Oral Human Papillomavirus Research Articles

Oral Human Papillomavirus Infection among Smokeless Tobacco-using Tribal Women in Mysuru, India.

Smokeless tobacco (SLT) is consumed by more than 300 million people worldwide. Studies show high use among Indian indigenous women who are also at high risk for oral cancers. Both human papillomavirus infection (HPV) and SLT have been associated with oral cancer, this study examined the presence of high-risk HPV in oral samples collected from tribal smokeless tobacco users in Mysuru, India. Between June and August 2019, 100 tribal females (50 SLT-users and 50 non-users) from rural Mysuru District, Karnataka, were enrolled in a cross-sectional study. Following informed consent, demographic data and oral samples were collected and processed using a digene HC2 High-Risk HPV DNA test (Qiagen, USA). On average participants were 45.5 (SD: ±6.6) years. Chronic SLT users were mostly married (73%), Hindu (100%), illiterate (62%), and employed (90%). One woman was positive for high-risk HPV infection. Oral HPV infection was low in this sample and this is consistent with the literature from other low and middle-income countries. SLT use is high in this group so interventions to reduce tobacco use are warranted.

Prognostic significance of HPV16 infection in oral squamous cell carcinoma

Background/Aim: Many studies confirmed strong association between oncogenic genotypes of Human Papillomaviruses (HPVs) and some oropharyngeal and oral squamous cell carcinomas (OSCCs). The aim of this study was to determine the prognostic significance of HPV16 infection in OSCC in population of Montenegro i.e. correlation between HPV16 infection and disease free interval (DFI), disease recurrence and metastasis occurrence. Material and Methods: We examined surgically obtained specimens from 60 patients with OSCC (localized on the lower lip, tongue or/and floor of the mouth) in six years period. Tumor tissue samples were used for histological analysis and HPV16 genome PCR detection (primers for detection of E6 gene). Patients were followed up for the 3 years. Results: HPV16 infection was more commonly detected in females with OSCC (p=0.038), while no correlation between this infection and disease recurrence (p= 0.122) and/or metastasis occurrence (p= 0.934) was found. DFI was not significantly different between patients with or without HPV16 infection (p= 0.427), but DFI was significantly shorter (p= 0.003) in females with oral HPV16 infection compared to male patients with this infection. Conclusions: Counting that HPV16 infection has a negative prognostic significance in OSCC, the HPV immunization program against genital HPV infection, would also have a positive impact on the frequency of HPV-mediated OSCC in Montenegrin population.

Prevalence and concordance of oral and genital HPV by sexual orientation among US men.

The objective of our study was to describe oral and genital human papillomavirus (HPV) infection prevalence and concordance by sexual orientation among US men using a nationally representative sample. We conducted a retrospective cross-sectional analysis of the 2013-2016 National Health and Nutrition Examination Survey. The survey conducts a physical examination and collects oral rinse and genital swab specimens; demographic and health behaviors are self-reported. We used descriptive statistics and multivariate regression models to estimate HPV infection prevalence and the likelihood of HPV infection, respectively. All analyses were adjusted for National Health and Nutrition Examination Survey design and weights, and statistical significance was tested at a 2-sided P value of less than .05. Men who have sex with men had a statistically significantly higher prevalence of oral HPV (high-risk, 9-valent, 4-valent, and HPV 16 and 18), genital HPV (9-valent, 4-valent, and HPV 16 and 18), and concordant oral and genital HPV (high-risk and 9-valent) infections compared with heterosexual men. Improved HPV prevention among men is needed.

Role of oral microbiome in oral oncogenesis, tumor progression, and metastasis.

Squamous cell carcinoma is the most common malignant tumor of the oral cavity and its adjacent sites, which endangers the physical and mental health of patients and has a complex etiology. Chronic infection is considered to be a risk factor in cancer development. Evidence suggests that periodontal pathogens, such as Porphyromonas gingivalis, Fusobacterium nucleatum, and Treponema denticola, are associated with oral squamous cell carcinoma (OSCC). They can stimulate tumorigenesis by promoting epithelial cells proliferation while inhibiting apoptosis and regulating the inflammatory microenvironment. Candida albicans promotes OSCC progression and metastasis through multiple mechanisms. Moreover, oral human papillomavirus (HPV) can induce oropharyngeal squamous cell carcinoma (OPSCC). There is evidence that HPV16 can integrate with host cells' DNA and activate oncogenes. Additionally, oral dysbiosis and synergistic effects in the oral microbial communities can promote cancer development. In this review, we will discuss the biological characteristics of oral microbiome associated with OSCC and OPSCC and then highlight the mechanisms by which oral microbiome is involved in oral oncogenesis, tumor progression, and metastasis. These findings may have positive implications for early diagnosis and treatment of oral cancer.

Abstract A002: Logistical issues in implementing a clinical trial on oral cancer prevention through HPV vaccination: Implementation of Ulacnet201 in Mexico

Abstract This poster describes logistical issues related to implementing a randomized, double- blinded, placebo-controlled Phase III interventional trial on the nine-valent HPV vaccine (9vHPV) among cisgender men and transgender women living with HIV, at the Mexico site. The trial seeks to demonstrate that 9vHPV reduces the incidence of persistent oral HPV infection (a surrogate for HPV-associated oropharyngeal cancer) with the 9 vaccine types. Five-hundred participants will be randomized in a 1:1 allocation to receive 9vHPV or placebo, stratified based on clinical site (Brazil, Mexico, Puerto Rico) and age. The team invites potential participants through local community organizations and public HIV clinics. People may be invited when waiting in line in the morning to get laboratory testing done, when they have an appointment for HIV care or through their treating physician or a community organizer. Initially, we worked at a single HIV clinic, although we did distribute study flyers to treating physicians at other clinics. As of mid-2022 we began enrolling at two additional clinics. Participants are prescreened when initially invited or by phone to prevent unnecessary trips for those ineligible. Once prescreened, participants are given an appointment for their first study visit; reminders about their first or other study visits are sent by text message 2-3 times before the appointment. Participants are provided with financial compensation in cash at each visit. We have implemented both study-wide mechanisms and additional locally-designed strategies and forms to guarantee quality control. For example, registering participant issues, study agent trail and persons invited, pre-screened and enrolled (including reasons for exclusion). Data is registered on paper forms and in a bespoke data base program (DatStat, designed at Moffitt Cancer Center). DatStat carries out the randomization (only the Mexico site pharmacist is unblinded) and requires a wireless internet connection, which can sometimes fail even though a router is installed by the study at each clinic. Vaccine and syringe importation can be time consuming and cause enrollment delays, given the need to acquire permissions for importation or problems getting the shipment out of Customs. Making sure shipments go through an airport with better functioning Customs offices is also important. Citation Format: Betania Allen-Leigh, Alejandra Portillo-Romero, Manuel Quiterio, Maribel Acosta, Abraham Rivera- Ramirez, Guillermina Sanchez, Aurelio Cruz, Tonatiuh Barrientos, Carlos Magis, Kimberly Isaacs-Soriano, Martha E. Abrahamsen, Margaret House, Emma Brofsky, Vikrant Sahasrabuddhe, Timothy Wilkin, Anna Giuliano, Luisa Villa, Eduardo Lazcano-Ponce. Logistical issues in implementing a clinical trial on oral cancer prevention through HPV vaccination: Implementation of Ulacnet201 in Mexico [abstract]. In: Proceedings of the Second Biennial NCI Meeting: Translational Advances in Cancer Prevention Agent Development (TACPAD); 2022 Sep 7-9. Philadelphia (PA): AACR; Can Prev Res 2022;15(12 Suppl_2): Abstract nr A002.

Oral human papilloma virus infection among dental clinic attendees in Ibadan, Nigeria.

Human papilloma virus (HPV) is associated with a subset of oropharyngeal squamous cell carcinoma and mouth or throat warts. However, there is currently limited information about oral HPV infections in Nigeria. This study aimed to provide information on the occurrence and circulating genotypes of HPV among patients attending three (one government and two private) dental clinics in Ibadan, Nigeria. An oral swab was collected from 231 dental clinic attendees in Ibadan between January 2016 and March 2017 and tested for HPV DNA by polymerase chain reaction targeting the E6/7 genes of the virus. Twenty-three of the 231 swab samples were HPV DNA positive comprising 16 mono-infections and seven co-infections in 13 males and ten females. Genotype 16 was present in ten patients, genotype 6/11 in five, Genotype 18 and genotype 33 in four each, genotype 31 in three and genotype 39 in one. Twenty-one cases were high-risk HPV genotypes, while two were low-risk. Samples had co-infection and five had low risk type 6/11 either as single or as co-infection. Persons who had engaged in oral sex as well as those aged 21-30 years has significantly higher prevalence. This study showed that although HPV genotype 16 is the most common type among dental clinic attendees in Ibadan, other genotypes are also circulating and that oral sex is a risk factor for the infection. Therefore, introducing a multivalent HPV vaccine will reduce the risk of HPV-associated oropharyngeal carcinoma and other cancers in Nigeria.

Peripheral Blood T-lymphocyte Phenotypes in Mother-Child Pairs Stratified by the Maternal HPV Status: Persistent HPV16 vs. HPV-Negative: A Case-Control Study.

Only few studies exist on the phenotype distribution of peripheral blood lymphocytes concerning persistent oral HPV infection. T-lymphocyte subsets were phenotyped in women who had persistent genital or oral HPV16 infection, using HPV-negative women as a reference group. A subset of 42 mothers and their children (n = 28), were stratified into two groups according to the mothers' HPV status. PBMCs from previously cryopreserved venous samples were immunophenotyped by flow cytometry. Proportions of the CD4+ or CD8+ lymphocytes by their immunophenotype subsets were compared between HPV-positive and -negative mothers and their children. The mean rank distribution of CD8+ memory cells was significantly higher among mothers with persistent genital HPV16 infection. The median levels of both the antigen-presenting CD4+ cells and activated CD8+ cells were significantly lower in mothers with persistent oral HPV16 infection. When oral and genital HPV16-persistors were analyzed as a group, a marker of terminal effector cells was significantly increased as compared to HPV-negative women. Significantly higher levels of activated CD4+, CD8+ and circulating CD8+ memory cells were found among children whose mothers had persistent oral HPV16 infection. Persistent HPV16 infections are associated with changes in peripheral blood T-lymphocyte subsets. The mother's persistent oral HPV16 infection possibly results in immune alterations in her offspring.

Longitudinal Dynamics of HPV16 Antibodies in Saliva and Serum among Pregnant Women.

Oral infections with high-risk (hr)HPV genotypes are associated with a subset of head and neck squamous cell carcinomas. Oral hrHPV infections may result from having oral sex, but also from horizontal infection from mouth to mouth. In such cases, saliva can serve as a vehicle for HPV transmission. Still, the prevalence and dynamics of salivary HPV antibodies in healthy non-vaccinated individuals are poorly known and the role of the salivary antibodies in protection from oral HPV infection is unclear. We used an ELISA assay to evaluate the dynamics and correlation of oral HPV16 infection and HPV16L1 and E7 specific antibody levels in saliva and serum samples among 39 women, 13 of which had persistent oral HPV16 infection. The women were mothers-to-be, sampled before delivery and followed up for 36 months postpartum. HPV16L1 IgG and sIgA antibodies were regularly detected in saliva. Antibody levels in serum remained stable during the 36-month follow-up, while antibody levels in saliva fluctuated. There was considerable individual variation in salivary HPV16L1 antibody levels, and some women had persistent oral HPV16 infection but no salivary antibodies. No differences in salivary HPV16L1 levels were found between the women with persistent or transient oral HPV16 infection.

Impact of HPV vaccination on HPV-related oral infections

BackgroundHuman papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Although the efficacy of the HPV vaccine in preventing the development of cervical pre-malignant lesions has been well demonstrated, the efficacy of the HPV vaccine in preventing HPV infection in the upper respiratory tract has been poorly studied. MethodsIn the context of the IARC cohort study of two versus three doses of HPV vaccine in India, we compared the HPV type prevalence in the oral cavity of women vaccinated with three doses, two doses, or a single dose of quadrivalent HPV vaccine with that of unvaccinated women. A total of 997 oral samples, from 818 vaccinated women and 179 unvaccinated women, were collected at three study sites. All the participants were sexually active at the time of sample collection. ResultsThe age-standardized proportion (ASP) of HPV16/18 infections was 2.0 % (95 % CI, 1.0–3.0 %) in vaccinated women and 4.2 % (95 % CI, 1.2–7.2 %) in unvaccinated women. HPV16 was detected in 3.5 % of single-dose recipients, 1.2 % of two-dose recipients (days 1 and 180), and 1.5 % of three-dose recipients (days 1, 60, and 180), whereas 3.3 % of the unvaccinated women tested positive for HPV16. The same trend was observed for HPV18. DiscussionOur findings agree with those of previous studies on the efficacy of HPV vaccination in reducing oral HPV infections and provide indications that a single vaccine dose may be less efficient than two or three doses in preventing oral HPV infection.

Characterization of oral microbiota in HPV and non-HPV head and neck squamous cell carcinoma and its association with patient outcomes

ObjectiveTo investigate the interplay among the oral microbiota, HPV infection, traditional risk factors and patient outcomes in head and neck squamous cell carcinoma (HNSCC). Materials and MethodsA multi-center study of HNSCC patients with paired tumor and control tissues. We characterized the oral microbiota and HPV infection of tissues in 166 Chinese adults by sequencing the bacterial 16S rRNA V3-V4 and HPV L1 regions, respectively, and examined the associations among the oral microbiota, HPV and clinical features. ResultsA total of 15.7% of the surveyed HNSCC patients were positive for HPV DNA, with infection rates varying from 66.7% in oropharyngeal SCC to 10.4% in oral cavity SCC (OSCC). No HPV infection was detected in the surveyed hypopharyngeal SCC. HPV16 was largely the predominant type. HPV infection in non-OSCC, especially oropharyngeal SCC, was associated with advanced N stage and superior survival outcomes. Oral microbiota dysbiosis was observed in HNSCC tumors, with differentially abundant taxa mainly associated with HNSCC subtype, T stage, survival/relapse, HPV infection, and smoking. Notably, the enrichment of Fusobacterium in tumor tissues of OSCC patients was associated with no smoking, early T stage, early N stage, and better 3-year disease-specific survival. ConclusionOur findings underscore the involvement of oral microbiota dysbiosis in OSCC pathogenesis, Fusobacterium is involved with improved OSCC patient outcomes, especially in patients lacking traditional risk factors. Understanding the complex interactions among the oral microbiota, HPV infection and other risk factors for HNSCC will provide important insights into the pathogenesis of HNSCC.

Prevalence of oral HPV in the adult sample population in Sydney.

Oropharyngeal squamous cell carcinomas are increasing in incidence. Risk factors include sexual behaviour, high-risk oral HPV infection and poor oral hygiene. We aimed to provide initial information on the prevalence and assess the feasibility of testing in dental settings. Patients ≥18 years old attending dental clinics in Sydney, Australia, were recruited, oral hygiene assessed, and 10 mL saline oral rinses obtained. Rinses were tested for HBG and HPV by PCR. Participants completed demographic and behavioural questionnaires. The mean age was 48 years, of whom 131 (43.6%) were male. HPV genotypes, one each of 16, 66, 51, 35 and 58 in five participants, and 18 and 52 in one participant, were detected in six samples (2.0%), all men. Oral sex was reported by 89 (67.9%) male participants. One participant (4.3%) of the 23 with poor OH had at least one HPV genotype detected. With dental patients willing to provide rinse samples and disclose potentially sensitive information, we found the hrHPV prevalence of 2%. Given large proportions of the general population attending dental clinics regularly, dentists may be ideally placed to screen for oropharyngeal carcinoma and contribute to the currently limited knowledge of oral HPV prevalence in Australian adults. © 2022 Australian Dental Association.

ORAL WARTS IN A PEDIATRIC PATIENT WITH TRISOMY 21 SUCCESSFULLY TREATED WITH HUMAN PAPILLOMAVIRUS VACCINE

<h3>Introduction</h3> Trisomy 21 is associated with immune dysregulation through overexpression of interferon genes on chromosome 21, affecting innate and humoral immunity. Patients with Trisomy 21 have high rates of infections, notably of the respiratory tract as well as otitis media and periodontal disease. We present the case of a 5-year-old male with Trisomy 21 with extensive oral warts successfully treated with Recombinant Human Papillomavirus vaccination. <h3>Case Description</h3> A 5-year-old male with Trisomy 21, atrioventricular canal defect, asthma, and obstructive sleep apnea was referred to Pediatric Allergy and Immunology for evaluation of numerous oral cutaneous warts refractory to treatments including cimetidine and topical compounded cidofovir. Biopsy revealed HPV positivity with low-risk strains, 6 and 11. The patient received 2 doses of 9-valent Human Papillomavirus vaccine, which includes strains 6 and 11, with near complete resolution and no appreciated side effects. <h3>Discussion</h3> To our knowledge, this is the first case of the treatment of oral HPV with HPV vaccine in a pediatric patient with Trisomy 21. Presently, the 9-valent recombinant HPV vaccine is approved for ages 9-45. A review of the literature highlights the use of the quadrivalent vaccine in HIV-positive children ages 7-12, however it is not routinely given in younger patients with primary immunodeficiency. One prior case report detailed the successful treatment of recurrent laryngeal papillomatosis in a healthy 2-year-old. Our case demonstrates a clear immune response as elicited by the resolution of his warts and highlights the potential for expanded use of HPV vaccination in pediatric patients with immune dysregulation.

Trend Analysis of Global Web Searches (2004–2022) on Oral Cancer and Its Major Risk Factors

Abstract Background Oral cancer is the 15th leading cause of mortality globally. The Internet is an online source of information pertaining to oral cancer and its major risk factors. This study aims to analyze the trend of global online interest on oral cancer and its major risk factors through an analysis of web searches of oral cancer. Materials and Methods This study analyzed the web searches conducted, from 2004 to January 2022, on oral cancer and its major risk factors (tobacco use, harmful alcohol use, and human papillomavirus [HPV] infection) using data obtained from Google Trends. Results Within the time frame under study, oral cancer had multiple peak search periods, with the highest relative search volume index (SVI) for a period being 1; the peak search period for alcohol was March 2020 (SVI = 100); the peak search periods for tobacco were March to April 2004 (SVI = 17); and the peak search period of HPV was April 2004 (SVI = 1). Globally, alcohol was the most common searched term among these four terms (oral cancer, alcohol, tobacco, and HPV) except in Turkey where tobacco was the most common (55%) searched term. The top 25 search queries for oral cancer, HPV, tobacco, and alcohol had SVI ranges of 22 to 100, 12 to 100, 28 to 100, and 18 to 100, respectively. From these search queries, it was observed that people have interest in oral cancer symptomatology, and the adverse effects of tobacco, alcohol, and HPV. Conclusion This study revealed an overall decline in the online interest on oral cancer and its major risk factors on a global scale.

Epidemiological Review: Esophagus Squamous Cell Carcinoma in India

AbstractWorldwide the incidence of esophagus squamous cell carcinoma (ESCC), remains one of the most common causes of cancer death. ESCC is one of the leading types of cancer in the North and Northeast regions of India among both genders. Risk factors of ESCC include tobacco, alcohol, areca nut, hot beverages, low fruit diet, poor oral hygiene, unpiped water, and human papillomavirus infection. This review tries to elaborate on various modifiable risk factors for ESCC, which have been studied worldwide and need to be studied in India. PubMed was used as a search platform using keywords, such as “esophagus cancer,” “esophagus squamous cell carcinoma,” “epidemiology,” “India,” “incidence,” “mortality,” “risk factors,” “treatment,” “survival,” “prevention” and their corresponding Medical Subject Heading terms, were used in combination with Boolean operators “OR” and “AND.” Studies from India are mostly hospital-based case-control studies from the North region. Further research is required in India to understand the etiology, to design large-scale screening and prevention strategies.

Prevalence and Genotyping of HPV in Oral Squamous Cell Carcinoma in Northern Brazil.

Highly oncogenic human papillomavirus (HPV) is well known to be associated with and a risk factor for various types of oral carcinomas such as oral squamous cell carcinoma (OSCC). The aim of this study was to evaluate and describe the HPV-induced OSCC prevalence and genotyping in the city of Belém, northern Brazil. This cross-sectional study features 101 participants who attended an oral pathology referral center in a dental college looking for diagnoses of oral lesions (OL). After signing the consent term and meeting the inclusion criteria, all participants went through a sociodemographic and epidemiological questionnaire. Then, OL were collected by excisional or incisional biopsy depending on OL size; after that, OL tissues were preserved in paraffin blocks to histopathological diagnoses. Afterwards, paraffin blocks were divided into benign and malignant/premalignant lesions based on the classification of potentially malignant disorders of the oral and oropharyngeal mucosa. Then, the paraffin blocks had DNA extraction performed by the ReliaPrep FFPE gDNA Miniprep method in order to identify HPV DNA of high oncogenic risk and low oncogenic risk. Then, the viral DNA was amplified and typed using the Inno-Lipa genotyping Extra II method, and the collected data were analyzed by Chi-square and G-tests. In total, 59/101 (58.4%) OL were malignant/premalignant lesions, of which OSCC was the most prevalent with 40/59 (67.7%) and 42/101 (41.6%) benign lesions. The most common area of OL incidence was upper gingiva 46/101 (45.5%). Regarding HPV DNA detection, approximately 27/101 (26.7%) had positive results; of these, 17/59 (28.8%) were malignant/premalignant lesions, and the most prevalent genotypes detected were 16, 18, 52 and 58, while among benign lesions, 10/42 (66.6%) had HPV-positive results, and the most prevalent genotypes detected were 6, 11 and 42. Age range was the only risk factor with a significant association between HPV and OSCC presence (p-value: 0.0004). A correlation between OSCC and oral HPV among analyzed samples could not be demonstrated in our small cohort.

A clinician’s dilemma: what should be communicated to women with oncogenic genital HPV and their partners regarding the risk of oral viral transmission?

Head and neck cancer, the sixth most common cancer worldwide, account for about 1 out of 20 malignant tumors. In recent years a reduction in the incidence of cervical cancer, but a concomitant major increase in the incidence of HPV-mediated oropharyngeal cancer caused by orogenital HPV transmission has been observed. Consequently, in wealthy countries oropharyngeal squamous-cell carcinomas (OPSCC) is now the most frequent HPV-related cancer, having overtaken cervical cancer. Without effective medical interventions, this incidence trend could continue for decades. As no specific precursor lesion has been consistently identified in the oral cavity and oropharynx, HPV vaccination is the logical intervention to successfully counteract also the rising incidence of OPSCCs. However, HPV vaccine uptake remains suboptimal, particularly in males, the population at higher risk of OPSCC. Alternative primary prevention measures, such as modifications in sexual behaviors, could be implemented based on knowledge of individual genital HPV status. Until recently, this information was not available at a population level, but the current gradual shift from cytology (Pap test) to primary HPV testing for cervical cancer screening is revealing the presence of oncogenic viral genotypes in millions of women. In the past, health authorities and professional organizations have not consistently recommended modifications in sexual behaviors to be adopted when a persistent high-risk HPV cervicovaginal infection was identified. However, given the above changing epidemiologic scenario and the recent availability of an immense amount of novel information on genital HPV infection, it is unclear whether patient counseling should change. The right of future partners to be informed of the risk could also be considered. However, any modification of the provided counseling should be based also on the actual likelihood of a beneficial effect on the incidence of HPV-associated oropharyngeal cancers. The risk is on one side to induce unjustified anxiety and provide ineffective instructions, on the other side to miss the opportunity to limit the spread of oral HPV infections. Thus, major health authorities and international gynecologic scientific societies should issue or update specific recommendations, also with the aim of preventing inconsistent health care professionals’ behaviors.

Prevalence of oral and anal human papillomavirus infection in Czech predominantly HIV-positive men having sex with men - data from a previously unreported population.

HIV-positive men who have sex with men (MSM) are more likely to experience human papillomavirus (HPV) infection. The persistent HPV infection is the major factor in the development of anal and oropharyngeal neoplasms. Data on the prevalence of anal and oral HPV in MSM are almost absent from the countries of Central and Eastern Europe. We conducted a cross-sectional study focused on the prevalence of oral and anal HPV infections and the relationship between current anal and oral HPV intrapersonal infection in a Czech population of predominantly HIV-positive MSM. Oral gargle and anal swab samples from 205 predominantly HIV-positive MSM from the Czech Republic were analysed for HPV infection using PCR. Selected sociodemographic and clinical data were correlated with HPV detection using generalized linear models and multivariate analysis. HPV infection was detected in 183 (96.8%) anal and 48 (23.6%) oral samples. The most common type of HR-HPV was HPV16 in both anal (25.4%) and oral (2.5%) samples. Multiple anal HPV infections and the presence of vaccine-targeted HR-HPV types were significantly correlated with abnormal anal cytology and HIV status. The prevalence of anal HPV infection in Czech predominantly HIV-positive MSM ranks among the highest reported, while oral HPV prevalence is consistent with MSM populations. Minimal overlap of oral and anal HPV types within a patient was observed.

High-risk Human papillomavirus 16/18 in oral mucosa and cervix of sexually active women: A comparative pilot study using conventional nested PCR and an in-house real-time PCR

BackgroundHuman papillomavirus (HPV) is known to be associated with both cervical and oropharyngeal cancers, yet little are known about the co-occurrence of similar HPV subtypes in these subsites. With the changing sexual behaviour it is necessary to evaluate the risk of a woman with abnormal cervix developing cancer of the oropharynx. A study evaluating HPV infection in both oral mucosa and the cervix is therefore needed to understand the co-occurrence of HPV infection in 2 different sites MethodsOral mucosa and cervical wash specimens were collected from a total of 100 women aged 20-60 years who visited for routine Pap test. DNA was extracted and then subjected to an in house real-time PCR and conventional nested PCR for the detection high risk HPV 16/18 subtypes. A limit of detection was established using serially diluted HPV positive DNA from cell lines and the sensitivity and specificity of both the assays were evaluated ResultsThe prevalence of HPV-16/18 in the cervical samples (19.7% vs 6.2%) and the oral mucosa (16.6% vs nil) were higher as detected by our in house real-time PCR in comparison to the conventional nested PCR. Oral HPV infection was found in 25% of the women with SCC of the cervix ConclusionDue to the changing sexual behaviour there is a possibility that women with HPV-related cervical lesions can easily transfer the virus to the partner or even self-inoculate which might lead to the development of lesions in the head & neck turning into cancer.

Oral Papillomatosis: Its Relation with Human Papilloma Virus Infection and Local Immunity—An Update

Oral papilloma lesions may appear as a result of HPV infection, or not, and only special molecular methods could differentiate them. Low-risk and high-risk HPV types could induce oral HPV papillomatosis with different natural evolution, clearance and persistence mechanisms. The pathogenic mechanisms are based on the crosstalk between the oral epithelial and immune cells and this very efficient virus. HPV acts as a direct inducer in the process of transforming a benign lesion into a malignant one, the cancerization process being also debated in this paper. According to the degree of malignity, three types of papillomatous lesions can be described in the oral cavity: benign lesions, potential malign disorders and malignant lesions. The precise molecular diagnostic is important to identify the presence of various virus types and also the virus products responsible for its oncogenicity. An accurate diagnostic of oral papilloma can be established through a good knowledge of etiological and epidemiological factors, clinical examination and laboratory tests. This review intends to update the pathogenic mechanisms driving the macroscopic and histological features of oral papillomatosis having HPV infection as the main etiological factor, focusing on its interreference in the local immunity. In the absence of an accurate molecular diagnostic and knowledge of local immunological conditions, the therapeutic strategy could be difficult to decide.

Prevalence of genital and oral human papillomavirus infection among psoriasis patients on biologic therapy.

Current knowledge about human papillomavirus (HPV) infection in psoriasis patients treated with biologics is limited. In this study we evaluated the prevalence of oral and genital HPV infection in psoriasis patients treated with biologics or topical therapy for at least 6 months. The presence of HPV DNA in oral rinse and genital smears was evaluated. In total, 267 patients who met the inclusion criteria and agreed to participate were enrolled: 110 (41.2%) on topical therapy, 84 (31.5%) on anti-TNF-alpha therapy, 31 (11.6%) on anti-IL-12/23 therapy and 42 (15.7%) on anti-IL-17 therapy. The presence of genital HPV infection was detected in 34.6% of men receiving anti-TNF-α treatment, in 25.0% of patients on anti-IL-12/23 and 18.8% of patients on anti-IL-17 therapy. The difference in prevalence was not statistically different from men on topical treatment (26.3%). Prevalence of oral HPV infection was higher across all of the biologic groups (11.9% for anti-TNF-α, 12.9% for anti-IL-12/23 and 19.0% for anti-IL-17) compared to patients on topical therapy (7.3%), but statistically significant only for anti-IL-17 (p < 0.05). The presence of oral HPV infection in patients treated with biologics was significantly higher (44.0%) in patients on long-term biologic treatment (>8 years) compared to patients taking biologics for a shorter period (9.1%; p < 0.01). Our results suggest that patients on biologics for psoriasis have a higher prevalence of oral HPV infection compared to patients on topical treatment. Long-term treatment with biologics seems to be associated with a higher prevalence of oral HPV infection, independent of previous conventional immunosuppressive therapy.