Oncogenic Oral Human Papillomavirus Clearance Patterns over 10 Years.
Cancer Epidemiol Biomarkers Prev
; 33(4): 516-524, 2024 Apr 03.
Article
en En
| MEDLINE
| ID: mdl-38294704
ABSTRACT
BACKGROUND:
Effective screening for oropharyngeal cancer is lacking. Four oncogenic HPV clearance definitions were explored to understand long-term natural history for persistent oncogenic oral HPV (oncHPV), the precursor of oropharyngeal cancer.METHODS:
Prospective multicenter cohort of participants living with/at-risk for HIV, with oral rinse and gargle samples collected every 6 to 12 months for up to 10 years and tested for oncHPV. HPV clearance definitions included 1 (clear1), 2 (clear2), 3 (clear3) consecutive negatives, or being negative at last two visits (clearlast).RESULTS:
Median time to clearance of oncHPV exceeded 2 years for conservative definitions (clear3 2.38, clearlast 2.43), but not lenient (clear1 0.68, clear2 1.15). By clear3, most incident infections cleared at 2, 5, 8 years (55.1%, 75.6%, 79.1%), contrary to prevalent infections (37.1%, 52.5%, 59.5%, respectively). In adjusted analysis, prevalent oncHPV, older age, male sex, and living with HIV were associated with reduced clearance. Of 1,833 subjects screened, 13.8% had prevalent oncHPV and 47.5% of those infections persisted ≥5 years, representing 6.5% of persons screened. Two men with prevalent oral HPV16 developed incident oropharyngeal cancer [IR = 1.62 per 100 person-years; 95% confidence interval (CI), 0.41-6.4]. Many with oral HPV16 persisted ≥5 years (and/or developed HPV-oropharyngeal cancer) among those with 2 (72.2%), ≥2 of first 3 (65.7%), or 3 (80.0%) consecutive positive oHPV16 tests, but not after 1 (39.4%).CONCLUSIONS:
In our 10-year study, most incident infections cleared quickly. However, half of prevalent oncHPV persisted ≥5 years, suggesting increased risk with persistent oncHPV at >2 visits. IMPACT We identified groups with persistent oncHPV at increased risk of oropharyngeal cancer and contextualized risk levels for those with oral HPV16 infection.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Orofaríngeas
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Infecciones por VIH
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Infecciones por Papillomavirus
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Enfermedades de la Boca
Tipo de estudio:
Clinical_trials
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Prognostic_studies
Límite:
Humans
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Male
Idioma:
En
Año:
2024
Tipo del documento:
Article