Six-month natural history of oral versus cervical human papillomavirus infection
Six-month natural history of oral versus cervical human papillomavirus infection
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DOI：
10.1002/ijc.22667
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发表时间：
2007-07-01
影响因子：
6.4
通讯作者：
Gillison, Maura L.
中科院分区：
文献类型：
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作者：
D'Souza, Gypsyamber;Fakhry, Carole;Gillison, Maura L.
人乳头瘤病毒（HPV）感染与口腔癌的一个子集的病因相关，然而，口腔HPV感染的自然史仍然未被探索。研究口腔HPV自然史的可行性进行了评估，收集口腔冲洗样品在两个场合在6个月的间隔从136个HIV阳性和63个HIV阴性的参与者。同时收集宫颈阴道灌洗样本进行比较。用通用引物PCR检测口腔和宫颈标本中HPV基因组DNA，并对37种HPV进行分型。口腔HPV感染的6个月累积患病率显著低于宫颈感染（p < 0.0001）。艾滋病毒阳性妇女比艾滋病毒阴性妇女更有可能检测到口腔（33%对15%，p = 0.016）或宫颈（78%对51%，p < 0.001）感染。在HIV阴性（60% vs. 51%，p = 0.70）和HIV阳性（55% vs. 63%，p = 0.27）妇女中，基线时检测到的口腔HPV感染与宫颈感染一样可能持续6个月。口腔HPV持续性独立升高的因素与宫颈感染不同，包括当前吸烟（OR = 8，95%CI = 1.3-53），年龄大于44岁（OR = 20，95%CI = 4.1-83），CD 4 < 500（OR = 6，95%CI = 1.1-26），使用HAART治疗（OR = 12，95%CI = 1.0-156），HAART治疗时间（趋势p = 0.04）。在HIV阳性（p < 0.001）和HIV阴性女性（p < 0.001）中，随访时新检测到的口腔HPV感染率显着低于宫颈感染。我们的研究不仅证明了用口腔冲洗液采样研究口腔HPV感染的自然史是可行的，而且还表明口腔和宫颈HPV感染的自然史可能不同。(C)2007 Wiley-Liss，Inc.
Human papillomavirus (HPV) infection is etiologically associated with a subset of oral cancers, and yet, the natural history of oral HPV infection remains unexplored. The feasibility of studying oral HPV natural history was evaluated by collecting oral rinse samples on 2 occasions at a 6-month interval from 136 HIV-positive and 63 HIV-negative participants. Cervical vaginal lavage samples were concurrently collected for comparison. HPV genomic DNA was detected in oral and cervical samples by consensus primer PCR and type-specified for 37 HPV types. The six-month cumulative prevalence of oral HPV infection was significantly less than for cervical infection (p < 0.0001). HIV-positive women were more likely than HIV-negative women to have an oral (33 vs. 15%, p = 0.016) or cervical (78 vs. 51%, p < 0.001) infection detected. Oral HPV infections detected at baseline were as likely as cervical infections to persist to 6 months among HIV-negative (60 % vs. 51 %, p = 0.70) and HIV-positive (55 % vs. 63 %, p = 0.27) women. Factors that independently elevated odds for oral HPV persistence differed from cervical infection and included current smoking (OR = 8, 95% CI = 1.3-53), age above 44 years (OR = 20, 95% CI = 4.1-83), CD4 < 500 (OR = 6, 95% CI = 1.1-26), use of HAART therapy (OR = 12, 95% CI = 1.0-156), and time on HAART therapy (trend p = 0.04). The rate of oral HPV infections newly detected at follow-up was significantly lower than cervical infection among HIV-positive (p < 0.001) and HIV-negative women (p < 0.001). Our study not only demonstrates that it is feasible to study the natural history of oral HPV infection with oral rinse sampling, but also indicates that oral and cervical HPV natural history may differ. (C) 2007 Wiley-Liss, Inc.