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

Abstract

Background: Human 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. Methods: Oral 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. Results: The 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. Conclusion: Due 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.