Share this article on:

Oral human papillomavirus infection in HIV-negative and HIV-infected MSM

Mooij, Sofie H.a,e; Boot, Hein J.b,†; Speksnijder, Arjen G.C.L.a; Stolte, Ineke G.a; Meijer, Chris J.L.M.c; Snijders, Peter J.F.c; Verhagen, Dominique W.M.d; King, Audrey J.b; de Vries, Henry J.C.a,b,f; Quint, Wim G.V.g; van der Sande, Marianne A.B.b,h; Schim van der Loeff, Maarten F.a,e

doi: 10.1097/QAD.0b013e328362395c
Epidemiology and Social

Objective: Oral infection with human papillomavirus (HPV) is associated with a subset of head and neck cancers. We compared prevalence of, and risk factors for, oral HPV infection among HIV-negative and HIV-infected MSM.

Design: Analysis of baseline data from a prospective cohort study.

Methods: MSM aged 18 years or older were recruited from three study sites in Amsterdam, the Netherlands. Participants completed a self-administered risk-factor questionnaire. Oral-rinse and gargle specimens were analyzed for HPV DNA and genotyped using a highly sensitive PCR and reverse line blot assay [short PCR fragment (SPF)10-PCR-DNA Enzyme Immuno Assay (DEIA)/LiPA25 system].

Results: In 2010–2011, 794 MSM were included, of whom 767 participants had sufficient data for analysis. Median age was 40.1 years [interquartile range (IQR) 34.8–47.5] and 314 men were HIV-infected (40.9%). Any of 25 typable HPV types was present in 24.4% of all oral samples. Oncogenic HPV types were detected in 24.8 and 8.8% of oral samples from HIV-infected and HIV-negative MSM, respectively (P < 0.001). Of these high-risk types, HPV-16 was the most common (overall 3.4%). Oral infection with high-risk HPV was associated with HIV infection in multivariable analysis (P < 0.001). Increasing age was significantly associated with oral HPV infection in HIV-negative, but not in HIV-infected MSM.

Conclusion: Oral HPV infection is very common among MSM. HIV infection was independently associated with high-risk oral HPV infection, suggesting an important role of HIV in oral HPV infection.

Supplemental Digital Content is available in the text

aCluster of Infectious Diseases, Public Health Service, Amsterdam

bCentre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu (RIVM)), Bilthoven

cDepartment of Pathology, Vrije Universiteit-University Medical Center

dDepartment of Internal Medicine, Jan van Goyen Medical Center

eCenter for Infection and Immunity Amsterdam (CINIMA), Department of Internal Medicine, Academic Medical Center, Amsterdam

fDepartment of Dermatology, Academic Medical Center, Amsterdam

gDDL Diagnostic Laboratory, Rijswijk

hJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

Our inspiring colleague Hein Boot died before publication of this article.

Correspondence to Sofie H. Mooij, Public Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands. Tel: +31 020 555 5705; fax: +31 020 555 5533; e-mail:

Received 6 February, 2013

Revised 12 April, 2013

Accepted 12 April, 2013

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (

© 2013 Lippincott Williams & Wilkins, Inc.