title: Oral human papillomavirus (HPV) infection in men who have sex with men: prevalence and lack of anogenital concordance.
abstract: OBJECTIVE
  To estimate the prevalence of oral detectable human papillomavirus (HPV) DNA in HIV-negative men who have sex with men (MSM) attending a sexual health clinic in London and concordance with anogenital HPV infection. Such data are important to improve our understanding of the epidemiology of oral HPV and the potential use of vaccines to prevent oropharyngeal cancers.
  
  
  METHODS
  Paired oral rinse samples and anogenital samples were available from 151 HIV-negative MSM within a larger cross-sectional survey. All samples were tested in parallel for 21 types of HPV DNA using an in-house assay.
  
  
  RESULTS
  The median age of participants was 30 (IQR 25-35). The prevalence of any oral HPV and of high-risk HPV (HR-HPV) was 13.7% (n=21; 95% CI 8.7 to 20.2) and 5.9% (n=9; 95% CI 2.7 to 10.9) compared with 64.9% (n=98; 95% CI 56.7 to 72.5) and 34.4% (n=52; 95% CI 26.9 to 42.6) in any anogenital sample, respectively. The prevalence of types prevented by the bivalent (HPV16/18), quadrivalent (HPV6/11/16/18) and nonavalent (HPV6/11/16/18/31/33/45/52/58) vaccines was 1.3% (95% CI 0.2 to 4.7), 2.6% (95% CI 0.7 to 6.6) and 4.6% (95% CI 1.9 to 9.3), respectively. There was no concordance between HPV genotypes detected in oral and anogenital sites.
  
  
  CONCLUSIONS
  HR-HPV DNA, including HPV 16/18, was detected in oral specimens from HIV-negative MSM attending sexual health clinics, suggesting a potential role for vaccination, but is far less common than anogenital infection. How this relates to the risk and natural history of HPV-related head and neck cancers warrants further study. Lack of concordance with anogenital infection also suggests that oral HPV infection should be considered separately when estimating potential vaccine impact.
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: King
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK The Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Gilson
authors.affiliation: Virus Reference Department, Public Health England, London, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Beddows
authors.affiliation: Centre for Communicable Disease Surveillance and Control (CIDSC), Public Health England, London, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Soldan
authors.affiliation: Virus Reference Department, Public Health England, London, UK.
authors.forename: Kavita
authors.initials: K
authors.lastname: Panwar
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK The Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK.
authors.forename: Carmel
authors.initials: C
authors.lastname: Young
authors.affiliation: Modelling and Economics Unit, Public Health England, London, UK Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Jit
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: W John
authors.initials: WJ
authors.lastname: Edmunds
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: Pam
authors.initials: P
authors.lastname: Sonnenberg
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000821:virology; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D005837:Genitalia, Male / Q000821:virology; D005838:Genotype; D018451:Homosexuality, Male; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D009055:Mouth / Q000821:virology*; D009959:Oropharyngeal Neoplasms / Q000517:prevention & control / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control; D053918:Papillomavirus Vaccines; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D053918:Papillomavirus Vaccines
keywords: GAY MEN; HPV; ORAL CAVITY; SEXUAL HEALTH; VACCINATION