title: The sero-epidemiology of human papillomavirus among Caucasian transplant recipients in the UK.
abstract: BACKGROUND
  Despite intensive study of high-risk mucosal human papillomaviruses (HPV), little is known of the epidemiology of cutaneous HPV. As part of a study of cutaneous squamous cell carcinoma and HPV among organ transplant recipients (OTR) from London and Oxford, we investigated the seroprevalence and risk factors for 34 HPV types (detected using Luminex technology) among 425 Caucasian OTR without skin cancer.
  
  
  RESULTS
  Overall, 86% of participants were seropositive to at least one HPV: 41% to mucosal alpha types, 33% to cutaneous alpha types, 57% to alpha types, 56% to beta, 47% to gamma types and 45% to other types (nu, mu, HPV101 and 103). In both centres, the most common types were HPV6 (33% and 26% for London and Oxford respectively), HPV8 (24% and 18%), HPV15 (26% and 29%), HPV17 (25% and 21%), HPV38 (23% and 21%), HPV49 (19% and 21%), HPV4 (27% and 23%), HPV65 (30% and 25%), HPV95 (22% and 20%), HPV1 (33% and 24%) and HPV63 (28% and 17%). The seroprevalence of 8 HPV types differed significantly (P < 0.05) between London and Oxford. Those individuals seropositive to multiple types of one genus were more likely to be seroreactive to multiple types of another genus. As expected, antibodies against mucosal alphaHPV types were more frequent in younger patients and among women. Sunbed use and sunbathing was associated with seropositivity to multiple gammaHPV (P-trend = 0.007) and self-history of abnormal smear was related to seroactivity to multiple betaHPV (P = 0.01). Skin type and other self reported markers of exposure to ultraviolet radiation were not consistently associated with any HPV types. No other distinguishing epidemiological features of transplant recipients with antibodies against single or multiple HPV types were identified.
  
  
  CONCLUSIONS
  Findings for mucosal HPV types were in line with results from previous studies. We observed differences in HPV seroprevalence between organ transplant recipients from two geographically close centres but no clear risk factor was found associated with cutaneous HPV seropositivity among organ transplant recipients. These findings have implications for interpretation of future seroepidemiology studies addressing the association between HPV and cutaneous SCC in OTR populations.
authors.affiliation: Cancer Epidemiology Unit, Richard Doll Building, University of Oxford, Old Road Campus, Roosevelt Drive, Headington, Oxford, OX3 7LF, UK. dcasabonne@iconcologia.net
authors.forename: Delphine
authors.initials: D
authors.lastname: Casabonne
authors.forename: Tim
authors.initials: T
authors.lastname: Waterboer
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Michael
authors.forename: Michael
authors.initials: M
authors.lastname: Pawlita
authors.forename: Aoife
authors.initials: A
authors.lastname: Lally
authors.forename: Liza
authors.initials: L
authors.lastname: Mitchell
authors.forename: Beata
authors.initials: B
authors.lastname: Imko-Walczuk
authors.forename: Fenella
authors.initials: F
authors.lastname: Wojnarowska
authors.forename: Robert
authors.initials: R
authors.lastname: Newton
authors.forename: Charlotte
authors.initials: C
authors.lastname: Proby
authors.forename: Catherine
authors.initials: C
authors.lastname: Harwood