Oral manifestations of human papillomavirus infections

• Published in: European journal of oral sciences Vol. 126; no. S1; pp. 49 - 66
• Main Author: Syrjänen, Stina
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.10.2018; John Wiley and Sons Inc
• Subjects: Benign; Cofactors; Dentistry; Genome, Viral - genetics; Head; Head and neck; Homage to 100 years of dental research in Scandinavia; Human papillomavirus; human papillomaviruses; Humans; Hyperplasia; Immune system; Infants; Infections; Lesions; Malignancy; Mouth - pathology; Mouth - virology; Mouth Diseases - etiology; Mouth Diseases - virology; Oral cancer; oral infection; Papilloma; Papillomaviridae; Papillomaviridae - genetics; Papillomavirus Infections - complications; Papillomavirus Infections - pathology; Papillomavirus Infections - transmission; prevention; Saliva; Sexual behavior; Squamous cell carcinoma; Symposium Contribution; transmission; Viruses; saliva; human papillomaviruses; transmission; oral infection; prevention
• ISSN: 0909-8836; 1600-0722
• DOI: 10.1111/eos.12538

Papillomaviruses are one of the oldest viruses known, dating back 330 million years. During this long evolution, human papillomaviruses (HPV) have developed into hijackers of human cellular and immune systems in which they replicate and remain silent. Systematic studies on oral HPV infections and their outcomes are still scarce. Oral HPV infections have been linked to sexual behaviour, but recent evidence supports their horizontal, mouth‐to‐mouth, transmission. Most HPV infections in infants are acquired vertically from the mother during the intrauterine period, during delivery, or later via saliva. The best‐known benign clinical manifestations of HPV infection are oral papilloma/condyloma and focal epithelial hyperplasia. Evidence is emerging which suggests that some oral HPV infections might persist. Persistent HPV infection is mandatory for HPV‐associated malignant transformation. However, progression of HPV‐induced lesions to malignancy requires additional cofactors. In the early 1980s, we provided the first evidence that a subset of oral cancers and other head and neck cancers might be causally linked to HPV infection. This review summarizes current knowledge on the virus itself, its transmission modes, as well as the full spectrum of oral HPV infections – from asymptomatic infections to benign, potentially malignant oral lesions, and squamous cell carcinoma.