Abstract
Background The main objective of this study was to estimate the prevalence of human papillomavirus-DNA (HPV-DNA) in the saliva of sexually active women with HPV-related cervical intraepithelial neoplasias (CIN) and compare the findings with a healthy control group. The secondary objectives were: 1) to determine the concordance between genital and oral HPV types in sexually active women with HPV-related CIN; 2) to analyze whether sexual habits influence the presence of HPV-related CIN; 3) to determine whether sexual habits influence the presence of oral HPV. Material and Methods Saliva samples were collected from 100 sexually active women, 50 with HPV-related CIN and 50 healthy subjects presenting normal cytology. PCR assay was used to detect HPV-DNA. Results The prevalence of oral HPV infection in saliva samples was 14% in women with HPV-related CIN, while in the healthy group it was 12%, without statistically significant difference (p =0.766). As for the concordance between genital and oral HPV types in women with HPV-related CIN, concordance was only observed for HPV-16, whereby among 22 women with genital HPV-16, only one (4.54%) also presented oral HPV-16. Regarding the possible influence of sexual habits on the presence of cervical pathology and presence of oral HPV, it was found that marital status, age at first intercourse, number of lifetime sexual partners, and condom use are related with the presence of cervical pathology (p<0.001; p=0.017; p=0.002; and p <0.001, respectively); condom use was also found to be related to the presence of oral HPV (p<0.001). Conclusions The prevalence of HPV-DNA in the saliva of sexually active women with HPV-related CIN is similar to healthy women. The concordance between genital and oral HPV types is low. Both the presence of cervical pathology and the presence of oral HPV are related to sexual habits. Wider sample size is required to confirm this results. Key words:Cervical intraepithelial neoplasias, HPV, saliva, cervix, cancer.
Highlights
Cervical cancer is the second most common cancer among women around the world, and is more frequent (>85% of cases) in developing countries [1]
A higher percentage of women with human papillomavirus (HPV)-related cervical intraepithelial neoplasias (CIN) were single or not in a stable couple relationship (88% compared with 34% of control subjects), had had >4 children (16% compared with 4%), had had their first sexual intercourse aged ≤16 years (30% compared with 10%), had had a number of lifetime sexual partners ≥2 (98% compared with 60%), practiced oral-to-genital sex (92% compared with 70%), had had some sexually transmitted infection (16% compared with 4%), and a lower percentage of women in this group used condoms (34% compared with 74%); with statistically significant differences (p
The main aim was to estimate the prevalence of HPVDNA in the saliva of sexually active women with HPVrelated CIN compared with a healthy control group
Summary
Cervical cancer is the second most common cancer among women around the world, and is more frequent (>85% of cases) in developing countries (mainly Asia, Africa, and South America) [1]. There has been a rise in the frequency of oral-to-genital sex, which, in the U.S.A. is more common among Whites (75%), followed by Hispanics (63%), and Afro-Americans (62%) [11] These changes in sexual habits have increased the risk of infection by HPV, genitally and in the oral cavity with particular tropism in the lymphoid tissues, especially the epithelium coating the tonsillar crypts and the base of the tongue that form part of the Waldeyer ring. Increased incidence of oropharyngeal carcinoma in recent years, in the amigdala and the base of the tongue [13], in addition to the fact that research has linked HSCNN to HPV, especially HPV-16 [14,15], might suggest that sexually active women with HPV-related genital lesions are at greater risk of presenting some type of HPV in the oral cavity.
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