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

Abstract

Subclinical oral human papillomavirus (HPV) infection that persists for decades is likely to precede an HPV-driven squamous cell carcinoma of the head and neck, but little is known about the natural history of oral HPV. We systematically reviewed and abstracted data from nine manuscripts that examined human immunodeficiency virusnegative and cancer-free subjects for oral HPV DNA to determine the pooled baseline prevalence and incidence of newly acquired oral HPV infections, and specifically for HPV-16. We also documented the clearance rate and the median time to clearance, where data existed. Of 3762 individuals, 7.5 % had an oral infection with any HPV type (1.6 % for HPV-16). Meta-regression analysis estimated the 12-month cumulative incidence to be 4.8 % (95 % confidence interval 3.2-7.3 %). The overall oral HPV clearance was reported to be 0-80 % between studies, and the median time to clearance from 6.5 to 18 months. Oral HPV-16 clearance was 43-83 %, and median time to clearance for HPV-16 was 7-22 months. Oral HPV prevalence, incidence and clearance vary considerably between published studies from different geographical regions. Further research is required to identify predictors of persistent oral HPV infection. Measurable baseline prevalence was observed in all studies, as well as non-trivial incidence of newly acquired oral HPV infections and incomplete clearance.

Oral Human Papillomavirus Infection: Differences in Prevalence Between Sexes and Concordance With Genital Human Papillomavirus Infection, NHANES 2011 to 2014

“…A large multi-country cohort study—the HPV infection in men (HIM) study—found that acquisition of HR oral HPV infection was constant across the age (15). Therefore, the peaking of prevalence among older participants observed in our study might be a result of increased duration of infection at older ages in addition to increased acquisition (15, 16). We found that oncogenic HPV-16 was most prevalent among men 50–69 years of age.…”

The role of human papillomavirus in p16‐positive oral cancers

“…However, if this were to occur, we would recommend that LCM be performed prior to sensitive PCR‐based HPV testing, to reduce false‐positive results. The oral cavity can be colonized by oncogenic HPV without disease, usually cleared within the first year, and PCR may detect HPV infection in normal epithelium in addition to tumour tissue . LCM prior to DNA extraction precisely selects tumour cells and prevents contamination by adjacent tissue .…”

Anogenital HPV Infection as the Potential Risk Factor for Oropharyngeal Carcinoma

“…Hodnoty prevalence orální HPV infekce ve zdravé populaci se liší od prevalence 0,6 % v Japonsku [12] až k záchytu 95,4 % u britské bílé populace [13]. Všechny práce ale potvrzují jasnou dominanci genotypu HPV 16 [3][4][5]12,[14][15][16]. Recentní metaanalýza 29 studií na celkem 10 124 mužích a 12 623 ženách uvádí orální HPV prevalenci u 2,9 % žen, u 4,7 % heterosexuálních mužů a nejvíce u 12,2 % homosexuálních mužů [15].…”

“…Většina orálních HPV infekcí je přechodná. Ve Spojených státech se 60,6 % orálních HPV infekcí u žen eradikovalo během 3 měsíců [12] a dalších 20,0 % během následujících 3 měsíců [17]. Také jen necelá polovina (42 %) infekcí nejčastějšími HR HPV genotypy přetrvávala déle než 3 měsíce [12,17].…”

“…Ve Spojených státech se 60,6 % orálních HPV infekcí u žen eradikovalo během 3 měsíců [12] a dalších 20,0 % během následujících 3 měsíců [17]. Také jen necelá polovina (42 %) infekcí nejčastějšími HR HPV genotypy přetrvávala déle než 3 měsíce [12,17]. U HIV-infekce HR genotypy perzistovala 6,9 měsíce, ale genotyp HPV 16 zůstával přítomen v průměru 37,1 měsíce a u HIV+ dokonce až 42,3-48,3 měsíce [17].…”