title: Human papillomavirus detection in histologic samples of multifocal epithelial hyperplasia: a novel demographic presentation.
abstract: OBJECTIVE
  Human papillomavirus (HPV) typing of oral lesions microscopically consistent with multifocal epithelial hyperplasia (MEH) was performed to identify potential novel clinical presentations.
  
  
  METHODS
  MEH (N = 22 lesions, 17 patients) and squamous papilloma control samples (N = 9 lesions, 9 patients) were compared by using polymerase chain reaction-based HPV genotyping. Student's t tests were used to compare continuous characteristics.
  
  
  RESULTS
  Of the study cases, 86.4% of MEH and only 11% of controls were positive for HPV (P = .0002). In MEH lesions, 45.5% contained HPV32, 36.4% HPV6, and 4.5% HPV40. MEH lesions were mostly multifocal (50%) and occurred in HIV-negative patients (81.3%). They predominated on the labial/buccal mucosa (63.3%), and there were significant differences between groups by anatomic site (P < .0001). HPV32, but not HPV6, was detected in known HIV-positive patients.
  
  
  CONCLUSIONS
  A novel clinical presentation of MEH associated with HPV32 in HIV-negative, middle-aged to older adults is reported here. One case with HPV40 is the first to be reported. Future detection protocols should include HPV32, as it may be currently overlooked.
authors.affiliation: Graduate Research Assistant, James Graham Brown Cancer Center, PhD candidate, Department of Biochemistry and Molecular Genetics, University of Louisville, Louisville, KY, USA.
authors.forename: Sujita
authors.initials: S
authors.lastname: Khanal
authors.affiliation: Resident, Advanced Education in General Dentistry, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Eric T
authors.initials: ET
authors.lastname: Cole
authors.affiliation: Instructor, Department of Medicine, Member, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.
authors.forename: Joongho
authors.initials: J
authors.lastname: Joh
authors.affiliation: Assistant Professor, Department of Medicine, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.
authors.forename: Shin Je
authors.initials: SJ
authors.lastname: Ghim
authors.affiliation: Senior scientist, Professor of Vaccinology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.
authors.forename: Alfred Bennett
authors.initials: AB
authors.lastname: Jenson
authors.affiliation: Professor, Wendell Cherry Chair in Clinical Trial Research, Director, Biostatistics Shared Facility, James Graham Brown Cancer Center, Louisville, KY, USA.
authors.forename: Shesh N
authors.initials: SN
authors.lastname: Rai
authors.affiliation: Research Associate, Biostatistics Shared Facility, James Graham Brown Cancer Center, Louisville, KY, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Trainor
authors.affiliation: Associate Professor, Oral and Maxillofacial Pathology, Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, KY, USA. Electronic address: brian.shumway@louisville.edu.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Shumway
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D017573:Focal Epithelial Hyperplasia / Q000821:virology*; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction