Oral human papillomavirus infection and head and neck cancers in HIV-infected individuals

Abstract

Purpose of review: HIV-infected individuals are living longer due to effective antiretroviral therapy and may therefore have a greater opportunity to develop human papillomavirus (HPV)-associated malignancies. This review describes the risk factors and burden of oral HPV infection and HPV-associated head and neck cancer (HNC) among HIV-infected individuals.

Recent findings: Oral HPV infection is commonly detected in HIV-infected individuals and is elevated among those with a higher number of lifetime oral sexual partners, current tobacco use and immunosuppression. There are limited data on the natural history of oral HPV, but initial studies suggest that the majority of infections clear within 2 years. Although HIV-infected individuals are at a much higher risk of most HPV-associated cancers than the general population, studies suggest HIV-infected individuals have a more modest 1.5-4-fold greater risk for HPV-associated HNC.

Summary: HIV-infected individuals are living longer, have a high prevalence of oral HPV infection and have many of the currently determined risk factors for HPV-associated HNC.

Figure 1. Impact of immunosuppression on oral HPV prevalence

∼Data from a representative sample of the US population, from the National Health and Nutrition Examination Survey (NHANES)[22*] *Data from the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study(WIHS),[16**] HIV-uninfected individuals in this study were are at-risk for oral HPV due to their higher number of sexual partners and higher use of tobacco