title: Oral Human Papillomavirus Infection in Men Who Have Sex with Men: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  The epidemiology of oral human papillomavirus (HPV) infection in men who have sex with men (MSM) differs from anogenital HPV infection. The impact of HPV vaccination has, to date, largely focussed on anogenital outcomes. Vaccination of MSM in the UK has been recommended and, if implemented, baseline estimates of oral HPV prevalence will be useful.
  
  
  METHODS
  We searched Medline, Embase and psycINFO databases for studies reporting prevalence, incidence, and clearance of oral HPV infection in MSM. We performed a random-effects meta-analysis and meta-regression on prevalence estimates and summarised within-study risk factors for oral HPV DNA detection and incidence/clearance rates. We also performed a meta-analysis of the effect of MSM on oral HPV prevalence compared to heterosexual men.
  
  
  RESULTS
  26 publications were identified. The pooled prevalence of oral HPV16 from twelve estimates was 3.0% (95%CI 0.5-5.5) in HIV-negative and 4.7% (95%CI 2.1-7.3) in HIV-positive MSM. Median age of study participants explained 38% of heterogeneity (p<0.01) in HPV prevalence estimates (pooled = 17% and 29% in HIV-negative and HIV-positive, respectively; 22 estimates). Nine studies compared MSM to heterosexual men and found no difference in oral HPV prevalence (pooled OR 1.07 (95%CI 0.65-1.74)). The clearance rate was higher than incidence within studies. Type-specific concordance between oral and anogenital sites was rare.
  
  
  CONCLUSIONS
  There was substantial heterogeneity between estimates of oral HPV prevalence in MSM populations that was partly explained by HIV status and median age.
authors.affiliation: Research Department of Infection and Population Health, University College London, WC1E 6JB, London, United Kingdom.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: King
authors.affiliation: The Mortimer Market Centre, Central and North West London NHS Foundation Trust, WC1E 6JB, London, United Kingdom.
authors.forename: Soonita
authors.initials: S
authors.lastname: Oomeer
authors.affiliation: Research Department of Infection and Population Health, University College London, WC1E 6JB, London, United Kingdom.|The Mortimer Market Centre, Central and North West London NHS Foundation Trust, WC1E 6JB, London, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Gilson
authors.affiliation: Research Department of Infection and Population Health, University College London, WC1E 6JB, London, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Copas
authors.affiliation: Virus Reference Department, Public Health England, 61 Colindale Avenue, NW9 5EQ, London, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Beddows
authors.affiliation: Centre for Communicable Disease Surveillance and Control (CIDSC), Public Health England, 61 Colindale Avenue, NW9 5EQ, London, United Kingdom.
authors.forename: Kate
authors.initials: K
authors.lastname: Soldan
authors.affiliation: Modelling and Economics Unit, Public Health England, 61 Colindale Avenue, NW9 5EQ, London, United Kingdom.|Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT, London, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Jit
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT, London, United Kingdom.
authors.forename: W John
authors.initials: WJ
authors.lastname: Edmunds
authors.affiliation: Research Department of Infection and Population Health, University College London, WC1E 6JB, London, United Kingdom.
authors.forename: Pam
authors.initials: P
authors.lastname: Sonnenberg
mesh_terms: D004279:DNA, Viral / Q000302:isolation & purification; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D009059:Mouth Diseases / Q000453:epidemiology* / Q000821:virology; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use; D015995:Prevalence
chemical_list: D004279:DNA, Viral; D053918:Papillomavirus Vaccines