Smoking increases oral HPV persistence among men: 7-year follow-up study

Abstract

Persistent high-risk human papillomavirus (HR-HPV) infection is the key event in the progression of HPV lesions, and more data are urgently needed on asymptomatic oral HPV infections in men. Asymptomatic fathers-to-be (n = 131, mean age 28.9 years) were enrolled in the cohort, sampled by serial oral scrapings at baseline and at 2-month, 6-month, 12-month, 24-month, 36-month, and 7-year follow-up visits to accomplish persistent and cleared HPV infections. HPV genotyping was performed using nested PCR and Multimetrix® assay. Covariates of persistent and cleared oral HPV infections were analysed using generalised estimating equation (GEE) and Poisson regression. Altogether, 17 HPV genotypes were detected in male oral mucosa point prevalence, varying from 15.1 % to 31.1 %. Genotype-specific HPV persistence was detected in 18/129 men the mean persistence time ranging from 6.0 to 30.7 months. History of genital warts decreased (p = 0.0001; OR = 0.41, 95 % CI 0.33-0.51) and smoking increased (p = 0.033, OR = 1.92, 95 % CI 1.05-3.50) the risk of persistent species 7/9 HPV infections. Of the 74 HPV-positive men, 71.6 % cleared their infection actuarial and crude clearance times, varying between 1.4 and 79.6 months. No independent predictors were identified for species 7/9 clearance. At the last follow-up-visit, 50.1 % of the fathers had oral mucosal changes, correlating only with smoking (p = 0.046). To conclude, most of the persisting oral infections in males were caused by HPV16. Smoking increased while previous genital warts decreased oral HR-HPV persistence. No predictors of HR-HPV clearance were disclosed.

Oral human papillomavirus infection incidence and clearance: a systematic review of the literature

“…Nine publications comprising 3762 cancer-free participants were identified and are presented in Table 1 [10][11][12][13][14][15][16][17][18]. Sample sizes ranged from 131 [11] to 1626 [12] participants.…”

“…Sample sizes ranged from 131 [11] to 1626 [12] participants. The studies were performed in the USA, Brazil, Mexico and Finland.…”

“…The HPV Infection in Men (HIM) Study investigated men only from three countries (USA, Brazil and Mexico) [12,14]. The Finnish Family HPV Study analysed oral specimens from pregnant women, fathers-to-be and mothers [11,13,15,16]. Beachler et al included a US highrisk population (defined as 'HIV-uninfected people at risk of HIV infection') in their recent study [10].…”

“…The lowest overall oral HPV incidence (2 %) was reported in US university students [18] and the highest (69 %) in fathers-to-be in the Finnish study [11]. The type-specific HPV-16 incidence ranged from 0.6 % in the HIM Study [12] to 65 % in the Finnish Family HPV Study [13].…”

“…Clearance for any oral HPV infection spanned from 0 % among pregnant women in the Finnish study [16] to 80 % in the US high-risk population [10], and time to clearance of any HPV type ranged from 6 to 18 months [11,15]. HPV-16 type-specific clearance was less heterogeneous than overall HPV clearance and was lowest (43 %) in Finnish mothers [13] and highest (83 %) in two separate studies from the USA (the HIM Study and the high-risk population) [10,12].…”