Dynamics of oral human papillomavirus infection in healthy population and head and neck cancer

Vani, N V; Madhanagopal, R; Swaminathan, Rajaraman; Ganesan, Trivadi S.

doi:10.1002/cam4.5686

Cited by 10 publications

(9 citation statements)

References 114 publications

(243 reference statements)

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“…Regarding the prevalence of HPV infection in HIV+ patients, our study showed a prevalence of 19.7%, in line with values reported in literature, ranging from 11% to 35% [26,[47][48][49][50][51]. As expected, the prevalence was higher than that reported, on average, for the general population (4.8%) [48], although literature shows that HPV infection can be prevalent also in healthy individuals, with highly variable percentages [30]. The difference between general and HIV+ populations, however, can be explained by the higher virulence of HPV in HIV+ patients, which is due to a reduced host immune response, an increased susceptibility to infection, and to the direct interactions between the two viruses, e.g., HIV is able to increase the expression of HPV E6 and E7 oncogenes [52].…”

Section: Discussionsupporting

confidence: 91%

“…Cross-sectional studies on Italian HIV+ men (predominantly men having sex with men, MSM) showed that oral HPV DNA could be detected in approximately 20% of cases, which is to a much lower extent compared to anal sites [26][27][28][29]. To interpret this data, it is important to highlight that also the global prevalence of oral HPV infection in healthy individuals can be relevant, ranging from 0.67% to 35% [30]; the oral cavity contains a wide spectrum of HPVs, with beta types representing the predominant genus [31]. In the general population, HPV has been found to be more prevalent in males, while subclinical oral HPV infection was detected more frequently in adults aged under 40 or over 60 years [32].…”

Section: Introductionmentioning

confidence: 99%

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HIV-Related Oral Mucosa Lesions: A Cross-Sectional Study on a Cohort of Italian Patients

Tarozzi,

Baruzzi,

Decani

et al. 2024

Biomedicines

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Background: Human immunodeficiency virus (HIV) infection can be associated with oral mucosal diseases, including oral candidiasis and HPV infection, which are putative indicators of the immune status. Aim and Methods: This retrospective cross-sectional study was aimed at assessing the prevalence of HIV-related oral mucosal lesions in a cohort of Italian HIV+ patients regularly attending the Clinics of Infectious Diseases. Results: One hundred seventy-seven (n = 177) patients were enrolled and 30 (16.9%) of them showed HIV-related diseases of the oral mucosa. They were mainly found in male patients over 35 years old, undergoing Combination Antiretroviral Therapy (cART), and with CD4+ count < 500/µL. Oral candidiasis was the most common HIV-related oral lesion. No significant correlations could be detected between the prevalence of HPV infection and other clinical parameters (lymphocyte count, cART treatment and viral load). Conclusions: HIV-related oral mucosal diseases can correlate with immunosuppression. Early diagnosis and management of oral lesions in HIV+ patients should be part of the regular follow-up, from a multidisciplinary perspective of collaboration between oral medicine and infectious disease specialists, in an attempt to reduce morbidity due to oral lesions and modulate antiretroviral therapy according to the patient’s immune status.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

HIV-Related Oral Mucosa Lesions: A Cross-Sectional Study on a Cohort of Italian Patients

Tarozzi,

Baruzzi,

Decani

et al. 2024

Biomedicines

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“…The HPV6, HPV11, HPV16, HPV18, HPV31, HPV33, HPV45, HPV52, and HPV58 strains are accounting for 90% of HNC cases ( 24 , 26 , 113 ). The percentage of HPV positivity varies with the type of HNCs and the different geographic regions ( 26 , 27 , 113 – 117 ), the highest incidence being reported for sub-Saharan African region (HPV has been identified in 50% of oropharyngeal cancers, 27% of laryngeal cancers, and 23% of oral cavity cancers, with the predominance of HPV16 ( 118 ).…”

Section: Hpv Viral Components and Molecular Genetic And Epigenetic Me...mentioning

confidence: 99%

Implications of oral dysbiosis and HPV infection in head and neck cancer: from molecular and cellular mechanisms to early diagnosis and therapy

Constantin,

Chifiriuc,

Mihaescu

et al. 2023

Front. Oncol.

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Head and neck cancer (HNC) is the sixth most common type of cancer, with more than half a million new cases annually. This review focuses on the role of oral dysbiosis and HPV infection in HNCs, presenting the involved taxons, molecular effectors and pathways, as well as the HPV-associated particularities of genetic and epigenetic changes and of the tumor microenvironment occurred in different stages of tumor development. Oral dysbiosis is associated with the evolution of HNCs, through multiple mechanisms such as inflammation, genotoxins release, modulation of the innate and acquired immune response, carcinogens and anticarcinogens production, generation of oxidative stress, induction of mutations. Thus, novel microbiome-derived biomarkers and interventions could significantly contribute to achieving the desideratum of personalized management of oncologic patients, regarding both early diagnosis and treatment. The results reported by different studies are not always congruent regarding the variations in the abundance of different taxons in HNCs. However, there is a consistent reporting of a higher abundance of Gram-negative species such as Fusobacterium, Leptotrichia, Treponema, Porphyromonas gingivalis, Prevotella, Bacteroidetes, Haemophilus, Veillonella, Pseudomonas, Enterobacterales, which are probably responsible of chronic inflammation and modulation of tumor microenvironment. Candida albicans is the dominant fungi found in oral carcinoma being also associated with shorter survival rate. Specific microbial signatures (e.g., F. nucleatum, Bacteroidetes and Peptostreptococcus) have been associated with later stages and larger tumor, suggesting their potential to be used as biomarkers for tumor stratification and prognosis. On the other hand, increased abundance of Corynebacterium, Kingella, Abiotrophia is associated with a reduced risk of HNC. Microbiome could also provide biomarkers for differentiating between oropharyngeal and hypopharyngeal cancers as well as between HPV-positive and HPV-negative tumors. Ongoing clinical trials aim to validate non-invasive tests for microbiome-derived biomarkers detection in oral and throat cancers, especially within high-risk populations. Oro-pharyngeal dysbiosis could also impact the HNCs therapy and associated side-effects of radiotherapy, chemotherapy, and immunotherapy. HPV-positive tumors harbor fewer mutations, as well as different DNA methylation pattern and tumor microenvironment. Therefore, elucidation of the molecular mechanisms by which oral microbiota and HPV infection influence the HNC initiation and progression, screening for HPV infection and vaccination against HPV, adopting a good oral hygiene, and preventing oral dysbiosis are important tools for advancing in the battle with this public health global challenge.

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“…Most studies have determined the presence of HR-HPV DNA without evaluating the biomarkers of HPV carcinogenesis (ie, E6/E7 mRNA and p16 protein), thus failing to distinguish between transient and persistent HPV infection. 6 HPV E6/E7 mRNA detection is a gold-standard test for transcriptionally active HPV infection. 7 The modified eighth American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) classification recommends p16 as an HPV surrogate marker in OPC as it correlates with an improved survival rate.…”

Section: Introductionmentioning

confidence: 99%

“… 9 Hence, p16-positive cases must be confirmed by HPV DNA status to consider causality in OPC. 6 To our knowledge, there is a lack of meta-analysis on the proportion of HPV-associated HNC in Indian patients with a high burden of HPV-driven malignancies such as cervical cancer. Therefore, this systematic review and meta-analysis aimed to provide information about HPV prevalence and genotype distribution in HNC in India.…”

Section: Introductionmentioning

confidence: 99%

Human Papillomavirus–Attributable Head and Neck Cancers in India—A Systematic Review and Meta-Analysis

Vani,

Rama,

Madhanagopal

et al. 2024

JCO Glob Oncol

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PURPOSE Head and neck cancer accounts for about one third of the global burden in India. Mucosal high-risk human papillomavirus (HPV) has been hypothesized as a contributory risk factor for head and neck cancer (HNC) but its prevalence in Indian patients is not well established. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of HPV in HNC in India and their attributable fraction by considering the biomarkers of carcinogenesis, p16, and HPV E6/E7 mRNA. METHODS A systematic literature search was done in Medline via PubMed, Embase, Scopus, ScienceDirect, ProQuest, and Cochrane to identify studies on HPV and HNC in the Indian population, published between January 1990 and October 2022. Fifty-four eligible studies were identified and relevant clinical information was collected. Meta-analysis was conducted to estimate the pooled prevalence of HPV DNA, p16INK4a, and E6/E7 mRNA percent positivity by random-effect logistic regression model using Metapreg, STATA 18. RESULTS Thirty-four high-quality studies were taken for meta-analysis. The pooled prevalence of HPV in HNC was 20% (95% CI, 12 to 32) with a high level of heterogeneity ( I2 = 90.79%). The proportion of HPV in oropharyngeal cancer (OPC; 22% [95% CI, 13 to 34]) and laryngeal cancer (LC; 29% [95% CI, 17 to 46]) was higher than in oral cancer (OC; 16% [95% CI, 8 to 30]). The HPV-attributable fraction of OPC, considering the E6/E7 mRNA and p16 positivity, was 12.54% and 9.68%, respectively, almost similar to LC (11.6% and 9.57%), while it was much lower in OC (3.36% and 4%). CONCLUSION The HPV-attributable fraction is considerably lower for OC, suggesting a negligible causative role of HPV in OC. A significant proportion of OPC and LC are attributed to HPV; however, their exact causative role is unclear because of the presence of other known risk factors.

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Dynamics of oral human papillomavirus infection in healthy population and head and neck cancer

Cited by 10 publications

References 114 publications

HIV-Related Oral Mucosa Lesions: A Cross-Sectional Study on a Cohort of Italian Patients

HIV-Related Oral Mucosa Lesions: A Cross-Sectional Study on a Cohort of Italian Patients

Implications of oral dysbiosis and HPV infection in head and neck cancer: from molecular and cellular mechanisms to early diagnosis and therapy

Human Papillomavirus–Attributable Head and Neck Cancers in India—A Systematic Review and Meta-Analysis

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