Sequential acquisition of human papillomavirus infection between genital and oral anatomic sites in males

Abstract

AbstractOral human papillomavirus (HPV) is associated with increasing rates of HPV-associatedoropharyngeal cancer (OPC) in men. Sequential infection from one site to another hasbeen demonstrated at the cervix and anus. Thus, risk of an oral HPV infection after agenital infection of the same type in the HPV infection in men study was investigated.Samples from 3140 men enrolled in a longitudinal cohort were assessed for sequentialgenital to oral infection with one of nine HPV types (HPV 6, 11, 16, 18, 31, 33,45, 52 and 58); and then also sequential, same-type oral to genital infection. Incidencerate ratios (IRRs) compared rates of oral HPV among men with and without prior genitalinfection of the same type. Risk of sequential HPV infections were assessed using Coxproportional hazards model. Incidence of an oral HPV infection was significantly higheramong men with a prior genital infection of the same type for any of the 9 HPV types(IRR: 2.3; 95 CI: 1.7-3.0). Hazard ratio of asequential genital to oral HPV infection was2.3 (95 CI: 1.7-3.1) and 3.5 (95 CI: 1.9-6.4) for oral to genital infection. Both changedminimally after adjustment for age, country, circumcision, alcohol use, lifetime sexualpartners and recent oral sex partners. HPV infections at one site could elevate risk of asubsequent genital or oral HPV infection of the same type in men, emphasizing theimportance of vaccination toprevent all HPV infections