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Oral HPV prevalence in women positive for cervical HPV infection and their sexual partners: a German screening study

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Abstract

The incidence of human papillomavirus (HPV) associated oropharyngeal squamous cell cancer (OSCC) is on the rise. With the HPV-positive uterine cervix as a reservoir, HPV-positive OSCC is discussed as a sexually transmitted disease. Mechanisms of HPV transmission to the oral cavity are poorly understood. To gain more insight into HPV-transmission routes, cervically HPV-positive women and their sexual partners are screened for oral HPV infection. Women with cervical dysplasia underwent HPV testing of the uterine cervix and tonsillar region via brush test. In addition, sexual partners received oral HPV testing. Tonsillar brush tests of patients admitted for routine surgery served as the control group. The HPV-PCR (Roche Linear Array Kit) was used to differentiate 37 HPV types. All participants completed a risk-factor questionnaire focusing on sexual habits. 101 women were tested HPV-positive at the cervix. Only 3/101 (3 %) were tested HPV-positive in the oropharynx. In 60/101 (60 %) women the sexual partner could be tested for oral HPV infection: testing was positive in 3/60 (5 %). No oral HPV was detected in the control group. The risk-factor questionnaire revealed significant differences between the female study- and control group in terms of age at first sexual intercourse and smoking habits. The limited data suggest that among sexual partners in Germany, HPV transmission to the oropharynx by oral–genital sex or by autoinoculation is a rare and unlikely event with low HPV concordance. Another explanation for the low oral prevalence could be an independent clearance of HPV from the oropharyngeal site compared to cervix uteri or at different time intervals.

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Acknowledgments

This work was funded by the Asklepios Klinik Hamburg GmbH. The authors thank Peter Wohlmuth from the Department of Statistics, ProResearch, Asklepios Klinik Hamburg for helping to analyse the collected data. Special thanks are sent to Jay Moss for proof reading this paper.

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    Authors and Affiliations

    1. Department of Otolaryngology, Head and Neck Surgery, Asklepios Klinik Hamburg Altona, Paul-Ehrlich-Strasse 1, 22763, Hamburg, Germany

      Ralf B. Uken & Ingo U. Teudt

    2. Tagesklinik Altonaer Strasse, Private Gynaecology Praxis, Hamburg, Germany

      Oliver Brummer

    3. Department of Gynaecology, Obstetrics and Dysplasia Centre, Asklepios Klinik Hamburg Altona, Hamburg, Germany

      Carolin von Schubert-Bayer

    4. Department of Molecular Genetics, MEDILYS Laborgesellschaft mbH, c/o, Asklepios Klinik Hamburg Altona, Hamburg, Germany

      Thomas Brodegger

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    Correspondence to Ingo U. Teudt.

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    The authors declare that they have no conflict of interest. Parts of the data were presented at the 30th International Papillomavirus Conference in Lisbon, Portugal 2015.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. However, due to the retrospective type of the study no formal consent was required.

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    R. B. Uken and I. U. Teudt equally contributed to the article.

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    Uken, R.B., Brummer, O., von Schubert-Bayer, C. et al. Oral HPV prevalence in women positive for cervical HPV infection and their sexual partners: a German screening study. Eur Arch Otorhinolaryngol 273, 1933–1942 (2016). https://doi.org/10.1007/s00405-016-3953-1

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