Natural history of oral papillomavirus infections in spouses: A prospective Finnish HPV Family Study
Introduction
In oral mucosa, human papillomavirus (HPV) is associated with several benign lesions including condyloma accuminatum, papilloma, focal epithelial hyperplasia, verruca vulgaris (reviewed in Syrjänen and Syrjänen, 2000, Syrjänen, 2003). In 1983 we showed first evidence that HPV infection might be etiologically related to of oral cancers (Syrjänen et al., 1983). Recent meta-analysis and case-control studies have confirmed HPV infection as a risk factor for head and neck cancer with odd ratios of 3.7–5.4 (Syrjänen and Syrjänen, 2000, Miller and Johnstone, 2001, Herrero et al., 2003). Similar to genital mucosa, HPV is also detected in clinically healthy oral mucosa in 10–13% of the adult population as reported in a meta-analysis or literature survey until 1997 (reviewed in Syrjänen and Syrjänen, 2000, Miller and Johnstone, 2001, Syrjänen, 2003). At least 37 of the 106 different HPV types have been detected in oral mucosa; HPV 16 being the most common type, followed by HPV 6 (Syrjänen and Syrjänen, 2000, Syrjänen, 2003, Kreimer et al., 2004, Cañadas et al., 2004).
The origins of oral HPV infection are not fully elucidated yet. Sexual transmission explains oral HPV infections poorly, because the oral and genital HPV types of partners are different in most published studies (Kellokoski et al., 1992a, Kellokoski et al., 1992b). Similarly, oral and genital mucosas were shown to harbour different HPV types in women, simultaneously (Kellokoski et al., 1992a, Badaracco et al., 1998, Bennedetti Panici et al., 1998, Cañadas et al., 2004). Frequent detection of skin warts concomitantly with oral HPV DNA might suggest the possibility of hand-to-oral transmission (Kellokoski et al., 1992b, Terai et al., 1999), which parallels the findings of hand–genital transmission (Fairley et al., 1995, Sonnex et al., 1999). Apart from sexual transmission and auto-inoculation, other possible HPV transmission modes are horizontal transmission, vertical transmission and transmission via fomites or saliva (Syrjänen and Puranen, 2000).
To shed more light on the dynamics of HPV transmission within a family, we set up the prospective Finnish HPV Family Study, assessing the modes of HPV spread among infants and their parents (Rintala et al., 2005). The present report is the first prospective study, where the natural history of high-risk (HR) HPV and acquisition and clearance rates were analyzed in healthy oral mucosa of spouses followed-up for two years.
Section snippets
Subjects
This study is a part of the prospective study known as the Finnish HPV Family Study, conducted at the Department of Obstetrics and Gynecology, Turku University Central Hospital and at the Department of Dentistry, University of Turku, Turku, Finland (Rintala et al., 2005). The Joint Commission on Ethics of University of Turku and TUCH has approved the study protocol (#3/1998). The present report includes data on the 331 women in the third trimester of pregnancy and 131 fathers-to-be with a mean
Detection of oral HPV DNA
The detection rates of any oral high-risk HPV DNA as detected with the HR-oligoprobe cocktail in both spouses are shown in Fig. 1. HR HPV DNA detection varied from 16% to 27% in women and from 18% to 25% in men. When analyzed pair-wise (n = 131) for their HPV status in different visits, only the baseline oral HPV status in both spouses was significantly interrelated (odds ratio 4.34; 95% confidence interval 1.58–11.91; P = 0.006).
Outcome of oral HPV
The outcome of oral HPV infection in both spouses is very similar as
Discussion
In the earlier studies, the natural history of HPV infections has been extensively studied only in the genital tract, the uterine cervix in particular. Until today, HPV in normal oral mucosa has been mostly studied in cross-sectional (prevalence) studies (Jenison et al., 1990, Lawton et al., 1992, Kellokoski et al., 1992a, Kellokoski et al., 1992b, Lambropoulos et al., 1997, Badaracco et al., 1998, Terai et al., 1999, Kreimer et al., 2004). Only one earlier study describes the natural history
References (34)
- et al.
The future of HPV testing in clinical laboratories and applied virology research
Clin Diagn Virol
(1997) - et al.
The use of nested polymerase chain reaction and restriction fragment length polymorphism for the detection and typing of mucosal human papillomaviruses in samples containing low copy numbers of viral DNA
J Virol Methods
(2002) - et al.
Low prevalence of HPV infection and its natural history in normal oral mucosa among volunteers on Miyako Island, Japan
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(2004) - et al.
Increased frequency of detection of human papillomavirus deoxyribonucleic acid in exfoliated cervical cells during pregnancy
Am J Obstet Gynecol
(1989) - et al.
PCR detection of human papillomavirus of the mucosa: comparison between MY09/11 and GP5+/6+ primer sets
J Clin Virol
(2004) - et al.
Morphological and immunohistochemical evidence suggesting human papillomavirus (HPV) involvement in oral squamous cell carcinogenesis
Int J Oral Surg
(1983) - et al.
Laryngeal papillomatosis: clinical, histopathologic and molecular studies
Laryngoscope
(1987) - et al.
Concurrent HPV infection in oral and genital mucosa
J Oral Pathol Med
(1998) - et al.
Concurrent HPV infection in oral and genital mucosa
J Oral Pathol Med
(1998) - et al.
Concordance of prevalence of human papillomavirus DNA in anogenital and oral infections in a high-risk population
J Clin Microbiol
(2004)
HPV prevalence in cytomorphologically normal cervical scrapes of pregnant women as determinated by PCR: the age-related pattern
J Med Virol
Hand–genital transmission of genital warts? An analysis of prevalence data
Epidemiol Infect
Epidemiology of acquisition and clearance of cervical human papillomavirus infection in women from a high-risk area for cervical cancer
J Infect Dis
Incidence, prevalence, and clearance of type-specific human papillomavirus infections: the young women's health study
J Infect Dis
Human papillomavirus and oral cancer: the international agency for research on cancer multicenter study
J Natl Cancer Inst
Evidence of prevalent genital-type human papillomavirus infections in adults and children
J Infect Dis
Dot blot hybridization in detection of human papillomavirus (HPV) infections in the oral cavity of women with genital HPV infections
Oral Microbiol Immunol
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