Risk factors for oral HPV infection among a high prevalence population of HIV-positive and at-risk HIV-negative adults

Daniel C. Beachler, Kathleen M. Weber, Joseph B. Margolick, Howard Strickler, Ross D. Cranston, Robert D. Burk, Dorothy J. Wiley, Howard Minkoff, Susheel Reddy, Emily E. Stammer, Maura L. Gillison, Gypsyamber D'Souza

Research output: Contribution to journalArticle

119 Citations (Scopus)

Abstract

Introduction: Human papillomavirus (HPV) is an important risk factor for oropharyngeal cancer. Individuals with human immunodeficiency virus (HIV) have higher oral HPV prevalence but the risk factors for oral HPV infection are not well understood for either HIV-positive or HIV-negative individuals. Methods: This study was nested within the Multicenter AIDS Cohort Study (MACS; men) and Women Interagency HIV Study (WIHS; women) cohorts. Exfoliated oral epithelial cells were collected from 379 HIV-positive and 266 at-risk HIV-negative individuals using a rinse and gargle with Scope mouthwash. Samples were tested for 36 types of HPV DNA using PGMY09/11 consensus primers and reverse line blot hybridization. Risk factors for oral HPV infection were explored using logistic regression with generalized estimating equations in this cross-sectional analysis. Results: Prevalent oral HPV infection was common (34%), including HPV 16 infection in 5.7% of participants. HIV-positive individuals had increased odds of prevalent oral HPV infection compared with HIV-negative individuals [adjusted OR = 2.1; 95% confidence interval (CI), 1.6-2.8]. Risk factors for prevalent oral HPV differed in HIV-positive and HIV-negative participants. Among HIV-negative individuals, higher number of recent oral sex or rimming partners were strong risk factors for prevalent oral HPV infection (each P trend < 0.01). In contrast, among HIV-positive individuals, lower CD4 T-cell count (P trend < 0.001) and higher number of lifetime sexual partners (P trend = 0.03) were strong risk factors. Conclusions: Oral HPV prevalence was elevated in HIV-positive individuals after controlling for differences in cigarette smoking and sexual behavior, supporting the possibility that HIV may affect the natural history of oral HPV. Impact: Immunosuppression may contribute to increased persistence or progression of oral HPV infection.

Original languageEnglish (US)
Pages (from-to)122-133
Number of pages12
JournalCancer Epidemiology Biomarkers and Prevention
Volume21
Issue number1
DOIs
StatePublished - Jan 2012

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Papillomavirus Infections
HIV
Population
Sexual Behavior
Oropharyngeal Neoplasms
Human papillomavirus 16
Sexual Partners
CD4 Lymphocyte Count
Natural History
Immunosuppression

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Risk factors for oral HPV infection among a high prevalence population of HIV-positive and at-risk HIV-negative adults. / Beachler, Daniel C.; Weber, Kathleen M.; Margolick, Joseph B.; Strickler, Howard; Cranston, Ross D.; Burk, Robert D.; Wiley, Dorothy J.; Minkoff, Howard; Reddy, Susheel; Stammer, Emily E.; Gillison, Maura L.; D'Souza, Gypsyamber.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 21, No. 1, 01.2012, p. 122-133.

Research output: Contribution to journalArticle

Beachler, DC, Weber, KM, Margolick, JB, Strickler, H, Cranston, RD, Burk, RD, Wiley, DJ, Minkoff, H, Reddy, S, Stammer, EE, Gillison, ML & D'Souza, G 2012, 'Risk factors for oral HPV infection among a high prevalence population of HIV-positive and at-risk HIV-negative adults', Cancer Epidemiology Biomarkers and Prevention, vol. 21, no. 1, pp. 122-133. https://doi.org/10.1158/1055-9965.EPI-11-0734
Beachler, Daniel C. ; Weber, Kathleen M. ; Margolick, Joseph B. ; Strickler, Howard ; Cranston, Ross D. ; Burk, Robert D. ; Wiley, Dorothy J. ; Minkoff, Howard ; Reddy, Susheel ; Stammer, Emily E. ; Gillison, Maura L. ; D'Souza, Gypsyamber. / Risk factors for oral HPV infection among a high prevalence population of HIV-positive and at-risk HIV-negative adults. In: Cancer Epidemiology Biomarkers and Prevention. 2012 ; Vol. 21, No. 1. pp. 122-133.
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abstract = "Introduction: Human papillomavirus (HPV) is an important risk factor for oropharyngeal cancer. Individuals with human immunodeficiency virus (HIV) have higher oral HPV prevalence but the risk factors for oral HPV infection are not well understood for either HIV-positive or HIV-negative individuals. Methods: This study was nested within the Multicenter AIDS Cohort Study (MACS; men) and Women Interagency HIV Study (WIHS; women) cohorts. Exfoliated oral epithelial cells were collected from 379 HIV-positive and 266 at-risk HIV-negative individuals using a rinse and gargle with Scope mouthwash. Samples were tested for 36 types of HPV DNA using PGMY09/11 consensus primers and reverse line blot hybridization. Risk factors for oral HPV infection were explored using logistic regression with generalized estimating equations in this cross-sectional analysis. Results: Prevalent oral HPV infection was common (34{\%}), including HPV 16 infection in 5.7{\%} of participants. HIV-positive individuals had increased odds of prevalent oral HPV infection compared with HIV-negative individuals [adjusted OR = 2.1; 95{\%} confidence interval (CI), 1.6-2.8]. Risk factors for prevalent oral HPV differed in HIV-positive and HIV-negative participants. Among HIV-negative individuals, higher number of recent oral sex or rimming partners were strong risk factors for prevalent oral HPV infection (each P trend < 0.01). In contrast, among HIV-positive individuals, lower CD4 T-cell count (P trend < 0.001) and higher number of lifetime sexual partners (P trend = 0.03) were strong risk factors. Conclusions: Oral HPV prevalence was elevated in HIV-positive individuals after controlling for differences in cigarette smoking and sexual behavior, supporting the possibility that HIV may affect the natural history of oral HPV. Impact: Immunosuppression may contribute to increased persistence or progression of oral HPV infection.",
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T1 - Risk factors for oral HPV infection among a high prevalence population of HIV-positive and at-risk HIV-negative adults

AU - Beachler, Daniel C.

AU - Weber, Kathleen M.

AU - Margolick, Joseph B.

AU - Strickler, Howard

AU - Cranston, Ross D.

AU - Burk, Robert D.

AU - Wiley, Dorothy J.

AU - Minkoff, Howard

AU - Reddy, Susheel

AU - Stammer, Emily E.

AU - Gillison, Maura L.

AU - D'Souza, Gypsyamber

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AB - Introduction: Human papillomavirus (HPV) is an important risk factor for oropharyngeal cancer. Individuals with human immunodeficiency virus (HIV) have higher oral HPV prevalence but the risk factors for oral HPV infection are not well understood for either HIV-positive or HIV-negative individuals. Methods: This study was nested within the Multicenter AIDS Cohort Study (MACS; men) and Women Interagency HIV Study (WIHS; women) cohorts. Exfoliated oral epithelial cells were collected from 379 HIV-positive and 266 at-risk HIV-negative individuals using a rinse and gargle with Scope mouthwash. Samples were tested for 36 types of HPV DNA using PGMY09/11 consensus primers and reverse line blot hybridization. Risk factors for oral HPV infection were explored using logistic regression with generalized estimating equations in this cross-sectional analysis. Results: Prevalent oral HPV infection was common (34%), including HPV 16 infection in 5.7% of participants. HIV-positive individuals had increased odds of prevalent oral HPV infection compared with HIV-negative individuals [adjusted OR = 2.1; 95% confidence interval (CI), 1.6-2.8]. Risk factors for prevalent oral HPV differed in HIV-positive and HIV-negative participants. Among HIV-negative individuals, higher number of recent oral sex or rimming partners were strong risk factors for prevalent oral HPV infection (each P trend < 0.01). In contrast, among HIV-positive individuals, lower CD4 T-cell count (P trend < 0.001) and higher number of lifetime sexual partners (P trend = 0.03) were strong risk factors. Conclusions: Oral HPV prevalence was elevated in HIV-positive individuals after controlling for differences in cigarette smoking and sexual behavior, supporting the possibility that HIV may affect the natural history of oral HPV. Impact: Immunosuppression may contribute to increased persistence or progression of oral HPV infection.

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