Department of Population Health, QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia.
Int J Cancer. 2021 Apr 15;148(8):1964-1972. doi: 10.1002/ijc.33442. Epub 2020 Dec 27.
Oral infection with human papillomavirus (HPV) is likely to underpin the rapidly rising incidence of oropharyngeal squamous cell carcinoma; however, there are few data describing the natural history of oral HPV infection. We recruited 704 participants aged 20 to 70 years from worksites, universities and primary care practices in Brisbane, Australia. Participants completed questionnaires at baseline, 12 and 24 months and donate four saliva samples at baseline, 6, 12 and 24 months for HPV polymerase chain reaction testing and typing. We estimated the prevalence of oral HPV infection at baseline, incidence of new infections among those HPV-negative at baseline, clearance rate and persistent infections. At baseline, 10.7% of participants had oral HPV infections from 26 different HPV types. Sexual behaviours were associated with oral HPV infection, including more partners for passionate kissing (29 or more; odds ratio [OR] 3.4, 95% confidence interval [CI] 1.5-8.0), and giving and receiving oral sex (16 or more; OR 5.4, 95% CI 1.6-17.7 and OR 5.6, 95% CI 1.6-18.7, respectively). Of 343 participants, HPV-free at baseline and with subsequent saliva samples, 87 (25%) acquired new infections over the 24 months. Sixty-eight of 87 people included in the clearance analysis (78%) cleared their oral HPV infections. Clearance was associated with being a nonsmoker (OR 12.7, 95% CI 1.3-122.8), and no previous diagnosis of a sexually transmitted infection (OR 6.2, 95% CI 2.0-19.9). New oral infections with HPV in this sample were not rare. Although most infections were cleared, clearance was not universal suggesting a reservoir of infection exists that might predispose to oropharyngeal carcinogenesis.
口腔感染人乳头瘤病毒（HPV）可能是口咽鳞状细胞癌发病率迅速上升的原因；然而，目前关于口腔 HPV 感染的自然史的数据很少。我们从澳大利亚布里斯班的工作场所、大学和初级保健诊所招募了 704 名 20 至 70 岁的参与者。参与者在基线、12 个月和 24 个月时完成了问卷调查，并在基线时、6 个月、12 个月和 24 个月时捐献了四份唾液样本，用于 HPV 聚合酶链反应检测和分型。我们估计了基线时口腔 HPV 感染的流行率、基线时 HPV 阴性者中新感染的发生率、清除率和持续性感染。基线时，10.7%的参与者感染了 26 种不同 HPV 类型的口腔 HPV。性行为与口腔 HPV 感染有关，包括更多的激情接吻伴侣（29 个或更多；优势比[OR]3.4，95%置信区间[CI]1.5-8.0）和口交（16 个或更多；OR 5.4，95%CI 1.6-17.7 和 OR 5.6，95%CI 1.6-18.7）。在 343 名基线时无 HPV 且随后有唾液样本的参与者中，有 87 人（25%）在 24 个月内新感染了 HPV。在 87 名纳入清除分析的人中，有 68 人（78%）清除了他们的口腔 HPV 感染。清除与不吸烟（OR 12.7，95%CI 1.3-122.8）和没有性传播感染的既往诊断（OR 6.2，95%CI 2.0-19.9）有关。在这个样本中，新的口腔 HPV 感染并不罕见。虽然大多数感染都被清除了，但清除并不普遍，这表明存在感染储备，可能导致口咽癌的发生。
