title: Oral Human Papillomavirus Infection and Oral Lesions in HIV-Positive and HIV-Negative Dental Patients.
abstract: We evaluated the risk factors associated with oral human papillomavirus (HPV) infection and oral lesions in 161 human immunodeficiency virus (HIV)-positive patients and 128 HIV-negative patients presenting for oral examination at 2 urban healthcare centers. Patients were interviewed on risk factors and provided oral-rinse samples for HPV DNA typing by polymerase chain reaction. Statistical associations were assessed by logistic regression. Oral HPV was prevalent in 32% and 16% of HIV-positive patients and HIV-negative patients, respectively, including high-risk HPV type 16 (8% and 2%, respectively; P = .049) and uncommon HPV types 32/42 (6% and 5%, respectively; P = .715). Among HIV-negative patients, significant risk factors for oral HPV included multiple sex partners (≥21 vs ≤5; odds ratio [OR], 9.1; 95% confidence interval [CI], 1.7-49.3), heavy tobacco smoking (>20 pack-years vs none; OR, 9.2; 95% CI, 1.4-59.4), and marijuana use (OR, 4.0; 95% CI, 1.3-12.4). Among HIV-positive patients, lower CD4(+) T-cell count only was associated with oral HPV detection (≤200 vs ≥500 cells/mm(3); OR, 4.5; 95% CI, 1.3-15.5). Detection of high-risk HPV was also associated with concurrent detection of potentially cancerous oral lesions among HIV-negative patients but not among HIV-positive patients. The observed risk factor associations with oral HPV in HIV-negative patients are consistent with sexual transmission and local immunity, whereas in HIV-positive patients, oral HPV detection is strongly associated with low CD4(+) T-cell counts.
authors: Department of Oral Health and Society, McGill Dentistry, Montreal, Canada.
authors: Katia
authors: K
authors: Muller
authors: Department of Dentistry.
authors: Julie
authors: J
authors: Kazimiroff
authors: Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, New Jersey.
authors: Mahnaz
authors: M
authors: Fatahzadeh
authors: Department of Otorhinolaryngology-Head and Neck Surgery Department of Pathology.
authors: Richard V
authors: RV
authors: Smith
authors: Department of Dentistry.
authors: Mauricio
authors: M
authors: Wiltz
authors: Department of Dentistry.
authors: Jacqueline
authors: J
authors: Polanco
authors: Division of Infectious Diseases.
authors: Robert M
authors: RM
authors: Grossberg
authors: Department of Pathology.
authors: Thomas J
authors: TJ
authors: Belbin
authors: Department of Epidemiology and Population Health.
authors: Howard D
authors: HD
authors: Strickler
authors: Department of Epidemiology and Population Health Division of Genetics, Department of Pediatrics Department of Microbiology and Immunology Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York.
authors: Robert D
authors: RD
authors: Burk
authors: Division of Oncology, Department of Medicine Department of Epidemiology and Population Health.
authors: Nicolas F
authors: NF
authors: Schlecht
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000453:epidemiology* / Q000473:pathology* / Q000821:virology; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology* / Q000821:virology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: HIV; human papillomavirus (HPV); immunity; oral lesions; sexual activity