Might Oral Human Papillomavirus (HPV) Infection in Healthy Individuals Explain Differences in HPV-Attributable Fractions in Oropharyngeal Cancer? A Systematic Review and Meta-analysis

Mena, Marisa; Cequier, Ángel; Monfil, Laura; Arbyn, Marc; Sanjosé, Sílvia de; Bosch, F. Xavier; Alemany, Laia; Bruni, Laia

doi:10.1093/infdis/jiy715

Cited by 32 publications

(46 citation statements)

References 48 publications

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“…The prevalence of HPV-DNA in HNSCCs can differ widely according to the cancer site, method of detection, and the geographical area [31,32]; being high among HNSCC cases in Sweden (93%) [33], the United States (71%) [34] and Eastern Denmark (62%) [35]. In the current study, HPV16 DNA prevalence was 52.9%, which was in concordance with former studies where HPV16 DNA prevalence was 51.7% [36] and 50% [37].…”

Section: Discussionsupporting

confidence: 89%

Diagnostic and prognostic impact of E6/E7 mRNA compared to HPV DNA and p16 expression in head and neck cancers: an Egyptian study

Dwedar

Omar

Eissa

et al. 2020

Alexandria Journal of Medicine

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Introduction: Human papillomavirus (HPV) is identified as a culprit in a subset of head and neck squamous cell carcinomas (HNSCCs). The clinicopathologic profile displayed by this subset diverges from that of HPV-negative HNSCCs. Despite a variety of available tests, there is no consensus on which technique is the best for detection of HPV in HNSCCs. Although this field has received substantial interest within different continents, African and Egyptian populations are not yet well studied within the literature. Methods: This cross-sectional study was carried out to detect HPV prevalence in HNSSC and to correlate the viral prevalence with different clinicopathologic parameters as well as with the patients' outcome. For 51 patients with HNSCC, HPV-16 DNA was determined via PCR, while E6/ E7 mRNA was detected employing real-time PCR. Immunohistochemistry (IHC) was performed to assess p16 status. Results: P16 was overexpressed in 49% of cases, while HPV-16 DNA was detected in 52.9% of cases, and likewise, E6/E7 mRNA was found in 52.9% of cases. There was a very good agreement between HPV16 DNA and RNA results (κ = 0.843, P-value <0.001). Meanwhile, a good agreement was revealed between HPV16 DNA and p16 IHC results (κ = 0.608, P-value <0.001). Similarly, there was a good agreement between HPV RNA results and p16 IHC results (κ = 0.608, P-value <0.001). By the end of the study period, 13.7% of the enrolled patients died, with the overall survival of the studied patients being 17.29 months. Of note, there was no statistically significant correlation between the overall survival and HPV status. Conclusion: The present study highlights the significant role played by HPV in HNSCC. Furthermore, it reveals that although p16 has been a marker of HPV existence in HNSCC, it should not be the sole determinant of HPV role in tumorigenesis.

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Section: Discussionsupporting

confidence: 89%

Diagnostic and prognostic impact of E6/E7 mRNA compared to HPV DNA and p16 expression in head and neck cancers: an Egyptian study

Dwedar

Omar

Eissa

et al. 2020

Alexandria Journal of Medicine

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“…Several oral HPV meta‐analyses have been recently published, some of which examined the association between age and oral HPV prevalence. However, these analyses utilized data collected using different HPV DNA genotyping protocols, different underlying age structures, did not carefully assess same‐sex behavior, and were prone to ecologic bias.…”

Section: Discussionmentioning

confidence: 99%

“…HPV estimates across studies may be due to greater inclusion of high risk men in the HIM Study than NHANES or use of more sensitive SPF 10 PCR-DEIA-LiPA 25 system for HPV genotyping in the HIM Study compared to the Linear Array assay utilized in NHANES (Manuscript undergoing peer review). 24 Several oral HPV meta-analyses have been recently published, [25][26][27] some of which examined the association between age and oral HPV prevalence. However, these analyses utilized data collected using different HPV DNA genotyping protocols, different underlying age structures, did not carefully assess same-sex behavior, and were prone to ecologic bias.…”

Section: Discussionmentioning

confidence: 99%

“…HPV genotyping was performed utilizing the RHA Kit HPV SPF 10 -LiPA 25 (DDL Diagnostic Laboratory, Rijswijk, The Netherlands), an in vitro reverse hybridization assay (RHA). The LiPA 25 targets a 65 base pair fragment of the L1 region of the HPV genome and requires a three-step process: (i) qPCR that determines sample adequacy based on detection of RNAse P; (ii) a DNA enzyme immunoassay (DEIA) or ELISA method that detects 65 HPV types; and (iii) a LiPA 25 genotyping multiplex PCR that selectively identifies the following HPV types by reverse hybridization: 6,11,16,18,31,33,34,35,39,40,42,43,44,45,51,52,53,54,56,58,59, 66, 68/73, 70 and 74. Samples that were considered adequate via qPCR in step (i) were further analyzed using steps (ii) and (iii).…”

Section: Dna Extraction and Hpv Testingmentioning

confidence: 99%

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Oral human papillomavirus prevalence and type distribution by country (Brazil, Mexico and the United States) and age among HPV infection in men study participants

Bettampadi

Villa

Ponce

et al. 2019

Intl Journal of Cancer

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Incidence of human papillomavirus (HPV) attributable oropharyngeal cancers (OPCs) has been increasing globally, especially among men in high‐income countries. There is a lack of studies comparing oral HPV prevalence by age and country among healthy men. The purpose of our study was to assess oral HPV prevalence by country and age. Participants of the HPV Infection in Men Study (HIM), a cohort of 3,098 healthy men from São Paulo, Brazil, Cuernavaca, Mexico and Tampa, USA, were studied. Oral HPV prevalence and type distribution were assessed using the SPF10 PCR‐DEIA‐LiPA25 system. The prevalence of any HPV in Brazil, Mexico and the US was 8.7% (95% CI: 7.1%, 10.4%), 10.0% (95% CI: 8.3%, 12.1%) and 7.6% (95% CI: 5.9%, 9.5%), respectively, while the prevalence of high‐risk HPV was 5.3% (95% CI: 4.1%, 6.7%), 7.3% (95% CI: 5.7%, 9.0%) and 5.4% (95% CI: 4.0%, 7.0%), respectively. No significant differences in prevalence of grouped HPV types were observed by country despite significant differences in sexual behaviors. However, the age‐specific prevalence of oral HPV differed by country. Brazilian (6.0% [95% CI: 3.4%, 9.7%]) and Mexican (9.2% [95% CI: 5.6%, 14.0%]) participants had peak high‐risk HPV prevalence among men aged 41–50 years whereas the US participants had peak prevalence at ages 31–40 years (11.0% [95% CI: 6.4%, 17.3%]). In conclusion, oral HPV prevalence was low with no difference in overall prevalence observed by country. Factors associated with the differences in oral HPV age‐patterning by country and sexual orientation require further study.

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“…Oral HPV infection is rare in the general population, with an overall prevalence of 5%–8% and of 2.0%–3.5% for oncogenic types 6 7. A twofold to threefold increased prevalence is observable in men who have sex with men (MSM),6 8–10 with a further increase in HIV-infected subjects 8 11–13.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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 and gargles were collected semiannually from 244 MSM (103, 42.2% HIV-infected). HPV-DNA testing was performed with the Linear Array HPV Genotyping test. A Markov model was used for estimation of incidence, clearance and risk factor analysis.ResultsIncidence rates for any HPV were 21.2 and 15.0×1000 person-months in HIV-infected and uninfected MSM, respectively. The respective figures for high-risk HPVs were 10.7 and 6.5×1000 person-months. The clearance rate was 4–12 times higher than the respective incidence rate. HIV-infected MSM with >95 lifetime oral sex partners showed increased incidence of any HPV (adjusted HR, aHR: 8.46, 95% CI 1.89 to 37.92). Condomless oral sex appeared the strongest predictor for incident infection by high-risk HPVs in this group (aHR: 13.40, 95% CI 2.55 to 70.53). Those aged >46 years (aHR: 0.30, 95% CI 0.12 to 0.74) and those with nadir CD4+ T count of <200 cells/mm3 (aHR: 0.14, 95% CI 0.03 to 0.75) displayed a significantly reduced clearance of any and high-risk HPVs, respectively. HIV-uninfected MSM aged >46 years had increased risk of acquiring any HPV (aHR: 3.70, 95% CI 1.30 to 10.52) and high-risk HPV (aHR: 5.33, 95% CI 1.06 to 26.68). Any HPV clearance declined in those with more than six recent oral sex partners (aHR: 0.18, 95% CI 0.05 to 0.65).ConclusionsAcquisition of oral HPV infection in MSM seems to occur rarely, whereas clearance seems to be a frequent event. Oral HPV natural history in these at-risk subjects is differently influenced by age and sex behaviour, depending on HIV status.

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Might Oral Human Papillomavirus (HPV) Infection in Healthy Individuals Explain Differences in HPV-Attributable Fractions in Oropharyngeal Cancer? A Systematic Review and Meta-analysis

Cited by 32 publications

References 48 publications

Diagnostic and prognostic impact of E6/E7 mRNA compared to HPV DNA and p16 expression in head and neck cancers: an Egyptian study

Diagnostic and prognostic impact of E6/E7 mRNA compared to HPV DNA and p16 expression in head and neck cancers: an Egyptian study

Oral human papillomavirus prevalence and type distribution by country (Brazil, Mexico and the United States) and age among HPV infection in men study participants

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

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