期刊
JNCI CANCER SPECTRUM
卷 4, 期 5, 页码 -出版社
OXFORD UNIV PRESS
DOI: 10.1093/jncics/pkaa047
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类别
资金
- NIDCR, NIH [R01DE021395, R35DE026631]
- National Heart, Lung, and Blood Institute (NHLBI)
- Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD)
- National Human Genome Research Institute (NHGRI)
- National Institute On Aging (NIA)
- National Institute Of Dental & Craniofacial Research (NIDCR)
- National Institute Of Allergy And Infectious Diseases (NIAID)
- National Institute Of Neurological Disorders And Stroke (NINDS)
- National Institute Of Mental Health (NIMH)
- National Institute On Drug Abuse (NIDA)
- National Institute Of Nursing Research (NINR)
- National Cancer Institute (NCI)
- National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- National Institute on Deafness and Other Communication Disorders (NIDCD)
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- UCSF CTSA [UL1-TR000004]
- Atlanta CFAR [P30-AI-050409]
- UNC CFAR [P30-AI-050410]
- UAB CFAR [P30-AI-027767]
- Atlanta CRS [U01-HL146241]
- Baltimore CRS [U01-HL146201]
- Bronx CRS [U01-HL146204]
- Brooklyn CRS [U01-HL146202]
- Data Analysis and Coordination Center [U01-HL146193]
- Chicago-Cook County CRS [U01-HL146245]
- Chicago-Northwestern CRS [U01-HL146240]
- Connie Wofsy Women's HIV Study, Northern California CRS [U01-HL146242]
- Los Angeles CRS [U01-HL146333]
- Metropolitan Washington CRS [U01-HL146205]
- Miami CRS [U01-HL146203]
- Pittsburgh CRS [U01-HL146208]
- UAB-MS CRS [U01-HL146192]
- UNC CRS [U01-HL146194]
Background: Human papillomavirus-related oropharyngeal cancer (HPV-OPC) incidence is increasing, but the natural history of the precursor-oral HPV-has not been well described. Methods: This observational cohort study of people living with HIV and at-risk HIV uninfected people evaluated participants semiannually using 30-second oral rinse and gargle specimens over 7 years. Initially, 447 participants were followed for 4 years as part of the Persistent Oral Papillomavirus Study, and a subset of 128 who showed persistent infections at the last Persistent Oral Papillomavirus Study visit had an additional visit, as part of the Men and Women Understanding Throat HPV Study, on average 2.5 years later. Extracted DNA from oral rinse and gargle specimens was amplified using polymerase chain reaction and type specification of 13 oncogenic HPV types. Risk factors for oncogenic oral HPV clearance were evaluated using Cox models. Results: The majority of oncogenic oral HPV infections cleared quickly, with a median time to clearance of 1.4 years (interquartile range = 0.5-3.9 years). After 7 years of follow-up, 97% of incident and 71% of prevalent infections had cleared. Lower HPV-16 viral load was statistically significantly associated with clearance (per 10-fold decrease in copy number: adjusted hazard ratio [aHR] = 2.51, 95% confidence interval [CI] = 1.20 to 5.26; P = .01). Adjusted analyses showed that oncogenic oral HPV clearance was lower among prevalent than incident-detected infections (aHR = 0.44, 95% CI = 0.35 to 0.55), among men than women (aHR = 0.74, 95% CI = 0.60 to 0.91), for older participants (aHR per 10 years increasing age = 0.81, 95% CI = 0.74 to 0.89), and among people living with HIV (aHR = 0.76, 95% CI = 0.60 to 0.95). One participant who had oral HPV-16 consistently detected at 10 study visits over 4.5 years was subsequently diagnosed with HPV-OPC. Conclusions: This prospective study of oncogenic oral HPV infection is the longest and largest quantification of oral HPV-16 infections to date.
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