Human papillomaviruses (HPVs) have been detected in urban wastewaters, demonstrating that epitheliotropic viruses can find their way into sewage through the washing of skin and mucous membranes. Papillomavirus shedding through faeces is still an unexplored issue. The objective of the present study was to investigate the presence of HPVs in stool samples. We analysed 103 faecal specimens collected from hospitalized patients with diarrhoea using validated primers able to detect a, b and c HPVs. PCR products underwent sequencing analysis and sequences were aligned to reference genomes from the Papillomavirus Episteme database. A total of 15 sequences were characterized from the faecal samples. Thirteen samples (12.6 %) were positive for nine genotypes belonging to the a and b genera: HPV32 (LR, a1), HPV39 (HR, a7), HPV44 (LR, a10), HPV8 (b1), HPV9, HPV23, HPV37, HPV38 and HPV120 (b2). Two putative novel genotypes of the b genus, species 1 and 2, were also detected. The tissue(s) of origin is unknown, since faeces can collect HPVs originating from or passing through the entire digestive system. To our knowledge, this is the first investigation on the occurrence and diversity of HPVs in faecal samples. Results from this study demonstrate that HPVs can find their way into sewage as a consequence of shedding in the faeces. This highlights the need for further studies aimed at understanding the prevalence of HPV in different water environments and the potential for waterborne transmission.
INTRODUCTIONPapillomaviruses (PVs) are a large family of viruses that infect skin and mucosal epithelia of vertebrates, including humans (HPV). Infections caused by most HPVs are subclinical; the spectrum of diseases ranges from prolific benign lesions such as common warts, to malignant carcinomas of the cervix, vulva, vagina, penis and anus (Bouvard et al., 2009; IARC, 2007). Worldwide, HPV infections have been linked to several cancers, including lung, breast, ovary, prostate, urinary bladder, urethra and colon rectal cancer, although data on the association between viruses and cancer are still controversial. Recently, two systematic reviews and meta-analysis have strongly supported the hypothesis that some high-risk HPVs are risk factors for colorectal cancers or for a subset of them (Baandrup et al., 2014;Damin et al., 2013). The viruses also invade human epithelial cells of the oral mucosa, oesophagus, larynx, trachea and conjunctiva of the eye. Today, it is well established that PVs cause a substantial proportion of head and neck cancers (D'Souza & Dempsey, 2011). The association between HPV infections and skin cancer is still a matter of debate, although increasing evidence supports their role in the development of nonmelanoma skin cancer (Schiller & Buck, 2011;zur Hausen, 2009).In spite of nearly 30 years of studies on PVs, only a small number of them are known in depth, compared with the huge number of PVs identified and sequenced so far. In fact, 176 HPVs have been completely sequenced and officially designated. These are di...