Oral HPV Infection in Women with HPV-Positive Cervix Is Closely Related to Oral Sex

The oral transmission of HPV and, consequently, the risk of oral cancer has increased in the last years. Oral sex has often been implicated among the risk factors for oral HPV infections, however, there is still no consensus on these topics, nor on the relationship between genital and oral HPV infec...

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Main Authors: Maria Teresa Bruno, Sara Boemi, Giuseppe Caruso, Francesco Sgalambro, Salvatore Ferlito, Antonio Cavallaro, Maria Chiara Sudano, Marco Palumbo
Format: Article
Language:English
Published: MDPI AG 2023-06-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/13/12/2096
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author Maria Teresa Bruno
Sara Boemi
Giuseppe Caruso
Francesco Sgalambro
Salvatore Ferlito
Antonio Cavallaro
Maria Chiara Sudano
Marco Palumbo
author_facet Maria Teresa Bruno
Sara Boemi
Giuseppe Caruso
Francesco Sgalambro
Salvatore Ferlito
Antonio Cavallaro
Maria Chiara Sudano
Marco Palumbo
author_sort Maria Teresa Bruno
collection DOAJ
description The oral transmission of HPV and, consequently, the risk of oral cancer has increased in the last years. Oral sex has often been implicated among the risk factors for oral HPV infections, however, there is still no consensus on these topics, nor on the relationship between genital and oral HPV infections. The present study aimed to evaluate the coexistence of papilloma virus, at the levels of the oral and genital mucosa, in women with a histologically confirmed HPV lesions (and a positive HPV test) at the genital level and a negative HPV control group. We also evaluated how some risk factors, such as smoking, the number of partners, age, and sexual habits can influence the possible presence of the virus itself in the oropharynx of the same women. In total, 117 unvaccinated women aged between 18 and 52 were enrolled. We found that the prevalence of oral HPV infection was high among the women with concomitant genital HPV infection (22%) compared to the HPV-negative women (0%), and the estimated odds ratio was 17.36 (95% CI: 1.02, 297.04). In none of the women with oral HPV did we find any relevant clinical lesions. The potential risk factors for HPV infections in the oropharynx and genitals were analyzed based on questionnaire responses. A multivariate analysis showed that genital HPV infections were significantly associated with a number of sexual partners > 10 (OR 138.60, 95% CI: 6.04–3181.30, <i>p</i> < 0.001), but the data also referred to having between 3–5 or 6–10 partners as being significant, as were a high level of education (OR 6.24, 95% CI: 1.67–4.23.26 <i>p</i> = 0.003), a frequency of sexual intercourse >10 (OR 91.67 95% CI: 3.20–2623.52, <i>p</i> = 0.004), oral sex (OR 6.16, 95% CI: 1.22–31.19, <i>p</i> = 0.014), and >20 cigarettes/day (OR 6.09 95% CI: 1.21–30.61, <i>p</i> = 0.014). Furthermore, being “separate” and having multiple sexually transmitted diseases were also significantly associated with genital HPV infection. In contrast, oral HPV infections were significantly associated with women aged 36 to 50 years (OR 27.38, 95% CI: 4.37–171.37; <i>p</i> = 0.000202) and oral sex (OR 95.5, 95% CI: 5.13–1782.75, <i>p</i> = 0.001126).Additionally, being separate, being cohabitant, lifetime sexual partners of >10, 3–5 lifetime sexual partners, <20 years of age, >10 sexual intercourse per month, occasional and regular anal sex, >20 cigarettes per day, a history of sexually transmitted disease (herpes and multiple), and having a history of genital warts were significant. Screening and early diagnosis are considered to be practically unfeasible for this category of cancer, given the lack of visible lesions; the 9-valent HPV vaccine remains the only means that could help to successfully counter the growing incidence of oral squamous cell carcinoma.
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spelling doaj.art-75d83fe91e784e6ebf9b4c363b448c802023-11-18T10:01:02ZengMDPI AGDiagnostics2075-44182023-06-011312209610.3390/diagnostics13122096Oral HPV Infection in Women with HPV-Positive Cervix Is Closely Related to Oral SexMaria Teresa Bruno0Sara Boemi1Giuseppe Caruso2Francesco Sgalambro3Salvatore Ferlito4Antonio Cavallaro5Maria Chiara Sudano6Marco Palumbo7Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Via S.Sofia 78, 95123 Catania, ItalyMultidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, ItalyDepartment of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Via S.Sofia 78, 95123 Catania, ItalyMultidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, ItalyMultidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, ItalyMultidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, ItalyMultidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, ItalyDepartment of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Via S.Sofia 78, 95123 Catania, ItalyThe oral transmission of HPV and, consequently, the risk of oral cancer has increased in the last years. Oral sex has often been implicated among the risk factors for oral HPV infections, however, there is still no consensus on these topics, nor on the relationship between genital and oral HPV infections. The present study aimed to evaluate the coexistence of papilloma virus, at the levels of the oral and genital mucosa, in women with a histologically confirmed HPV lesions (and a positive HPV test) at the genital level and a negative HPV control group. We also evaluated how some risk factors, such as smoking, the number of partners, age, and sexual habits can influence the possible presence of the virus itself in the oropharynx of the same women. In total, 117 unvaccinated women aged between 18 and 52 were enrolled. We found that the prevalence of oral HPV infection was high among the women with concomitant genital HPV infection (22%) compared to the HPV-negative women (0%), and the estimated odds ratio was 17.36 (95% CI: 1.02, 297.04). In none of the women with oral HPV did we find any relevant clinical lesions. The potential risk factors for HPV infections in the oropharynx and genitals were analyzed based on questionnaire responses. A multivariate analysis showed that genital HPV infections were significantly associated with a number of sexual partners > 10 (OR 138.60, 95% CI: 6.04–3181.30, <i>p</i> < 0.001), but the data also referred to having between 3–5 or 6–10 partners as being significant, as were a high level of education (OR 6.24, 95% CI: 1.67–4.23.26 <i>p</i> = 0.003), a frequency of sexual intercourse >10 (OR 91.67 95% CI: 3.20–2623.52, <i>p</i> = 0.004), oral sex (OR 6.16, 95% CI: 1.22–31.19, <i>p</i> = 0.014), and >20 cigarettes/day (OR 6.09 95% CI: 1.21–30.61, <i>p</i> = 0.014). Furthermore, being “separate” and having multiple sexually transmitted diseases were also significantly associated with genital HPV infection. In contrast, oral HPV infections were significantly associated with women aged 36 to 50 years (OR 27.38, 95% CI: 4.37–171.37; <i>p</i> = 0.000202) and oral sex (OR 95.5, 95% CI: 5.13–1782.75, <i>p</i> = 0.001126).Additionally, being separate, being cohabitant, lifetime sexual partners of >10, 3–5 lifetime sexual partners, <20 years of age, >10 sexual intercourse per month, occasional and regular anal sex, >20 cigarettes per day, a history of sexually transmitted disease (herpes and multiple), and having a history of genital warts were significant. Screening and early diagnosis are considered to be practically unfeasible for this category of cancer, given the lack of visible lesions; the 9-valent HPV vaccine remains the only means that could help to successfully counter the growing incidence of oral squamous cell carcinoma.https://www.mdpi.com/2075-4418/13/12/2096oral HPVOCSSoral sex9-valent HPV vaccine
spellingShingle Maria Teresa Bruno
Sara Boemi
Giuseppe Caruso
Francesco Sgalambro
Salvatore Ferlito
Antonio Cavallaro
Maria Chiara Sudano
Marco Palumbo
Oral HPV Infection in Women with HPV-Positive Cervix Is Closely Related to Oral Sex
Diagnostics
oral HPV
OCSS
oral sex
9-valent HPV vaccine
title Oral HPV Infection in Women with HPV-Positive Cervix Is Closely Related to Oral Sex
title_full Oral HPV Infection in Women with HPV-Positive Cervix Is Closely Related to Oral Sex
title_fullStr Oral HPV Infection in Women with HPV-Positive Cervix Is Closely Related to Oral Sex
title_full_unstemmed Oral HPV Infection in Women with HPV-Positive Cervix Is Closely Related to Oral Sex
title_short Oral HPV Infection in Women with HPV-Positive Cervix Is Closely Related to Oral Sex
title_sort oral hpv infection in women with hpv positive cervix is closely related to oral sex
topic oral HPV
OCSS
oral sex
9-valent HPV vaccine
url https://www.mdpi.com/2075-4418/13/12/2096
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