, p = 0.05). There was moderate agreement between the methods (kappa = 0.49). The prevalence of oropharyngeal HPV DNA infection among this predominantly heterosexual sample of men living with HIV was low and consistent with the infrequent oral sex practices. Oral rinse performed better than oral swab in detecting oropharyngeal HPV DNA infection and might contribute to screening for OPCs.

Highlights

  • Worldwide, an estimated 96,000 cases of oropharyngeal cancer (OPC) occurred in 2012,1 with incidence rising over time.[2]

  • Higher oropharyngeal Human papillomavirus (HPV) prevalence in men has been ascribed to men being more likely to smoke, with smoking interfering with mucosal immunity, raising susceptibility to HPV infection

  • The primary aim of the cohort study was to evaluate the natural history of HPV infection and disease in HIV-infected men in South Africa to help inform the selection of HPV prevention interventions in this population

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Summary

Introduction

An estimated 96,000 cases of oropharyngeal cancer (OPC) occurred in 2012,1 with incidence rising over time.[2] The rate of OPCs is about 3–5-fold higher in men than in women.[2] A similar higher rate of OPC in men than in women was reported in South Africa.[3]. Human papillomavirus (HPV) plays an aetiological role in OPCs, with 25–50% of OPCs related to HPV.[1,2]. Oropharyngeal HPV infections mirror the gender patterns of OPCs.[4] Higher oropharyngeal HPV prevalence in men has been ascribed to men being more likely to smoke, with smoking interfering with mucosal immunity, raising susceptibility to HPV infection. Women are more likely to generate antibodies following genital

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