Risk Factors for Oral Human Papillomavirus in Adults Infected and Not Infected With Human Immunodeficiency Virus

COUTLÉE, FRANÇOIS MD*†‡; TROTTIER, ANNE‐MARIE MD*‡; GHATTAS, GEORGES MD*†; LEDUC, RAYMOND MD*§∥; TOMA, EMIL MD*§∥; SANCHE, GILBERT MD; RODRIGUES, ISABEL MD; TURMEL, BRUNO MD#; ALLAIRE, GUY MD*†; GHADIRIAN, PARVIS PhD*∥

Sexually Transmitted Diseases: January 1997 - Volume 24 - Issue 1 - p 23–31
Original Article

Background and Objectives:: To investigate in a cross‐sectional study the determinants of oral human papillomavirus infection in 287 individuals who are sexually active.

Goal:: To assess prevalence as well as risk factors for oral human papillomavirus infection.

Study Design:: One hundred seventy‐eight human immunodeficiency virus‐seropositive (158 men and 20 women) and 109 human immunodeficiency virus‐negative (73 men and 36 women) individuals were recruited consecutively from sexually transmitted disease‐human immunodeficiency virus clinics and gastrointestinal endoscopy clinics. Oral brushings were tested with the L1 consensus polymerase chain reaction assay for human papillomavirus detection.

Results:: Human papillomavirus DNA was detected in 32 (11.2%) of 287 individuals. Associated with oral human papillomavirus infection on univariate analyses were human immunodeficiency virus infection (odds ratio, 6.9; 95% confidence interval, 2.0–23.2), homosexuality (odds ratio, 3.7; 95% confidence interval, 1.5–9.4), unprotected oral sex (odds ratio, 5.5; 95% confidence interval, 1.6–18.4), syphilis (odds ratio, 2.5; 95% confidence interval, 1.1–6.3), gonorrhea (odds ratio, 4.2; 95% confidence interval, 1.9–9.1), Chlamydia trachomatis (odds ratio, 4.4; 95% confidence interval, 1.8–10.6), and genital herpes (odds ratio, 2.9; 95% confidence interval, 1.3–6.5). Human immunodeficiency virus infection and C. trachomatis were independently predictive of human papillomavirus infection in multivariate stepwise logistic regression.

Conclusions:: This study suggests that sexual activity plays an important role in the transmission of human papillomavirus in the oral cavity.

*From the Départements de Microbiologie et Immunologie, Médecine, Médecine familiale, Pathologie et Nutrition, Université de Montréal, Montréal, Québec, Canada; the †Départements de Microbiologie et Maladies Infectieuses, Pathologie et Gastroentérologie, Hôpital Notre‐Dame, Montréal, Québec, Canada; the ‡Centre de Recherche Louis‐Charles Simard, Hôpital Notre‐Dame, Montréal, Québec, Canada; the §Départements de Gastroentérologie et Microbiologie, Hôpital Hôtel‐Dieu, Montréal, Québec, Canada; the ∥Centre de Recherche de I'Hôtel‐Dieu de Montréal, Montréal, Québec, Canada; the ¶Centre Local de Services Communautaires du Marigot, Laval, Québec, Canada; and the #Clinique Médicale L'Alternative, Montréal, Québec, Canada

The authors thank Mme. Monique Latour for editorial assistance, Dr. Marc Dumont for the performance of the statistical analyses, and Mme. Chantal Perret for completing the questionnaires and ensuring high quality of data. The authors also thank the following for providing the plasmids containing human papillomaviruses: M. de Villiers and H. zur Hausen, Deutsches Krebsforschungszentrum, Heidelberg, Germany; A. Lörincz, Digene Diagnostics, Silver Spring, Maryland; G. Orth, Institut Pasteur, Paris, France; and K. Shah, Johns Hopkins School of Public Health, Baltimore, Maryland.

Supported by the Fonds de la Recherche en Santé du Québec (FRSQ), Recherche évaluative et épidémiologique. FC is a clinical research scholar from the FRSQ.

Presented in part at the 14th International Papillomavirus Conference, Quebec City, Canada, July 23–28, 1995.

Reprint requests: François Coutlée, Département de Microbiologie et Maladies Infectieuses, Hôpital Notre‐Dame, 1560 Sherbrooke est, Montréal, Québec, Canada, H2L 4M1.

Received for publication January 11, 1996, revised April 23, 1996, and accepted May 6, 1996.

© Copyright 1997 American Sexually Transmitted Diseases Association