Oral Human Papillomavirus Research Articles

Oral and oropharyngeal high-risk HPV prevalence, HIV status, and risk behaviours in a cohort of South African men who have sex with men.

Data lag is evident when observing studies focussing on human papillomavirus (HPV) prevalence in the head and neck of men who have sex with men (MSM) in Southern Africa. Sexual behaviours other than anal intercourse, and associated factors are similarly underreported. HPV vaccination has not yet commenced for this population group. One hundred and ninety-nine MSM were enrolled in this study. Participants completed a questionnaire followed by a clinical oral examination, and a rinse-and-gargle specimen in Thinprep® vials containing Preservcyt® solution was collected. Detection and genotyping for high-risk HPV were done by an automated system (Abbott® m2000sp). Six percent of MSM in this cohort had high-risk HPV present in the mouth/oropharynx. This cohort averages 29 years of age, more than half were unemployed (53.3%), and 66.8% were human immunodeficiency virus (HIV) seropositive. The most common sexual practice was anal sex (69.4%) followed by oral sex (28.6%), and by rimming (9.6%). A significant association between oral insertive sex and oral/oropharyngeal HPV status was demonstrated (p = 0.0038; phi coefficient = 0.20). An incidental but significant association between rimming and HIV status was found (p = 0.0046; phi coefficient = 0.19), and HIV seropositive participants had higher oral/oropharyngeal HPV presence. The HPV prevalence of 6% reported in this study is in alignment with global reports. The prevalence of oral/oropharyngeal HPV in this MSM cohort was influenced by sexual practices. MSM participants who practiced rimming appear to be at higher risk of HIV acquisition. Given the transmission routes of HPV in this vulnerable population, vaccination must be urgently studied as an intervention for prevention.

Human Papillomavirus infection in oral and anogenital sites: prevalence and rates of concordance

Introduction: HPV infection causes cancer at several anatomical sites. However, the infection’s natural history in non-cervical sites is understudied. Objective: To evaluate oral and anogenital HPV infections, correlating HPV prevalence rates and genotypes with site of infection and risk factors. Methods: In the present study, 351 samples from oral, genital, and anal sites of 117 patients were investigated by using PCR MY09/11 detection, followed by genotyping with RFLP. Results: HPV DNA prevalence was 89.7% (105/117) in genital lesions, 53.8% (63/117) in oral samples, and 58.9% (69/117) in anal samples. Regarding the risk factors associated with HPV in genital lesions, statistically significant rates for oral (p=0.039) and anal sex practices (p=0.0000012) were found. For oral samples, a relevant correlation concerning oral contraceptive use (p=0.039), tobacco smoking (p=0.036), and alcohol use (p=0.0075) were observed; whereas in anal samples, higher risk for HPV infection in patients who reported non-exclusive sexual partners (p=0.013) were found. The presence of viral DNA in all the three sites concurrently was observed in 36.8% of the cases (43/117). Among them, 18% (21/117) presented concordant HPV genotypes, diverging from the literature, and thus corroborating that there is still much to learn about HPV natural history, since different biological behaviors are expected within different populations. Differences in anatomy and physiology of the studied sites can determine different prevalence rates of infection by diverse genotypes. Conclusion: Due to the high prevalence of HPV DNA in extragenital sites, further studies are required to define aspects of HPV natural history among different human anatomical sites.

Natural history of oral HPV infection: Longitudinal analyses in prospective cohorts from Australia.

Oral infection with human papillomavirus (HPV) is likely to underpin the rapidly rising incidence of oropharyngeal squamous cell carcinoma; however, there are few data describing the natural history of oral HPV infection. We recruited 704 participants aged 20 to 70 years from worksites, universities and primary care practices in Brisbane, Australia. Participants completed questionnaires at baseline, 12 and 24 months and donate four saliva samples at baseline, 6, 12 and 24 months for HPV polymerase chain reaction testing and typing. We estimated the prevalence of oral HPV infection at baseline, incidence of new infections among those HPV-negative at baseline, clearance rate and persistent infections. At baseline, 10.7% of participants had oral HPV infections from 26 different HPV types. Sexual behaviours were associated with oral HPV infection, including more partners for passionate kissing (29 or more; odds ratio [OR] 3.4, 95% confidence interval [CI] 1.5-8.0), and giving and receiving oral sex (16 or more; OR 5.4, 95% CI 1.6-17.7 and OR 5.6, 95% CI 1.6-18.7, respectively). Of 343 participants, HPV-free at baseline and with subsequent saliva samples, 87 (25%) acquired new infections over the 24 months. Sixty-eight of 87 people included in the clearance analysis (78%) cleared their oral HPV infections. Clearance was associated with being a nonsmoker (OR 12.7, 95% CI 1.3-122.8), and no previous diagnosis of a sexually transmitted infection (OR 6.2, 95% CI 2.0-19.9). New oral infections with HPV in this sample were not rare. Although most infections were cleared, clearance was not universal suggesting a reservoir of infection exists that might predispose to oropharyngeal carcinogenesis.

Association of oral HPV16 infection with periodontal inflammation and the oral microbiome in older women.

The present preliminary study aimed to investigate the association between oral human papillomavirus type 16 (HPV16) DNA prevalence and periodontal inflammation in older women. The association between oral HPV16 infection and oral health status has not been fully elucidated in older Japanese women. The present study investigated older women aged ≥60 years who visited Hiroshima University Hospital. The present study excluded subjects with clinical factors affecting HPV infection, such as current smoking, oral cancer and pre-malignant lesions, and immunodeficiency. Finally, 46 female patients (mean age, 74.6 years) were analyzed. Quantitative PCR analysis was performed to detect HPV16 DNA in oral rinse samples. A total of 4 participants (8.7%) were HPV16 DNA positive. There was a significant association between the HPV16 DNA positivity rate and bleeding on probing (P=0.03). Additionally, Prevotella intermedia positive cases exhibited a significantly higher HPV16 DNA positivity rate than negative cases (33.3 vs 3.8%). Furthermore, analysis of 16S ribosomal RNA in bacterial flora was performed to examine microbiome diversity in participants with ≥6 mm periodontal pockets and bleeding on probing. Importantly, the average percentage of Porphyromonas was significantly higher in HPV16 DNA positive cases compared with in HPV16 DNA negative cases (5.57 vs. 1.44%). By contrast, the average percentage of Veillonella was significantly lower in HPV16 DNA positive cases than in HPV16 DNA negative cases (2.43 vs. 8.51%). Prevotella was also lower in HPV16 DNA positive cases than in HPV16 DNA negative cases (4.0 vs. 8.23%). These results indicated that people with both deep periodontal pocket inflammation and oral HPV16 infection may not have Prevotella- or Veillonella-dominant oral microbiomes, and their microbiomes may exhibit their own distinctive characteristics. In conclusion, the results suggested that oral HPV16 infection may be associated with periodontal inflammation in older Japanese women. Further research is required to clarify the detailed association between oral HPV infection and the oral microbiome.

Anal and Oral Human Papillomavirus Infection in Men Who Have Sex with Men: Implications for Risk-Targeted Vaccination

Aim: Men who have sex with men (MSM) harbor a significant burden of human papillomavirus (HPV)-related diseases that could be prevented by vaccination. Materials & methods: Prevalence of HPVs targeted by the quadrivalent (4vHPV) and nonavalent vaccines (9vHPV) was assessed in anal (n=443) and oral (n=193) specimens of immunocompetent, sexually active MSM, using the Linear Array. Results: Of the anal samples, 34.1and 46.0% were positive for at least one genotype of those covered by the 4vHPV and 9vHPV, respectively. At least one of the HPVs targeted by the 9vHPV was detected in 5.7% of the oral specimens. Conclusion: The majority of the subjects were not currently infected by HPV-16 and other vaccine-preventable HPVs. Universal HPV vaccination should be strongly promoted in order to achieve protection for all risk groups. In the meanwhile, vaccination should be offered to sexually active adult MSM attendees of sexually transmitted infection centers, although its potential benefit for these subjectsneeds to be further investigated.

High-Risk Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma Among Non-Indigenous and Indigenous Populations: A Systematic Review.

To estimate the prevalence of oral high-risk human papillomavirus (hr-HPV) infection and the proportion of hr-HPV-related oropharyngeal squamous cell carcinoma (OPSCC) among Indigenous and non-Indigenous populations. Electronic database searches of PubMed, PubMed Central, Embase, MEDLINE, Scope, and Google Scholar were conducted for articles published from January 2000 until November 2019. Studies were included with a minimum of 100 cases assessing hr-HPV infection in either population samples or oropharyngeal cancer tumor series. The objective was to conduct meta-analyses to calculate the pooled prevalence of oral hr-HPV infection by adjusting for age group or sex in primary studies, the incidence of OPSCC, and the proportion of hr-HPV-related OPSCC in Indigenous people and non-Indigenous/general populations. We identified 47 eligible studies from 157 articles for meta-analyses. The pooled prevalence of oral hr-HPV infection was 7.494% (95% CI, 5.699%-9.289%) in a general population, with a higher prevalence among men (10.651%) than women (5.176%). The pooled incidence rate was 13.395 (95% CI, 9.315-17.475) and 7.206 (95% CI, 4.961-9.450) per 100,000 person-years in Indigenous and non-Indigenous populations, respectively. The overall pooled proportion of hr-HPV-related OPSCC was 50.812% (95 CI, 41.656%-59.969%). The highest proportion was in North America (60.221%), while the lowest proportion was in the Asia-Pacific (34.246%). Our findings suggest that in the general population, the prevalence of oral hr-HPV infection is lower among females and those in younger age groups. The incidence of OPSCC was higher among Indigenous than non-Indigenous populations, with the proportion being highest in North America.

Oral HPV among people who use crack-cocaine: prevalence, genotypes, risk factors, and key interventions in a remote Northern Brazilian region.

This study estimated the prevalence, genotype distribution, and the factors associated with oral human papillomavirus (HPV) in people who use crack-cocaine (PWUCC) in a remote Brazilian region. This cross-sectional study used community-based snowball sampling methods for participant recruitment. Socio-demographic, economic, drug use, and health-related information was collected from 278 PWUCC in the cities of Bragança and Capanema in northern Brazil. HPV diagnosis and genotyping were performed by a real-time polymerase chain reaction. Logistic regression identified the factors independently associated with oral HPV. In total, 111 (39.9%) PWUCC had HPV DNA. Several genotypes were identified, some of them with high oncogenic potential. Crack-cocaine use ≥40 months, unprotected sex, more than 10 sexual partners in the last 12 months, oral sex, exchange of sex for money or illicit drugs, oral mucosa lesions, not having access to public health services, and the absence of vaccination against HPV was all associated with HPV DNA. This study identified important epidemiological characteristics of oral HPV infection among PWUCC-a highly marginalized risk population-underlining the high prevalence of oral HPV with oncogenic potential and the urgent need for control and prevention measures, especially vaccination against this virus. It is necessary to understand the prevalence and risk factors of oral HPV in risk populations as people who use crack-cocaine.

Factors Associated With Persistence and Clearance of High-Risk Oral Human Papillomavirus (HPV) Among Participants in the HPV Infection in Men (HIM) Study.

BackgroundHuman papillomavirus (HPV)–attributable oropharyngeal cancer (HPV-OPC) incidence is increasing in many high-income countries among men. Factors associated with oral HPV persistence, the precursor of HPV-OPC, are unknown. Data from the HPV Infection in Men (HIM) Study, which followed participants >7 years, were utilized to examine rates of persistence and associated factors.MethodsOral gargle samples from 3095 HIM study participants were HPV genotyped using the SPF10 PCR-DEIA-LiPA25 assay (DDL Diagnostic Laboratory). Oral HPV persistence for individual and grouped high-risk HPV types among 184 men positive for any high-risk HPV at their oral baseline visit was assessed at 6-month intervals. Factors associated with grouped high-risk HPV/HPV16 persistence were examined using logistic regression. Kaplan-Meier curves were constructed to examine median time to HPV clearance overall, and by selected risk factors.ResultsAmong the 7 HPV vaccine types, HPV33 had the longest median duration (7.6 months) followed by HPV16 and HPV45 (6.4 months). 10–30% of oral high-risk HPV infections persisted ≥24 months. Six months’ persistence of oral high-risk HPV infections was positively associated with age and gingivitis and negatively with lifetime number of sexual partners, while 12 months’ persistence was only inversely associated with lifetime number of sexual partners. Oral HPV16 persistence was positively associated with baseline HPV16 L1 antibody status.ConclusionsEighteen percent of HPV16 infections persisted beyond 24 months, potentially conferring higher risk of HPV-OPC among these men. Older age appears to be an important factor associated with oral high-risk HPV persistence. More studies among healthy men are required to understand the progression of oral HPV infection to HPV-OPC.

Differences in Factors Associated With High- and Low-Risk Oral Human Papillomavirus Genotypes in Men.

Human papillomavirus (HPV) causes oral warts and oropharyngeal cancer (OPC). Human papillomavirus-attributable OPC incidence among men is significantly increasing worldwide, yet few studies have reported oral HPV across multiple countries or examined factors associated with low- and high-risk HPV separately. Oral gargles from 3095 men in the multinational HPV Infection in Men (HIM) Study were HPV genotyped. Multivariable models assessed factors independently associated with high-risk and low-risk HPV prevalence. The prevalence of high-risk and low-risk HPV was 6.0% and 2.8%, respectively. Greater number of sexual partners was only associated with high-risk HPV (1.88; 95% confidence interval [CI], 1.22-2.90) prevalence. In multivariable models, residing in Mexico (1.66; 95% CI, 1.15-2.40) and smoking (1.66; 95% CI, 1.13-2.44) were significantly associated with high-risk HPV, and history of consistent gum bleeding (2.16; 95% CI, 1.35-3.45) was significantly associated with low-risk HPV. Gender of the sexual partner did not alter the results for either high- or low-risk HPV endpoints. Different factors were independently associated with high- and low-risk oral HPV. Oral sexual behaviors were associated with high-risk HPV, and oral health was associated with low-risk HPV. High-risk HPV prevalence differed by country of residence, highlighting the need for additional studies in multiple countries.

Human papillomavirus and oral health.

Canada is among the world leaders in oral health. Despite this, there are growing concerns about the rising rates of HPV-related mouth and throat cancers. The link between human papillomavirus (HPV) and cervical cancer is well established; fortunately, thanks to detection and vaccination, Canada has one of the lowest incidence rates of cervical cancer in the world. The HPV-related mouth and throat cancers, however, present a different picture. In Canada, about 25% to 35% of mouth and throat cancers are related to oral HPV infection; and in 2012, the incidence rate of HPV-associated oropharyngeal cancer was more than 4.5 times higher in males than females. Furthermore, HPV vaccination uptake in Canada is higher among females than males. Physicians and nurses in public health and clinical settings have a role to play in the fight against HPV transmission, as do oral health professionals. Oral health professionals can play a key role in preventing HPV infection and HPV-related oropharyngeal cancers by raising awareness, educating and offering counselling to their clients, and promoting evidence-based preventive and diagnostic interventions.

Oral human papillomavirus infection in HIV-infected and HIV-uninfected MSM: the OHMAR prospective cohort study

ObjectiveWe aimed to assess incidence and clearance of oral human papillomavirus (HPV) infection and the respective risk factors in HIV-infected and uninfected men who have sex with men (MSM).MethodsOral rinse...

Twenty years of research on HPV vaccines based on genetically modified lactic acid bacteria: an overview on the gut-vagina axis.

Most cervical cancer (CxCa) are related to persistent infection with high-risk human papillomavirus (HR-HPV) in the cervical mucosa, suggesting that an induction of mucosal cell-mediated immunity against HR-HPV oncoproteins can be a promising strategy to fight HPV-associated CxCa. From this perspective, many pre-clinical and clinical trials have proved the potential of lactic acid bacteria (LAB) genetically modified to deliver recombinant antigens to induce mucosal, humoral and cellular immunity in the host. Altogether, the outcomes of these studies suggest that there are several key factors to consider that may offer guidance on improvement protein yield and improving immune response. Overall, these findings showed that oral LAB-based mucosal HPV vaccines expressing inducible surface-anchored antigens display a higher potential to induce particularly specific systemic and mucosal cytotoxic cellular immune responses. In this review, we describe all LAB-based HPV vaccine investigations by reviewing databases from international studies between 2000 and 2020. Our aim is to promote the therapeutic HPV vaccines knowledge and to complete the gaps in this field to empower scientists worldwide to make proper decisions regarding the best strategies for the development of therapeutic HPV vaccines.

Oral Human Papillomavirus (HPV) and sexual behaviors in a young cohort of oral cancer survivors.

Oral Human Papillomavirus (HPV) and sexual behaviors in a young cohort of oral cancer survivors.

A systematic review and meta-analysis of the association between periodontitis and oral high-risk human papillomavirus infection

The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCCs) is increasing globally. Common oral conditions such as periodontitis may contribute. We undertook a meta-analysis to quantify the association between periodontitis, oral HPV and OPSCCs. Multiple electronic databases were searched until 12 February 2020. Studies conducted in males and/or females aged≥18years that examined periodontitis, periodontal procedures, oral HPV infection, and where possible, oral cancers, were eligible. Meta-analyses were conducted and the GRADE approach was used to examine the quality of evidence. Of 2709 studies identified, 13 met the eligibility criteria. Five studies could be included in the meta-analyses. There was no significant increase in the odds of high-risk oral HPV infection among individuals with confirmed periodontitis (odds ratio 4.71, 95% confidence interval 0.57-38.97). Individuals with periodontitis had a 3.65 times higher odds of having any type of oral HPV infection compared with those without periodontitis (95% confidence interval 1.67-8.01). The overall body of evidence was rated as low to very-low certainty. Meta-analysis confirms there is a positive association between periodontitis and oral HPV infection, although the overall quality of this evidence is low. Evidence for an association between periodontitis and high-risk oral HPV infection is inconclusive.

The prevalence and risk-factors of oral HPV DNA detection among HIV-infected men between men who have sex with men and heterosexual men

Background Human papillomavirus (HPV)-associated oropharyngeal carcinomas are becoming more common with epidemiological impact on human immunodeficiency virus (HIV)- positive individuals. Objective: We evaluated prevalence and risk factors for oral HPV DNA among HIV-infected men who have sex with men (MSM) or heterosexual men. Methods: This cross-sectional hospital-based study included 255 HIV-infected men with different sexual orientation 142 MSM and 113 heterosexual men, who answered a self-administered questionnaire on sociodemographic, clinical and behavioural data. Oral swab and mouthwash samples were analysed by polymerase chain reaction and genotyped by AnyplexTM II 28 (Seegene®). Results: Oral HPV was detected in 17.6% (95% Confidence Interval (CI) 13.5–22.8%), 17.6% in MSM and 17.7% in heterosexual men (p = .984). Multiple HPV infections were detected in 86.7% of HPV-positive men. HPV 56 (13.7%) was the most prevalent high-risk genotype, HPV 66 (7.8%) and HPV 70 (12.3%) were the most prevalent probable HR and low-risk HPV genotypes (12.3% and 7.1%, respectively). At multivariable analysis models, oral HPV was associated with >100 lifetime sexual partners (Odds Ratio (OR) 3.73; 95% CI 1.42–9.77) or lifetime tongue-kissing partners (OR 3.20; 95% CI 1.22–8.39) and lower education level (OR 2.90; 95% CI 1.08–7.78 and 2.74; 95% CI 1.04–7.27, respectively). Conclusions: Oral HPV prevalence was similar between HIV-infected MSM and heterosexual men. Oral HPV was associated with lifetime sexual partners, lifetime tongue-kissing partners and being undergraduate, independently of sexual orientation.

HPV INFECTION ASSOCIATED WITH ORAL CAVITY CANCER

Introduction: The association of herpes papillomavirus (HPV; oncogenic human papillomavirus) with malignant neoplasms of the oral cavity, mainly epidermoid carcinoma, has been evident. Objective: This study aims to identify the repercussions caused by HPV aggregation on oral cavity cancer under the synergistic view of the agents involved. Methodology: Literature review was carried out in the SciELO and PubMed databases. At first, 2 search strategies were used through the MeSH terms HPV AND oral cancer and HPV AND oral infection, thus, 30 articles were found, of which, after applying the inclusion and exclusion criteria, 2 were used. In PubMed, the HPV AND oral cancer strategy was applied and 11 articles were found, of which only 1 was selected. There is also use of other relevant studies on the subject, which add knowledge to the present study. Discussion: Thus, through evaluation and review of articles, there is a relationship between HPV and oral carcinomas, but there is no concrete and quantitative basis for this association. Conclusion: Based on the research, there is evidence of the contribution of HPV in some types of oral carcinomas; however, this theme has been and will be the reason for many research studies. Introduction: The association of herpes papillomavirus (HPV; oncogenic human papillomavirus) with malignant neoplasms of the oral cavity, mainly epidermoid carcinoma, has been evident. Objective: This study aims to identify the repercussions caused by HPV aggregation on oral cavity cancer under the synergistic view of the agents involved. Methodology: Literature review was carried out in the SciELO and PubMed databases. At first, 2 search strategies were used through the MeSH terms HPV AND oral cancer and HPV AND oral infection, thus, 30 articles were found, of which, after applying the inclusion and exclusion criteria, 2 were used. In PubMed, the HPV AND oral cancer strategy was applied and 11 articles were found, of which only 1 was selected. There is also use of other relevant studies on the subject, which add knowledge to the present study. Discussion: Thus, through evaluation and review of articles, there is a relationship between HPV and oral carcinomas, but there is no concrete and quantitative basis for this association. Conclusion: Based on the research, there is evidence of the contribution of HPV in some types of oral carcinomas; however, this theme has been and will be the reason for many research studies.

Viruses and oral diseases in HIV-infected individuals on long-term antiretroviral therapy: What are the risks and what are the mechanisms?

As a result of the extension of life span produced by increasing access to combined antiretroviral therapy, people living with HIV/AIDS (PLWH) face new challenges from comorbidities. Although advances in medical care for HIV infection have dramatically reduced opportunistic infections and AIDS-defining cancers, some non-AIDS-defining cancers (NADC) and specific oral diseases such as periodontitis and salivary gland disease are now more prevalent. Cancer prevention is, therefore, a priority issue in care of PLWH, stressing both restoration of immune function and reduction of non-HIV cancer risk factors (tobacco in all its forms; areca nut; heavy alcohol consumption; diets lacking antioxidant vitamins and minerals; and oncogenic virus infections) through specific interventions, especially tobacco and areca nut cessation and alcohol moderation. Detection of oral high-risk human papillomaviruses (HR-HPV) and the universal preventive HPV vaccination among PLWH should be promoted to reduce the malignancy burden, along with routine oral examinations which remain the cheapest, most reliable, most reproducible, and non-invasive tool to identify suspicious lesions. Also, considerations of oral inflammation and periodontal health are important to replication and gene expression of viruses in the mouth. Considering that a key risk factor for this scenario is the presence of oncogenic virus infection such as several members of the human herpesvirus and human papillomavirus families, here we analyze the variables involved in the seeming increase in comorbidities in PLWH.

Sexual Behavior and High-Risk HPV Infection in the Head and Neck

In the second half of the 20th century, the sexual revolution went hand in hand with changes in common sexual practices. At the turn of the millennium, an increase in the detection rate of HPV-positive oropharyngeal carcinomas (OPC) in the USA was observed for the first time. An increase in the OPC was also observed in Europe. It was shown that this increase was due to HPV-positive OPC. However, the detection rate of the HPV-positive OPC has national and regional differences. Within Europe, the highest detection rate is in Northern Europe (56,5 %), followed by Central Europe (37,6 %). An association between patients with OPC and ≥ 6 sexual partners (OR = 1,25) and ≥ 4 oral sex partners (OR = 2,25) has been described. An HPV infection is usually asymptomatic and eliminated by the immune system within a few months. The persistence of the virus is oncogene. Smoking favors virus persistence, which is why the combination of smoking and oral sex with ≥ 5partners is a particular risk factor. It was also examined whether partners from patients with cervical cancer have an increased oropharyngeal HPV infection rate. There was no definite declaration on this, but further investigations are required. Oral condoms or dental dams are suitable for the prevention of an oral HPV infection. The studies regarding the effectiveness of HPV vaccination for the prevention of an OPC are poor. Authors described a significantly lower detection rate of oral HPV infection in vaccinated people than in non-vaccinated people (0,11 % vs. 1,61 %; p = 0,008).

Concurrent and Concordant Oral and Genital High-Risk Human Papillomavirus in the United States: Results from the National Health and Nutrition Examination Survey.

Oropharyngeal cancers associated with high-risk human papillomavirus (HR-HPV) infection are increasing in the United States, especially among men. We evaluated the prevalence and predictors of concurrent (genital and oral) and concordant (same-type) HR-HPV infections in the United States. We used the National Health and Nutrition Examination Survey from 2009 to 2016. Predictors were assessed via multivariable logistic regression. Among 10 334 respondents, 172 (2.1%) had concurrent infections (109 [3.5%] men and 63 [0.76%] women]. Ninety-three (1.0%) had concordant infections (54 [1.6%] men and 39 [0.5%] women). Predictors of concurrence in men included the following: no longer married versus married (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.3-4.9), living with a partner versus married (3.0; 1.2-7.5), and having 2-5 lifetime oral sex partners (3.0; 1.2-7.5). In women they included the following: no longer married versus married (3.6; 1.3-10.3), ≥2 recent sex partners (4.6; 1.4-15.6 for 2-5 partners and 3.9; 1.1-14.3 for ≥6 partners), and marijuana use (2.2; 1.0-4.5). The predictor of concordance in men and women was no longer married versus married (3.5; 1.2-9.9 in men and 3.2; 1.1-9.4 in women). Concurrent and concordant HR-HPV infections occur at a high rate, especially among men, and are associated with behavioral factors. This underscores the importance of HPV vaccination, screening, and education in men.

Exploring the relationship between oral high-risk HPV infection and sexual behavior among over 400 medical professionals in Japan

ObjectivesThis study investigated the relationship between oral high-risk HPV (HR HPV) infection and sexual behavior in Japanese medical professionals.Materials and methodsWe collected oral specimens and a self–administered questionnaire from 234 men and 171 women.ResultsThe oral HR HPV infection prevalence was 4.7% (95% confidence interval [CI]: 3.0–7.2]) overall, 7.3% (95% CI: 4.6–11.3) for men, and 1.2% (95% CI: 0.3–4.2) for women. The number of sex partners had a significant influence on this prevalence, with variation by type of sexual behavior. The prevalence of oral HR HPV infection was significantly higher (p < 0.0001) among those with more than 20 lifetime overall sex partners (23.8%, 95% CI: 13.5–38.5) or oral sex partners (25.0%, 95% CI: 14.2–40.2). In terms of the number of vaginal sex partners, the prevalence was approximately the same for those with 6–10 (8.3%, 95% CI: 3.9–17.0), 11–20 (11.1%, 95% CI: 5.2–22.2), or more than 20 (11.5%, 95% CI: 4.0–29.0) partners (p = 0.0043). Furthermore, dividing the number of vaginal and oral sex partners into four categories (both>5, only vaginal>5, only oral>5, and both≤5), the infection prevalence was significantly higher when both vaginal and oral sex partners were more than five (12.5%, 95% CI: 7.7–19.6). The prevalence was also higher for those who had more oral than vaginal partners, compared with other groups (13.5%, 95% CI: 6.7–25.3).Conclusions and clinical relevanceOral HR HPV infection in Japan seems to be influenced by sexual behavior, and preventive health efforts such as vaccination and health education should be implemented.