Analogies between HPV Behavior in Oral and Vaginal Cavity: Narrative Review on the Current Evidence in the Literature

Abstract

Human genital papilloma virus infection is the most prevalent sexually transmitted infection in the world. It is estimated that more than 75% of sexually active women contract this infection in their lifetime. In 80% of young women, there is the clearance of the virus within 18–24 months. In developed countries, oral squamous cell carcinoma (OSCC) is now the most frequent human papilloma virus (HPV)-related cancer, having surpassed cervical cancer, and it is predicted that by 2030 most squamous cell carcinomas will be the HPV-related rather than non-HPV-related form. However, there are currently no screening programs for oral cavity infection. While the natural history of HPV infection in the cervix is well known, in the oropharynx, it is not entirely clear. Furthermore, the prevalence of HPV in the oropharynx is unknown. Published studies have found wide-ranging prevalence estimates of 2.6% to 50%. There are also conflicting results regarding the percentage of women presenting the same type of HPV at two mucosal sites, ranging from 0 to 60%. Additionally, the question arises as to whether oral infection can develop from genital HPV infection, through oral and genital contact or by self-inoculation, or whether it should be considered an independent event. However, there is still no consensus on these topics, nor on the relationship between genital and oral HPV infections. Therefore, this literature review aims to evaluate whether there is evidence of a connection between oral and cervical HPV, while also endorsing the usefulness of the screening of oral infection in patients with high-risk cervical HPV as a means of facilitating the diagnosis and early management of HPV-related oral lesions. Finally, this review emphasizes the recommendation for the use of the HPV vaccines in primary prevention in the male and female population as the most effective means of successfully counteracting the increasing incidence of OSCC to date.

Human Papillomavirus in Oral Lichen Planus: Is There an Association? A Meta-Analysis

“…According to some authors, HPV16 detection in the mouth is strongly associated with HPV16 persistence in the genital tract and, therefore, may also lead to the progression of cervical cancer. These studies suggest that the oral region may act as a natural reservoir of HPV at a locus outside of the genital region, and potentially become a reinfection focus [42,43] as HPV16 can integrate with host-cell DNA and activate oncogenes. The interaction of various oral microorganisms and their adhesion results in the formation of a microbial community through aggregation and coaggregation.…”

“…The interaction of various oral microorganisms and their adhesion results in the formation of a microbial community through aggregation and coaggregation. The oral dysbiosis and synergistic effects in oral microbial communities may promote cancer development [43]. The persistence of the HPV infection in the oral area is more frequently associated with high-risk HPV genotypes and is the major risk factor for the oral dysplasia [43].…”

“…The oral dysbiosis and synergistic effects in oral microbial communities may promote cancer development [43]. The persistence of the HPV infection in the oral area is more frequently associated with high-risk HPV genotypes and is the major risk factor for the oral dysplasia [43].…”

“…A division of the virus oncogenic phenotypes into high-and low-risk types is based on the differences in the DNA base sequences of E6 and E7 genes. High-risk types include HPV 16,18,31,33,35,45,51,52,56,58, and 59, while the low-risk include HPV 6,11,42,43,and 44 [19,20]. The International Agency for Research on Cancer (IARC) classified HPVs into three groups according to their oncogenic activity.…”