Rates and determinants of oral human papillomavirus infection in young men.
BACKGROUND
Little is known about the rates and determinants of oral human papillomavirus (HPV) infection, an infection that is etiologically linked with oropharyngeal cancers.


METHODS
A cohort of male university students (18-24 years) was examined every 4 months (212 men, 704 visits). Oral specimens were collected via gargle/rinse and swabbing of the oropharynx. Genotyping for HPV-16 and 36 other α-genus types was performed by polymerase chain reaction-based assay. Data on potential determinants were gathered via clinical examination, in-person questionnaire, and biweekly online diary. Hazards ratios (HR) were used to measure associations with incident infection.


RESULTS
Prevalence of oral HPV infection at enrollment was 7.5%, and 12-month cumulative incidence was 12.3% (95% confidence interval [CI], 7.0, 21.3). Prevalence of oral HPV-16 was 2.8% and 12-month cumulative incidence was 0.8% (95% CI, 0.1%-5.7%). None of the incident oral HPV infections and 28.6% of the prevalent oral HPV infections were detected more than once. In a multivariate model, incident oral HPV infection was associated with recent frequency of performing oral sex (≥1 per week: HR, 3.7; 95% CI, 1.4-9.8), recent anal sex with men (HR, 42.9; 95% CI, 8.8-205.5), current infection with the same HPV type in the genitals (HR, 6.2; 95% CI, 2.4-16.4), and hyponychium (HR, 11.8, 95% CI, 4.1-34.2).


CONCLUSIONS
Although nearly 20% of sexually active male university students had evidence of oral HPV infection within 12 months, most infections were transient. Human papillomavirus type 16 was not common. Sexual contact and autoinoculation appeared to play independent roles in the transmission of α-genus HPV to the oral cavity of young men.
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA.
Zoe R
ZR
Edelstein
Stephen M
SM
Schwartz
Stephen
S
Hawes
James P
JP
Hughes
Qinghua
Q
Feng
Michael E
ME
Stern
Sandra
S
O'Reilly
Shu-Kuang
SK
Lee
Long
L
Fu Xi
Laura A
LA
Koutsky
D000293:Adolescent; D004279:DNA, Viral; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D005838:Genotype; D052162:Human papillomavirus 16 / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D009055:Mouth / Q000821:virology; D009059:Mouth Diseases / Q000453:epidemiology* / Q000235:genetics / Q000517:prevention & control; D016017:Odds Ratio; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000517:prevention & control; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000235:genetics / Q000517:prevention & control; D016133:Polymerase Chain Reaction; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000235:genetics / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
D004279:DNA, Viral