Abstract
BackgroundOur aim was to compare the 12-month incidence and clearance of oral high-risk HPV infection between HIV-infected men who have sex with men (MSM) and HIV-negative MSM.MethodsMSM aged 18 years or older were recruited in Amsterdam, the Netherlands. Questionnaire data and oral-rinse and gargle samples were collected at baseline, and after 6 and 12 months. HPV DNA was genotyped using the SPF10-PCR & DEIA-LiPA25 system (version 1). Determinants of oral HPV incidence and clearance were explored using Cox and logistic regression analyses respectively.Results433 HIV-negative and 290 HIV-infected MSM were included in these analyses. The median follow-up time per participant was 12 months (range 3–15). During follow-up, 114 incident oral high-risk HPV infections were observed. The incidence rate of HPV-16 was 3.5/1000 person-months (PM) in HIV-infected and 0.9/1000 PM in HIV-negative MSM (IRR 4.1; 95% CI 1.3-13.2). The incidence rates of other high-risk HPV types ranged between 1.3-3.5/1000 PM in HIV-infected and 0.0-1.1/1000 PM in HIV-negative MSM. In multivariable analyses, HIV infection (adjusted hazard ratio [aHR] 3.8; 95% CI 2.3-6.2) and a higher number of recent oral sex partners (aHR 2.4 for ≥8 partners compared to ≤2; 95% CI 1.4-4.2) were associated with HPV incidence. Of the 111 baseline oral high-risk infections, 59 (53.2%) were cleared. In multivariable analyses, only a higher number of recent oral sex partners was associated with HPV clearance (adjusted odds ratio 3.4 for ≥8 compared to ≤2 partners; 95% CI 1.3-9.0).ConclusionsThe incidence rate of oral high-risk HPV infection was higher in HIV-infected MSM and in those with a higher number of recent oral sex partners. Just over half of the oral high-risk HPV infections at baseline were cleared after 12 months, with a higher likelihood of clearance among MSM reporting higher numbers of recent oral sex partners, but no difference by HIV status.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0668-z) contains supplementary material, which is available to authorized users.
Highlights
Our aim was to compare the 12-month incidence and clearance of oral high-risk Human Papillomavirus (HPV) infection between HIV-infected men who have sex with men (MSM) and HIV-negative MSM
As HIV-infected MSM are at increased risk of HPV infection and HPV-related head and neck cancer [13,14], our aim was to compare the 12-month incidence and clearance of oral high-risk HPV infection between HIV-infected and HIV-negative MSM participating in the HIV & HPV in MSM (H2M) cohort in Amsterdam, the Netherlands
Incident oral high-risk HPV infection was significantly associated with HIV infection (adjusted hazard ratio 3.8, 95% Confidence interval (CI) 2.3-6.2) and with a higher number of recent oral sex partners among MSM overall
Summary
Our aim was to compare the 12-month incidence and clearance of oral high-risk HPV infection between HIV-infected men who have sex with men (MSM) and HIV-negative MSM. Oral sex is thought to be the most important risk factor of prevalent oral HPV infection, and male gender, increasing age, a higher number of recent or lifetime partners, current smoking and HIVinfection have often been associated with oral HPV infection [3,4,9,10]. Recent data suggest that older age and current smoking could be stronger risk factors for oral HPV persistence than the acquisition [5,8]
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