Prevalence and risk factors for oral DNA tumor viruses in HIV-infected youth.
Human papillomavirus (HPV), Epstein-Barr virus (EBV), and Kaposi sarcoma-associated herpes virus (KSHV) may promote oral cancers, especially among immunosuppressed individuals. The aims of this study were to examine whether demographic characteristics, medical history, sexual behaviors, substance use, CD4+ T-cell count, HIV viral load, and HPV vaccination were associated with HPV, EBV, and KSHV infection and viral load. Multivariable modeling using logistic or linear regression examined associations between independent variables and infection or viral load, respectively. Among 272 HIV-infected 12-24-year-old youth, 19.5% were positive for oral HPV, 88.2% for EBV, and 11.8% for KSHV. In multivariable models, recent marijuana use (OR 1.97, 95%CI 1.02-3.82) and lower CD4+ T-cell count (<350 vs. ≥350 cells/mm(3) : OR 1.92, 95%CI 1.003-3.69) were associated with HPV infection; lifetime tobacco use (estimated coefficient [EC] 1.55, standard error [SE] 0.53, P = 0.0052) with HPV viral load; recent tobacco use (OR 2.90, 95%CI 1.06-7.97), and higher HIV viral load (>400 vs. <400 copies/ml: OR 3.98, 95%CI 1.84-8.74) with EBV infection; Black versus White race (EC 1.18, SE 0.37, P = 0.0023), and lower CD4+ T-cell count (EC 0.70, SE 0.28, P = 0.017) with EBV viral load, male versus female gender (OR 10, 95%CI 1.32-100) with KSHV infection, and younger age at HIV diagnosis (1-14 vs. 18-20 years: EC 0.33, SE 0.16, P = 0.049; 15-17 vs. 18-20 years: EC 0.35, SE 0.13, P = 0.0099) with KSHV viral load. In conclusion, substance use and immunosuppression are associated with oral DNA tumor viruses in HIV-infected youth. J. Med. Virol. 88:1944-1952, 2016. © 2016 Wiley Periodicals, Inc.
Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio.
Jessica A
JA
Kahn
New York University School of Medicine, New York, New York.
Bret J
BJ
Rudy
Westat, Rockville, Maryland.
Jiahong
J
Xu
Maternal and Pediatric Infectious Disease Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland.
Bill
B
Kapogiannis
Wayne State University, Detroit, Michigan.
Elizabeth
E
Secord
Ohio State University, Columbus, Ohio.
Maura
M
Gillison
D000293:Adolescent; D018791:CD4 Lymphocyte Count; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D019288:Herpesvirus 8, Human / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009062:Mouth Neoplasms / Q000821:virology; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000208:ethnology / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D015995:Prevalence; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000150:complications / Q000453:epidemiology / Q000821:virology; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000453:epidemiology; D014412:Tumor Virus Infections / Q000150:complications* / Q000453:epidemiology*; D019562:Viral Load; D055815:Young Adult
D053918:Papillomavirus Vaccines
Epstein-Barr virus; human immunodeficiency virus; human papillomavirus; kaposi sarcoma-associated herpesvirus (human herpesvirus 8)