Screening for High-Risk Oral Human Papillomavirus (HPV31, HPV33, HPV35) in a Multi-Racial Pediatric and Adult Clinic Patient Population

Abstract

Many human papillomavirus (HPV) strains induce cancer in the cervix and the oral cavity. Although high-risk strains including HPV16 and HPV18 are commonly known, additional high-risk strains including HPV31, HPV33, and HPV35 may also induce carcinogenesis, and much less is known about their prevalence. Using an approved protocol, samples from a salivary biorepository were screened to find pediatric and adult samples from a multi-ethnic, university-based patient clinic population. A total of N = 86 samples from the saliva biorepository met the quality and concentration standards and were screened for high-risk HPV. qPCR screening of adult samples revealed n = 10/45 or 22% were HPV31- or HPV33-positive. In addition, a total of n = 9/41 or 21.9% of pediatric samples were either HPV31- or HPV33-positive (or both). No samples harbored HPV35. Most samples were derived from patients within the recommended vaccination or catch-up age range (age 9–45 years). These results demonstrated that a significant percentage of patients harbor additional high-risk HPV strains within the oral cavity, including HPV31 and HPV33. These data support oral healthcare provider recommendations for the newer nine-valent vaccine, which includes both HPV31 and HPV33.

Screening for High-Risk Human Papillomavirus Reveals HPV52 and HPV58 among Pediatric and Adult Patient Saliva Samples

“…In particular, many studies have assessed oral HPV infection and risk among pediatric patients and have primarily focused on high-risk strains HPV16 and HPV18 covered by the original quadrivalent vaccine [ 34 , 35 ]. In previous studies from this group evaluating pediatric oral HPV, it was observed that HPV16 and HPV18 were found in approximately 9.2% of patient samples [ 29 , 30 ]. However, a more recent longitudinal analysis of additional samples collected over the past decade found that the high-risk oral HPV prevalence was actually increasing year over year, from an initial baseline of 5.7% in 2010 to 18.1% in 2020.…”

“…Although these findings are significant, there are some intrinsic limitations found among retrospective studies that should also be considered. For example, this was an analysis of existing samples obtained from one-time sampling (cross-sectional collection); it does not provide any longitudinal or temporal information regarding the incidence of these high-risk strains over time and does not indicate whether these current findings represent an increase or decrease in these oral HPV strains [ 28 , 29 ]. In addition, as a retrospective study of existing biorepository samples, limited demographic data regarding these patients were available (sex, age, race, or ethnicity), and no other health or behavioral data were collected with the original saliva samples, such as HPV vaccination status or engagement with smoking or vaping products [ 46 , 47 , 48 ].…”

“…Although most of the research into these high-risk strains has focused on cervical infections, there is evidence that these strains may be involved in the oncogenesis and transformation of oral infections and may mediate or modulate oral carcinogenesis [ 25 , 26 , 27 ]. Although previous studies at this institution have explored the high-risk oral prevalence of HPV strains 16 and 18 among children and adults, only one study to date has assessed additional high-risk strains, such as HPV31, 33, and 35, and no study to date has evaluated the presence of HPV52 and HPV58 among this patient population [ 28 , 29 ].…”