Persistence and clearance of oral human papillomavirus infections: A prospective population‐based cohort study

• Published in: Journal of medical virology Vol. 92; no. 12; pp. 3807 - 3814
• Main Authors: Wong, Martin C. S., Vlantis, Alexander C., Liang, Miaoyin, Wong, Po Yee, Ho, Wendy C. S., Boon, Siaw S., Leung, Colette, Chan, Paul K. S., Chen, Zigui
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.12.2020
• Subjects: Adolescent; Adult; Aged; Alphapapillomavirus - classification; Alphapapillomavirus - genetics; clearance; Cohort analysis; Confidence intervals; Drinking; Drinking behavior; Female; Genotype; Genotyping; Human papillomavirus; Humans; Immunization; Incidence; Infections; Male; Meals; Middle Aged; Mouth - virology; Mouth Diseases - epidemiology; Mouth Diseases - virology; oral HPV infection; Papillomaviridae - classification; Papillomaviridae - genetics; Papillomaviridae - isolation & purification; Papillomavirus Infections - epidemiology; Papillomavirus Infections - prevention & control; Papillomavirus Infections - virology; persistence; Population studies; Population-based studies; Prospective Studies; Risk analysis; Risk Factors; Smoking; Virology; Young Adult; clearance; persistence; risk factors; oral HPV infection
• ISSN: 0146-6615; 1096-9071; 1096-9071
• DOI: 10.1002/jmv.26130

Objective This study aimed to evaluate the incidence of and factors associated with persistence and clearance of oral human papillomavirus (HPV) infections. Method A prospective cohort study invited 458 subjects (231 HPV‐positive and 227 HPV‐negative at baseline) to attend follow‐ups at 12 months. Those 231 HPV‐positive subjects and 10 new infections were invited to reassessment at 24 months. We used next‐gen sequencing for detection and genotyping of HPV. Results α‐HPV infections showed higher persistence rates than β/γ‐HPV (22.7% vs 9.2% at 12 months [P < .05], 10.6% vs 6.8% at 24 months [P = .30]). Clearance rates of α‐HPV were lower than β/γ‐HPV at 12 months (31.8% vs 45.1%; P = .05) and higher at 24 months (7.6% vs 4.8%; P = .36). Persistence of β/γ‐HPV was positively associated with males (crude odds ratio [COR] = 3.8, 95% confidence interval [CI] = 1.3‐11.2), elderly (51‐65 vs 16‐50 years; COR = 5.1, 95% CI = 1.2‐22.3), and smoking (COR = 4.3, 95% CI = 1.9‐9.6). Drinking (COR = 0.5, 95% CI = 0.3‐0.9), handwashing less than 90% of times before meals (COR = 0.6, 95% CI = 0.3‐0.9), and using public bath more than once per month (COR = 0.5, 95% CI = 0.2‐0.9) were risk factors hindering β/γ‐HPV clearance. Conclusions This study identified factors associated with persistence and clearance of oral HPV infections among Chinese. Studies on other ethnogeographic groups may further inform prevention strategies of oral HPV infection and immunization programmes. Research Highlights Persistence of β/γ‐HPV was positively associated with male gender, older age, and smoking. Alcohol drinking, washing hands less than 90% of the times before meals, and using public bath more than once per month were risk factors hindering its clearance.