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Low CD4 count linked to oral HPV in patients with HIV
Among HIV-positive patients, the only risk factor for oral HPV was lower CD4 count, according to researchers from Albert Einstein College of Medicine.
“Our study confirms previous reports that risk factors for oral HPV detection differ for HIV-positive and negative individuals,” the researchers wrote in Journal of Infectious Diseases. “Immune status appears to have a strong effect on oral HPV infection in HIV-positive individuals, which might mitigate the association with sexual risk factors. However, the high burden of oral HPV in both HIV-positive and HIV-negative individuals suggests that the mouth may be a reservoir of subclinical HPV infection with potential contribution to future oral disease.”
The researchers evaluated HIV-positive and HIV-negative patients with oral lesions who presented from 2008 to 2013 for dental care at one of two outpatient clinics. The patients provided oral rinse samples for HPV testing and underwent oral examinations of their lesions. The patients also were interviewed for demographic data and to determine tobacco, alcohol and drug use, sexual history and dental history.
The study included 161 HIV-positive patients and 128 HIV-negative patients. Oral HPV-DNA was found in 32% of the HIV-positive patients and in 16% of the HIV-negative patients. Thirty patients had multiple concurrent HPV types. HIV-positivity was associated with high-risk HPV types (P < .0005). Among HIV-negative patients, oral HPV was associated with a greater number of sexual partners, tobacco smoking and marijuana and other drug use, but there were no associations between these factors among HIV-positive patients.
Among HIV-positive patients, the only risk factor significantly associated with oral HPV detection was lower CD4 count: no more than 200 cells/mm3 vs. at least 500 cells/mm3 (OR = 4.1; 95% CI, 1.2-14.2).
“A novel finding in this study was the association between HPV32/42 and potentially precancerous lesions, among both HIV-positive and HIV-negative patients, although we could not distinguish between the closely related HPV types 32 and 42 with the MY09/11 PCR protocol,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.