A high incidence of human papillomavirus-linked oropharyngeal cancer (HPV-OPC) has been reported in the last decades, contrasting with the decline in incidence of other oral cancers of non-infectious etiology. An even higher risk of HPV-OPC has been reported in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) individuals even after following antiretroviral therapy (ART). Yet the relative contribution of risk factors influencing the higher prevalence of HPV-OPC in HIV/AIDS individuals and those at high risk of acquiring HIV has not been evaluated.
A cross-sectional study was reported on HPV-OPC in HIV-positive and HIV-negative individuals. Cohort-stratified enrollment included 365 subjects from MACS (the Multicenter AIDS Cohort Study) and 280 subjects from WIHS (the Women Interagency HIV Study). HIV status included 379 HIV+ and 266 HIV- subjects "at risk" while among HIV+ subjects; ART status included 312 subjects under ART and 67 ART-naive. HIV status enrollment per cohort included 192 HIV+ and 173 HIV- subjects from MACS and 187 HIV+ and 93 HIV- subjects from WIHS. Oral rinse specimens (HPV-DNAs) were analyzed to detect 36 HPV types by polymerase chain reaction (PCR) and reverse line blot hybridization.
A high prevalence of oral HPV infection (34 percent) was reported (40 percent in HIV+ vs. 25 percent in HIV- subjects). The following differences were observed in risk factors strongly linked to prevalent oral HPV infection: 1) in HIV+ subjects, lower CD4 count and higher number of lifetime sexual partner were key risk factors; while 2) in HIV- subjects, higher number of recent oral sex or rimming partners were significant risk factors. Understanding the role of HIV/AIDS and risk factors in the natural history of oral HPV is central to control HPV-OPC linked to HIV.
The research, published in January 2012 in Cancer Epidemiology, Biomarkers & Prevention, was conducted by Beachler DC, Weber KM, Margolick JB, Strickler HD, Cranston RD, Burk RD, Wiley DJ, Minkoff H, Reddy S, Stammer EE, Gillison ML, and D'Souza Gat the Johns Hopkins Bloomberg School of Public Health.