Six-month incidence and persistence of oral HPV infection in HIV-negative and HIV-infected men who have sex with men.

Sofie H Mooij,Marianne A B Van Der Sande,Chris J L M Meijer,Hein J Boot,Wim G V Quint,Maurits N C De Koning,Arjen G C L Speksnijder,Dominique W M Verhagen,Audrey J King,Anco Molijn,Henry J C De Vries,Maarten F Schim Van Der Loeff,Xuefeng Liu

doi:10.1371/journal.pone.0098955

Abstract

ObjectivesOur aim was to assess incidence and persistence of oral HPV infection in HIV-negative and HIV-infected men who have sex with men (MSM).MethodsMSM aged ≥18 years were included in Amsterdam (the Netherlands) in 2010–2011, and followed up 6 months later. Participants completed risk factor questionnaires. HPV DNA was analyzed in oral-rinse and gargle specimens using the SPF10-PCR DEIA/LiPA25 system (version 1). A subset of oral samples was subjected to SPF10 sequencing to identify additional HPV types. Multivariable logistic regression analyses using generalized estimating equations (GEE) were performed to assess determinants for oral high-risk HPV incidence and persistence.Results689/795 participant MSM provided both baseline and 6-month data. Baseline prevalence of high-risk HPV was 9.4% in HIV-negative and 23.9% in HIV-infected MSM (P<0.001). 56/689 MSM acquired ≥1 high-risk HPV infection (6-month incidence 8.1%; 95%CI 6.2–10.4%); incidence was 4.1% in HIV-negative and 14.1% in HIV-infected MSM (P<0.001). HIV infection and recent use of cannabis were both independently associated with high-risk HPV incidence. Persistent high-risk HPV was observed in 48/130 (36.9%) infections.ConclusionIncidence of oral high-risk HPV infection in MSM is substantial, and is associated with HIV infection. Over a third of HPV infections persisted over a 6-month period.

Highlights

Oral infection with high-risk Human Papillomavirus (HPV), in particular HPV type 16, is associated with a subset of head and neck cancers [1,2,3,4]
Oral high-risk HPV prevalence in the general population is estimated to be around 3.5% [13,14], but is much higher among HIV-infected men who have sex with men (MSM) [10,15], who are known to be at increased risk for HPV-related cancers [16,17]
A report on baseline prevalence of oral HPV and associations with baseline characteristics was published previously [15]; here we focus on the analysis of risk factors for oral high-risk HPV incidence and persistence

Summary

Introduction

Oral infection with high-risk (oncogenic) Human Papillomavirus (HPV), in particular HPV type 16, is associated with a subset of head and neck cancers [1,2,3,4]. Oral HPV infection is thought to be transmitted sexually [10,11,12,13], and higher prevalence has been reported among HIVinfected individuals [10,12]. Oral high-risk HPV prevalence in the general population is estimated to be around 3.5% [13,14], but is much higher among HIV-infected men who have sex with men (MSM) [10,15], who are known to be at increased risk for HPV-related cancers [16,17]. A large study among men observed no independent association between oral sexual behavior and oral high-risk HPV incidence [20]

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