title: Prevalence of human papillomavirus in the oral cavity/oropharynx in a large population of children and adolescents.
abstract: OBJECTIVE
  Human papillomavirus (HPV) in the oral cavity or oropharynx is associated with an increased risk of laryngeal papillomatosis, head and neck cancer, and cervical and other genital cancers. We evaluated the prevalence of HPV DNA in the oral cavity/oropharynx in a cross section of children aged 2 weeks to 20 years.
  
  
  METHODS
  A risk factor questionnaire and oral exfoliated cells were collected from children (N = 1235). HPV DNA was detected using PCR, dot blot hybridization, and DNA sequencing.
  
  
  RESULTS
  The HPV prevalence was 1.9% in the oral cavity/oropharynx of children. A bimodal age distribution was observed with the highest HPV prevalence in the youngest and oldest groups: 2.5% aged <1 year, 0.8% aged 1 to 4 years, 1.2% aged 5 to 11 years, 1.5% in aged 12 to 15 years, and 3.3% in aged 16 to 20 years. The prevalence of the HPV quadrivalent vaccine types (HPV-6, 11, 16, 18) reached 0.9% in the 16- to 20-year age group. In this age group, female gender [odds ratio (OR): 6.9, P = 0.04], genital warts (OR: 19.3, P < 0.01), and current smoker (OR: 6.5, P = 0.01) were associated with a higher risk of being detected with an oral HPV infection. No risk factors in parents were identified with transmission of HPV to infants.
  
  
  CONCLUSIONS
  The age-specific prevalence rates of HPV in this large cross section of children and adolescents demonstrate that HPV infection is acquired gradually in childhood. These data support a target age for HPV vaccination before puberty to prevent serious HPV-related genital and oral diseases.
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA. elaine-smith@uiowa.edu
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Smith
authors.forename: Sandhya
authors.initials: S
authors.lastname: Swarnavel
authors.forename: Justine M
authors.initials: JM
authors.lastname: Ritchie
authors.forename: Donghong
authors.initials: D
authors.lastname: Wang
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Haugen
authors.forename: Lubomir P
authors.initials: LP
authors.lastname: Turek
mesh_terms: D000293:Adolescent; D000328:Adult; D052685:Alphapapillomavirus / Q000145:classification / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007484:Iowa / Q000453:epidemiology; D008297:Male; D009055:Mouth / Q000821:virology*; D030361:Papillomavirus Infections / Q000453:epidemiology*; D010614:Pharynx / Q000821:virology*; D015995:Prevalence; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D017678:Sex Distribution; D011795:Surveys and Questionnaires