Type-specific persistence and clearance rates of HPV genotypes in the oral and oropharyngeal mucosa in an HIV/AIDS cohort

Abstract

Background

Oral high-risk human papillomavirus (HR-HPV) infections are frequent and persistent among HIV-positive population and are associated with an increased risk for head and neck cancer (HNC). In this study, we sought to determine the incidence, persistence, and clearance of HPV-infections in oral and oropharyngeal samples from HIV/AIDS subjects.

Methods

A longitudinal, observational, and analytical study was performed with an ongoing cohort of HIV/AIDS subjects in Mexico City (September 2013-February 2015). The study was approved by institutional committees, and demographic and clinical data were registered. At the baseline and three-month visits, oral examinations and cytobrush samples were obtained. DNA was purified, quantified and used to detect an HPV-L1 gene fragment by nested-PCR, using MY09/MY11 and GP5+/GP6+ primers. HPV-DNA products were purified, sequenced, and typed according to HPV-databases. Risk factors were assessed, and a multivariate modelling approach was used to determine independent effects.

Results

This study included 97 HIV/AIDS individuals (91% men [86.4% of which are men who have sex with men], median age: 36 years, 72.2% under HAART). From the baseline visit, HPV was observed in 55.7% (HR-HPV: 26.8%; HPV-18: 24.1%), with a higher HPV-positive samples for smokers (61.1 vs. 32.6%, p=0.005). The three-month overall HPV-incidence was 33.9%; type-specific HPV persistence was 33.3% (HR-HPV: 13.3%); and 13 of the 33 (39.4%) baseline HPV-positive individuals cleared the infection (HR-HPV: 53.8%).

Conclusions

Although HR-HPV persistence was low, and clearance of the infection was observed in most cases, a close follow-up is necessary, given the increase of HNC among HIV-subjects, particularly HPV-related cancer.

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