Oropharynx HPV status and its relation to HIV infection

Abstract

BackgroundThe number of oropharyngeal lesions caused by HPV (Human papillomavirus) has been increasing worldwide in the past years. In spite of the clinical relevance of HPV infection in the anogenital tract of HIV-positive patients, the relevance of oropharynx HPV infection in these patients is not clear. The aim of the present study was to detect HPV infection, and clinical and cytological changes in the oropharynx of HIV-positive patients.MethodsSamples collected from the oropharynx of 100 HIV-positive patients were subjected to hybrid capture (HC), conventional and liquid-based cytology. Clinical data were also collected to investigate the relation with HPV status.ResultsHigh and low-risk types of HPV were present in 8% and 16.7% of the total sample. The mean ± sd (maximum-minimum) of the relative ratio light unit (RLU)/cutoff (CO) was 2.94 ± 2.58 (1.09–7.87) and 1.61 ± 0.65 (1.07–2.8) for high- and low-risk-HPV, respectively. By cytology, dysplasia was not detected, but atypical squamous cells of undetermined significance (ASC-US) were diagnosed in two samples. No clinical change, suggestive of dysplasia/cancer, was detected.ConclusionOur study was able to detect and characterize HPV infection by hybrid capture, which may represent a good tool for screening and follow-up of HPV in the studied population. The frequency and viral load of HPV were low. Neither clinical nor cytological changes suggestive of dysplasia/neoplasia were observed in oropharynx of HIV-positive patients.

Human Papillomavirus Oral Infection: Review of Methodological Aspects and Epidemiology

“…Importantly, among men, smoking has been found to be associated with a longer persistence [96], a finding that may contribute to explaining the higher prevalence of oral HPV infection in men who are current smokers. On the other hand, an inverse association between smoking and oropharyngeal infection has been highlighted in a relatively recent study [97]. These results may be explained in part by the fact that smoking increases the level of secretory leukocyte protease inhibitor (SLPI), a protein involved in innate immunity that may, in turn, limit oral HPV acquisition [98].…”

Abnormal cytology in oropharyngeal brushings and in oral rinses is not associated with HPV infection: The OHMAR study

“…29 In our study, most of the cytologically abnormal oropharyngeal brushings and all of the cytologically abnormal oral rinses were classified as atypical (ie, atypical squamous cells of undetermined significance). Similarly, only cases of atypical squamous cells of undetermined significance were identified in previous studies on oropharyngeal cytology, 19,30 possibly because of the challenging collection of dysplastic/malignant cells by cytologic sampling (see below). We found that oral infection by high-risk HPVs was not significantly associated with abnormal cytology in either the oropharyngeal brushings or the oral rinses.…”

HIV Infection and Oral Manifestations: An Update

“…The OWs caused by HPV are among the most prevalent lesions of PLWH with a reported prevalence of about 0.5-6.9%, and HPV can be classified into subtypes according to its oncogenic level, and in the oral cavity, subtypes 6 and 11 are the most prevalent; about 90%, in OWs such as condylomas and laryngeal papillomas, have lower oncogenic potential. HPV is highly sexually transmitted; being frequent in the genital and anal region, its incidence in the oral mucosa is due to acts of self-inoculation or oral sexual contact [112][113][114][136][137][138][139].…”

“…Topically, a cream called imiquimod (50 mg/g) serves as an immunomodulatory cream that must be applied to the wart site once a day, three times a week for up to 28 days. Systemically, the use of antivirals such as cidofovir (5 mg/kg) is recommended, which should be administered once a week for up to 14 days [112][113][114][136][137][138][139].…”