Prevalence of HPV in the Oral Cavity of HIV+ Individuals

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DESCRIPTION (provided by applicant): Human immunodeficiency virus (HIV) has infected over 33 million people worldwide leading to immune suppression from the selective depletion of CD4+ T cells. This lack of immunity results in numerous opportunistic infections with over 50% of the HIV-infected individuals developing pathology involving the oral cavity. Among the pathogens responsible for oral disease in HIV+ patients is the mucosatropic human papillomavirus (HPV). Although HPV cannot be routinely cultured, it is the most common viral sexually transmitted disease. HPV is the etiologic agent of oral and genital warts, focal epithelial hyperplasia, and a large proportion of cervical, anogenital, and oral squamous cell carcinomas. HIV co-infection leads to increased rate of HPV genital infection, increased HPV persistence, and increased rates of HPV-related pathology (cervical or anal dysplasia), which is more difficult to treat. Similarly, preliminary studies indicate that HIV co-infection leads to increases in the prevalence of oral HPV and HPV-related oral pathology including oral cancer. Surprisingly, treatment of HIV with highly active anti-retroviral therapy (HAART) has led to increases in apparent HPV-related oral warts. These warts have been large, painful, and difficult to treat. Continued use of HAART for the HIV+ patient may lead to substantial increases in the incidence of oral warts and other HPV-related oral pathology such as squamous cell carcinomas. The studies to date have been limited by the lack of or the restrictive scope of the molecular techniques used to detect HPV infection. Thus, little is known about the prevalence, site of infection and natural history of oral HPV infection. A better understanding of oral HPV infection particularly in the HIV+ co-infected individual is of paramount importance in order to prevent HPV-related oral pathology. Preliminary data demonstrates the ability to detect oral HPV infection utilizing consensus PCR primer sets that were developed for detection of genital HPV. These techniques can be extended to detect oral HPV types. We hypothesize that a high throughput PCR-based method for detecting oral HPV types can be developed and utilized to determine the prevalence and site of oral HPV infection in a cohort of HIV+ individuals