Natural history of oral HPV infection: Longitudinal analyses in prospective cohorts from Australia

Abstract

Oral infection with human papillomavirus (HPV) is likely to underpin the rapidly rising incidence of oropharyngeal squamous cell carcinoma; however, there are few data describing the natural history of oral HPV infection. We recruited 704 participants aged 20 to 70 years from worksites, universities and primary care practices in Brisbane, Australia. Participants completed questionnaires at baseline, 12 and 24 months and donate four saliva samples at baseline, 6, 12 and 24 months for HPV polymerase chain reaction testing and typing. We estimated the prevalence of oral HPV infection at baseline, incidence of new infections among those HPV‐negative at baseline, clearance rate and persistent infections. At baseline, 10.7% of participants had oral HPV infections from 26 different HPV types. Sexual behaviours were associated with oral HPV infection, including more partners for passionate kissing (29 or more; odds ratio [OR] 3.4, 95% confidence interval [CI] 1.5‐8.0), and giving and receiving oral sex (16 or more; OR 5.4, 95% CI 1.6‐17.7 and OR 5.6, 95% CI 1.6‐18.7, respectively). Of 343 participants, HPV‐free at baseline and with subsequent saliva samples, 87 (25%) acquired new infections over the 24 months. Sixty‐eight of 87 people included in the clearance analysis (78%) cleared their oral HPV infections. Clearance was associated with being a nonsmoker (OR 12.7, 95% CI 1.3‐122.8), and no previous diagnosis of a sexually transmitted infection (OR 6.2, 95% CI 2.0‐19.9). New oral infections with HPV in this sample were not rare. Although most infections were cleared, clearance was not universal suggesting a reservoir of infection exists that might predispose to oropharyngeal carcinogenesis.

Human Papillomavirus Oral Infection: Review of Methodological Aspects and Epidemiology

“…In a more recent study on over 3000 HIM participants, 10-30% of oral High-risk HPV infections were found to persist beyond 24 months (18% in the case of HPV16) [102]. A very recent study conducted in Australia showed that around one quarter of the individuals that were HPV-negative at baseline acquired new Alpha-HPV infections over a 24-month period [25].…”

“…Saliva samples are usually shaken and incubated at 50 • C-56 • C for 1-2 h before nucleic acid extraction [25][26][27][28]. Oral rinse-and-gargles are obtained with 10-15 mL of commercial mouthwashes, buffer saline or water, used for rinse and gargle cycles of 30-60 s. In the pre-analytic phase, these samples are centrifuged (at least at 2000 rpm for 10 min) to obtain the cell pellet.…”

Cohort profile: indigenous human papillomavirus and oropharyngeal squamous cell carcinoma study - a prospective longitudinal cohort

“…21 Antonsson and colleagues described a longitudinal study (0, 6, 12 and 24 months) of 704 people from Brisbane (18-70 years old). 32 They reported an oral HPV prevalence of 10.7% (high-risk HPV prevalence 6.4%) at baseline in 636 people who tested positive for β-globin. 33 In our study, the most prevalent HPV types at baseline were those associated with Heck's disease (23% of the HPV types found); a relatively benign and rare condition caused by oral HPV types 13 or 32 that appears to be more prevalent among Indigenous populations around the world.…”

“… 21 Antonsson and colleagues described a longitudinal study (0, 6, 12 and 24 months) of 704 people from Brisbane (18–70 years old). 32 They reported an oral HPV prevalence of 10.7% (high-risk HPV prevalence 6.4%) at baseline in 636 people who tested positive for β-globin. The International Agency for Research on Cancer’s (IARC) definition of high-risk HPV was used: HPV 16, HPV 18, HPV 31 to HPV 33, HPV 35 to HPV 39, HPV 45 to HPV 51, HPV 52, HPV 56, HPV 58, HPV 59 to HPV 66.…”

A micro‑peptide encoded by HOXB‑AS3 promotes the proliferation and viability of oral squamous cell carcinoma cell lines by directly binding with IGF2BP2 to stabilize c‑Myc

“…The current therapy is only effective for early stage OSCC, and the 5-year overall survival rate was <50% in 2020 ( 2 ). Studies have indicated that tobacco addiction, excessive alcohol consumption and human papillomavirus (HPV) infection are the main risk factors for tumorigenesis and the development of OSCC ( 3 ). Current targeted therapies, such as targeting PD1/PDL1, are far from satisfactory ( 4 ); therefore; new predictive biomarkers and therapeutic targets are urgently required.…”