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Short report
Oral human papillomavirus (HPV) infection in men who have sex with men: prevalence and lack of anogenital concordance
  1. Eleanor M King1,
  2. Richard Gilson1,2,
  3. Simon Beddows3,
  4. Kate Soldan4,
  5. Kavita Panwar3,
  6. Carmel Young1,2,
  7. Mark Jit5,6,
  8. W John Edmunds6,
  9. Pam Sonnenberg1
  1. 1Research Department of Infection and Population Health, University College London, London, UK
  2. 2The Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
  3. 3Virus Reference Department, Public Health England, London, UK
  4. 4Centre for Communicable Disease Surveillance and Control (CIDSC), Public Health England, London, UK
  5. 5Modelling and Economics Unit, Public Health England, London, UK
  6. 6Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
  1. Correspondence to Dr Pam Sonnenberg, Research Department of Infection and Population Health, University College London, The Mortimer Market Centre, London WC1E 6JB, UK; p.sonnenberg{at}ucl.ac.uk

Abstract

Objectives 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.

  • HPV
  • ORAL CAVITY
  • SEXUAL HEALTH
  • VACCINATION
  • GAY MEN

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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