title: More men than women make mucosal IgA antibodies to Human papillomavirus type 16 (HPV-16) and HPV-18: a study of oral HPV and oral HPV antibodies in a normal healthy population.
abstract: BACKGROUND
  We have previously shown the high prevalence of oral anti-human papillomavirus type 16 (HPV-16) antibodies in women with HPV-associated cervical neoplasia. It was postulated that the HPV antibodies were initiated after HPV antigenic stimulation at the cervix via the common mucosal immune system. The present study aimed to further evaluate the effectiveness of oral fluid testing for detecting the mucosal humoral response to HPV infection and to advance our limited understanding of the immune response to HPV.
  
  
  METHODS
  The prevalence of oral HPV infection and oral antibodies to HPV types 16, 18 and 11 was determined in a normal, healthy population of children, adolescents and adults, both male and female, attending a dental clinic. HPV types in buccal cells were determined by DNA sequencing. Oral fluid was collected from the gingival crevice of the mouth by the OraSure method. HPV-16, HPV-18 and HPV-11 antibodies in oral fluid were detected by virus-like particle-based enzyme-linked immunosorbent assay. As a reference group 44 women with cervical neoplasia were included in the study.
  
  
  RESULTS
  Oral HPV infection was highest in children (9/114, 7.9%), followed by adolescents (4/78, 5.1%), and lowest in normal adults (4/116, 3.5%). The predominant HPV type found was HPV-13 (7/22, 31.8%) followed by HPV-32 (5/22, 22.7%). The prevalence of oral antibodies to HPV-16, HPV-18 and HPV-11 was low in children and increased substantially in adolescents and normal adults. Oral HPV-16 IgA was significantly more prevalent in women with cervical neoplasia (30/44, 68.2%) than the women from the dental clinic (18/69, 26.1% P = 0.0001). Significantly more adult men than women displayed oral HPV-16 IgA (30/47 compared with 18/69, OR 5.0, 95% CI 2.09-12.1, P < 0.001) and HPV-18 IgA (17/47 compared with 13/69, OR 2.4, 95% CI 0.97-6.2, P = 0.04).
  
  
  CONCLUSIONS
  The increased prevalence of oral HPV antibodies in adolescent individuals compared with children was attributed to the onset of sexual activity. The increased prevalence of oral anti-HPV IgA in men compared with women was noteworthy considering reportedly fewer men than women make serum antibodies, and warrants further investigation.
authors.affiliation: Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, 7925, Cape Town, South Africa. dmarais@curie.uct.ac.za
authors.forename: Dianne J
authors.initials: DJ
authors.lastname: Marais
authors.forename: Candice
authors.initials: C
authors.lastname: Sampson
authors.forename: Anthea
authors.initials: A
authors.lastname: Jeftha
authors.forename: Dherendra
authors.initials: D
authors.lastname: Dhaya
authors.forename: Jo-Ann S
authors.initials: JA
authors.lastname: Passmore
authors.forename: Lynette
authors.initials: L
authors.lastname: Denny
authors.forename: Edward P
authors.initials: EP
authors.lastname: Rybicki
authors.forename: Eric
authors.initials: E
authors.lastname: Van Der Walt
authors.forename: Lawrence Xg
authors.initials: LX
authors.lastname: Stephen
authors.forename: Anna-Lise
authors.initials: AL
authors.lastname: Williamson
mesh_terms: D000914:Antibodies, Viral / Q000276:immunology*; D005260:Female; D052140:Human papillomavirus 11 / Q000276:immunology / Q000302:isolation & purification; D052162:Human papillomavirus 16 / Q000276:immunology* / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D009092:Mucous Membrane / Q000276:immunology*; D030361:Papillomavirus Infections / Q000276:immunology*; D002583:Uterine Cervical Neoplasms / Q000276:immunology*
chemical_list: D000914:Antibodies, Viral