title: Risk factors for oral HPV infection among a high prevalence population of HIV-positive and at-risk HIV-negative adults.
abstract: BACKGROUND
  Human papillomavirus (HPV) is an important risk factor for oropharyngeal cancer. Individuals with human immunodeficiency virus (HIV) have higher oral HPV prevalence but the risk factors for oral HPV infection are not well understood for either HIV-positive or HIV-negative individuals.
  
  
  METHODS
  This study was nested within the Multicenter AIDS Cohort Study (MACS; men) and Women Interagency HIV Study (WIHS; women) cohorts. Exfoliated oral epithelial cells were collected from 379 HIV-positive and 266 at-risk HIV-negative individuals using a rinse and gargle with Scope mouthwash. Samples were tested for 36 types of HPV DNA using PGMY09/11 consensus primers and reverse line blot hybridization. Risk factors for oral HPV infection were explored using logistic regression with generalized estimating equations in this cross-sectional analysis.
  
  
  RESULTS
  Prevalent oral HPV infection was common (34%), including HPV16 infection in 5.7% of participants. HIV-positive individuals had increased odds of prevalent oral HPV infection compared with HIV-negative individuals [adjusted OR = 2.1; 95% confidence interval (CI), 1.6-2.8]. Risk factors for prevalent oral HPV differed in HIV-positive and HIV-negative participants. Among HIV-negative individuals, higher number of recent oral sex or rimming partners were strong risk factors for prevalent oral HPV infection (each P(trend) < 0.01). In contrast, among HIV-positive individuals, lower CD4 T-cell count (P(trend) < 0.001) and higher number of lifetime sexual partners (P(trend) = 0.03) were strong risk factors.
  
  
  CONCLUSIONS
  Oral HPV prevalence was elevated in HIV-positive individuals after controlling for differences in cigarette smoking and sexual behavior, supporting the possibility that HIV may affect the natural history of oral HPV.
  
  
  CONCLUSIONS
  Immunosuppression may contribute to increased persistence or progression of oral HPV infection.
authors: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 n Wolfe St. E6132B, Baltimore, MD 21205, USA.
authors: Daniel C
authors: DC
authors: Beachler
authors: Kathleen M
authors: KM
authors: Weber
authors: Joseph B
authors: JB
authors: Margolick
authors: Howard D
authors: HD
authors: Strickler
authors: Ross D
authors: RD
authors: Cranston
authors: Robert D
authors: RD
authors: Burk
authors: Dorothy J
authors: DJ
authors: Wiley
authors: Howard
authors: H
authors: Minkoff
authors: Susheel
authors: S
authors: Reddy
authors: Emily E
authors: EE
authors: Stammer
authors: Maura L
authors: ML
authors: Gillison
authors: Gypsyamber
authors: G
authors: D'Souza
mesh_terms: D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D006678:HIV / Q000235:genetics / Q000302:isolation & purification*; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D006679:HIV Seropositivity / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000453:epidemiology* / Q000821:virology; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology