Prevalence of human papillomavirus (HPV) in oral mucosal lesions in Iran: A systematic review and meta‐analysis

Abstract

The role of human papillomavirus (HPV) in the development of oral lesions is controversial. There has been no comprehensive study about HPV prevalence in Iran. This systematic review and meta-analysis were aimed at finding HPV prevalence of oral lesions and normal oral mucosa in Iran. International (PubMed, Web of Science, and Scopus) and national (Iranmedex, Irandoc, and SID) databases were searched systematically until October 2020. Studies that examined the prevalence of HPV in oral lesions by polymerase chain reaction method were included. The heterogeneity of articles was assessed with the Cochran test and I-Square statistics.The prevalence rate of HPV was calculated using a random-effect model. Of 3729 initially searched articles, 29 articles were eligible for inclusion. The overall prevalence of HPV in oral lesions was 21%. The prevalence was the highest in Rasht (50%) city. Lip lesions had the highest HPV prevalence (40%). According to the classification of lesions, the highest prevalence was of precancerous lesions (29%) and the lowest in normal mucosa (8%). Well-differentiated tumors showed a higher prevalence than poorly-differentiated ones. The highest prevalence of HPV was hairy leukoplakia (70%) and the lowest was of pyogenic granuloma (6%). Also, the prevalence was 31% in oral squamous cell carcinoma. There are differences between HPV prevalence according to the geographical area, intraoral location, type of lesion, and grading. As HPV prevalence was fairly high, further attention to vaccination and treatment for HPV in Iran, as a potential risk factor for oral precancerous and cancerous lesions is recommended.

Lineage and phylogenetic analysis of HPV-16, -18 in saliva of HNSCC patients

“…These studies reflect the controversial reports about HPV prevalence and its subtypes in Iran. This controversy recently confirmed by a systematic review study 18 .…”

Human Papillomaviruses-Related Cancers: An Update on the Presence and Prevention Strategies in the Middle East and North African Regions

“…In contrast, other investigations revealed a higher HPV positivity (7-43%) in head and neck squamous cell carcinomas [128][129][130]162], with HPVs -18, -52, and -61 as dominant subtypes [130,162]. Additionally, a systematic review and meta-analysis revealed an overall presence of HPV in oral lesions (21%), whereas, in oral squamous cell carcinoma, HPV prevalence was 31% [172]. Moreover, in laryngeal squamous cell carcinomas, 28% of the samples were HPV-positive; HPV16 was predominant, followed by HPV18 [150].…”

Mapping recommendations towards an Asian Code Against Cancer (ACAC) as part of the World Code Against Cancer Framework: an Asian National Cancer Centers Alliance (ANCCA) initiative

“…Prevalence of HPV, varies among Asian countries, were reported at 21% in Iran 30 (for oral mucosal lesions), 20% in Korea 31 (with 74% being HPV16/18) and 19.0–84.4% in China. 32 , 33 In a 2017 meta-analysis 34 conducted in Asian populations, HPV vaccines significantly enhanced HPV16 and HPV18-specific antibody levels.…”