Oral testing for high‐risk human papillomavirus DNA and E6/E7 messenger RNA in healthy individuals at risk for oral infection

Abstract

Background Testing for oral high‐risk human papillomavirus (HPV) DNA may be useful for identifying individuals at increased risk for HPV‐driven oropharyngeal cancer (OPC). However, positivity for HPV DNA provides no information on the transforming potential of the infection. In contrast, the detection of high‐risk HPV E6/E7 messenger RNA (mRNA) may help to identify clinically significant infections because of the indispensable role of E6/E7 viral oncoproteins in the carcinogenic process. Methods Oral rinses were collected with a mouthwash from cancer‐free individuals at increased risk for oral HPV infection. High‐risk HPV DNA and mRNA were evaluated via the testing of the oral rinses with the Linear Array HPV genotyping test and the Aptima HPV assay, respectively. Results Overall, 310 subjects with no clinical evidence of lesions of the oral cavity and oropharynx were included in the study. Thirty‐three (10.6%) harbored high‐risk HPV DNA in their oral rinse. These cases, together with 10 random samples negative for high‐risk HPV DNA, were tested with the Aptima assay. A valid result was obtained for 41 of the 43 specimens (95.3%). Among the 31 cases that were positive for high‐risk HPV DNA and had a valid Aptima result, 4 (12.9%) were positive for HPV mRNA. HPV mRNA was not detected in any of the samples negative for high‐risk HPV DNA. Conclusions HPV mRNA is detectable in oral rinses of cancer‐free subjects. Oral HPV mRNA testing may be useful in the screening and/or early detection of HPV‐driven OPC by possibly identifying active and transforming oral infections. The testing of individuals at increased risk for HPV‐related OPC via simply and noninvasively collected oral specimens is an attractive option for future screening strategies.

Oral human papillomavirus infection in HIV-infected and HIV-uninfected MSM: the OHMAR prospective cohort study

“…HIV-infected subjects also showed a lower clearance of any HPV compared with the HIV-uninfected MSM, whereas the opposite was observed for high-risk HPVs. Taken together, these data might explain the higher prevalence of any HPV in the HIV-infected subjects of the OHMAR study and the similar prevalence observed for high-risk types in the two study groups 21…”

Oral Infection by Mucosal and Cutaneous Human Papillomaviruses in the Men Who Have Sex with Men from the OHMAR Study

“…Of these, 117 were HIV-infected subjects (37.7%), for the most part on cART (110, 94.0%), with a median number of nadir and a current CD4+ T-cell count of 300 (IQR: 202-403) and 636 cells/mm3 (IQR: 473-812), respectively. Sociodemographic and behavioral characteristics of the participants in the OHMAR study were detailed in a previous report [32]. To summarize, HIV-infected subjects were significantly older (median age: 43 vs. 39 years, p = 0.005) and reported a significantly lower number of recent oral sex partners (median of two vs. four, p = 0.003) than the HIV-uninfected counterparts.…”

Predictors of Oral Infection by Mucosal and Cutaneous Human Papillomaviruses in HIV-Infected and Uninfected Men Who Have Sex with Men of the OHMAR Study

“…The large majority of these subjects were on combined antiretroviral therapy (cART) (110, 94.0%). With regard to sociodemographic features and lifestyle, the OHMAR study population has been previously described [15]. Briefly, HIV-infected and HIV-uninfected MSM differed significantly with respect to age (median age: 43 vs. 39 years) and number of recent oral sex partners (median of two vs. four).…”

“…Thus, additional studies are needed to thoroughly explore the determinants of infection with the different HPV genera. Compared with the general population, prevalence of oral infection by mucosal HPVs is higher in men who have sex with men (MSM), particularly in those living with HIV-1 infection [8,[11][12][13][14][15]. In a previous study, we showed that beta and gamma HPVs are abundantly present in oral specimens from MSM, and that oral infection by beta HPVs is significantly more common than that caused by alpha types, irrespective of HIV status [6].…”