Twelve-month incidence and clearance of oral HPV infection in HIV-negative and HIV-infected men who have sex with men: the H2M cohort study

• Published in: BMC infectious diseases Vol. 14; no. 1; p. 668
• Main Authors: van Aar, Fleur, Mooij, Sofie H, van der Sande, Marianne A B, Meijer, Chris J L M, King, Audrey J, Verhagen, Dominique W M, Heijman, Titia, Coutinho, Roel A, Schim van der Loeff, Maarten F
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 31-12-2014; BioMed Central
• Subjects: Adult; AIDS-Related Opportunistic Infections - complications; AIDS-Related Opportunistic Infections - epidemiology; AIDS-Related Opportunistic Infections - virology; Cervical cancer; Cohort Studies; Follow-Up Studies; Genotype; HIV; HIV Infections - complications; HIV Infections - epidemiology; HIV Infections - virology; Homosexuality, Male - statistics & numerical data; Human immunodeficiency virus; Human papillomavirus; Human papillomavirus 16 - genetics; Human papillomavirus 16 - isolation & purification; Humans; Incidence; Male; Middle Aged; Mouth - virology; Mouth Diseases - epidemiology; Mouth Diseases - virology; Netherlands - epidemiology; Papillomaviridae - classification; Papillomaviridae - genetics; Papillomaviridae - isolation & purification; Papillomavirus Infections - epidemiology; Papillomavirus Infections - etiology; Risk Factors; Sexual Behavior - statistics & numerical data; Sexual Partners; Studies; Viral Load; Netherlands; Netherlands, Noord-Holland, Amsterdam; ANE, Netherlands, Noord-Holland, Amsterdam
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-014-0668-z

Our aim was to compare the 12-month incidence and clearance of oral high-risk HPV infection between HIV-infected men who have sex with men (MSM) and HIV-negative MSM.
MSM aged 18 years or older were recruited in Amsterdam, the Netherlands. Questionnaire data and oral-rinse and gargle samples were collected at baseline, and after 6 and 12 months. HPV DNA was genotyped using the SPF10-PCR & DEIA-LiPA25 system (version 1). Determinants of oral HPV incidence and clearance were explored using Cox and logistic regression analyses respectively.
433 HIV-negative and 290 HIV-infected MSM were included in these analyses. The median follow-up time per participant was 12 months (range 3-15). During follow-up, 114 incident oral high-risk HPV infections were observed. The incidence rate of HPV-16 was 3.5/1000 person-months (PM) in HIV-infected and 0.9/1000 PM in HIV-negative MSM (IRR 4.1; 95% CI 1.3-13.2). The incidence rates of other high-risk HPV types ranged between 1.3-3.5/1000 PM in HIV-infected and 0.0-1.1/1000 PM in HIV-negative MSM. In multivariable analyses, HIV infection (adjusted hazard ratio [aHR] 3.8; 95% CI 2.3-6.2) and a higher number of recent oral sex partners (aHR 2.4 for ≥8 partners compared to ≤2; 95% CI 1.4-4.2) were associated with HPV incidence. Of the 111 baseline oral high-risk infections, 59 (53.2%) were cleared. In multivariable analyses, only a higher number of recent oral sex partners was associated with HPV clearance (adjusted odds ratio 3.4 for ≥8 compared to ≤2 partners; 95% CI 1.3-9.0).
The incidence rate of oral high-risk HPV infection was higher in HIV-infected MSM and in those with a higher number of recent oral sex partners. Just over half of the oral high-risk HPV infections at baseline were cleared after 12 months, with a higher likelihood of clearance among MSM reporting higher numbers of recent oral sex partners, but no difference by HIV status.