Prevalence of Oral Human Papillomavirus Infection among Indian HIV-positive Men who have Sex with Men: A Cross-Sectional Study
Background: Oral human papillomavirus (HPV) infection has been causally linked to a subset of oropharyngeal cancers in Western populations15-20, and both oropharyngeal cancer and oral HPV infection are increased among HIV-positive individuals24,41. India has high incidences of oral and oropharyngeal cancers, and Indian HIV-positive men who have sex with men (MSM) may be at increased risk of developing oropharyngeal cancers. However, there is little information available on the prevalence of oral HPV in this population.
Methods: We tested 302 HIV-positive Indian MSM for oral HPV infection using L1 HPV DNA PCR with probes specific for 29 types and a mixture of 10 additional types. CD4+ level and plasma HIV viral load (VL) were measured. Participants completed an interviewer-administered questionnaire including a sexual history.
Results: The prevalence of oral HPV was 23.7% (95% CI: 19-29%) and 2.4% of participants had oncogenic HPV types. No participants had oral HPV type 16 (HPV-16) and the prevalence of other anogenital HPV types was low. Participants with higher CD4+ levels had reduced odds of having any oral HPV infection (OR: 3.1 [1.4-6.9]) in multivariable analyses.
Conclusions: This is the first report of oral HPV among Indian HIV-positive MSM. Our results show a high prevalence of oral HPV infection consistent with studies from Western populations. However, oncogenic anogenital HPV types were relatively uncommon in our study population. It is unknown what the impact of this distribution of oral HPV will be on oropharyngeal cancers. HIV-positive MSM in India should be monitored closely for oral and oropharyngeal pre-cancer and cancer.
Posted 21 Jan, 2021
Invitations sent on 03 Feb, 2021
On 03 Feb, 2021
On 10 Jan, 2021
On 10 Jan, 2021
On 10 Jan, 2021
Received 10 Dec, 2020
On 10 Dec, 2020
On 22 Sep, 2020
Received 05 Sep, 2020
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On 30 Aug, 2020
On 18 Aug, 2020
On 17 Aug, 2020
On 17 Aug, 2020
On 16 Aug, 2020
Prevalence of Oral Human Papillomavirus Infection among Indian HIV-positive Men who have Sex with Men: A Cross-Sectional Study
Posted 21 Jan, 2021
Invitations sent on 03 Feb, 2021
On 03 Feb, 2021
On 10 Jan, 2021
On 10 Jan, 2021
On 10 Jan, 2021
Received 10 Dec, 2020
On 10 Dec, 2020
On 22 Sep, 2020
Received 05 Sep, 2020
Invitations sent on 30 Aug, 2020
On 30 Aug, 2020
On 18 Aug, 2020
On 17 Aug, 2020
On 17 Aug, 2020
On 16 Aug, 2020
Background: Oral human papillomavirus (HPV) infection has been causally linked to a subset of oropharyngeal cancers in Western populations15-20, and both oropharyngeal cancer and oral HPV infection are increased among HIV-positive individuals24,41. India has high incidences of oral and oropharyngeal cancers, and Indian HIV-positive men who have sex with men (MSM) may be at increased risk of developing oropharyngeal cancers. However, there is little information available on the prevalence of oral HPV in this population.
Methods: We tested 302 HIV-positive Indian MSM for oral HPV infection using L1 HPV DNA PCR with probes specific for 29 types and a mixture of 10 additional types. CD4+ level and plasma HIV viral load (VL) were measured. Participants completed an interviewer-administered questionnaire including a sexual history.
Results: The prevalence of oral HPV was 23.7% (95% CI: 19-29%) and 2.4% of participants had oncogenic HPV types. No participants had oral HPV type 16 (HPV-16) and the prevalence of other anogenital HPV types was low. Participants with higher CD4+ levels had reduced odds of having any oral HPV infection (OR: 3.1 [1.4-6.9]) in multivariable analyses.
Conclusions: This is the first report of oral HPV among Indian HIV-positive MSM. Our results show a high prevalence of oral HPV infection consistent with studies from Western populations. However, oncogenic anogenital HPV types were relatively uncommon in our study population. It is unknown what the impact of this distribution of oral HPV will be on oropharyngeal cancers. HIV-positive MSM in India should be monitored closely for oral and oropharyngeal pre-cancer and cancer.