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Risk factors associated with oral Human Papillomavirus (HPV) prevalence within a young adult population

Whitton, Aimee F.; Knight, Gillian L.; Marsh, Elizabeth K.

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Authors

Gillian L. Knight

Elizabeth K. Marsh



Abstract

Background: The prevalence of, and risk factors for, genital Human Papillomavirus (HPV) infections within the young adult population are well-established; the same is not known for oral HPV. This observational study aimed to determine oral HPV prevalence and abundance within a UK young adult population, and examine if sexual practices and established risk factors of oropharyngeal squamous cell carcinomas (OPSCCs) (such as smoking and alcohol consumption) influenced HPV prevalence. Methods: Convenience sampling was used to recruit a small sample of 452 UK-based young adults studying at a higher education (HE) institution to the study; the study was not powered. A highly sensitive real-time PCR HPV screening method was developed for the detection of multiple HPV subtypes from oral swabs. HPV-positive samples were subsequently screened by qPCR for viral subtypes HPV-6, HPV-11, HPV-16, HPV-18. Results were analysed by univariate and multivariate methods and stratified for gender, with lifestyle behaviour data collected via questionnaire. Socio-economic status was not captured within the questionnaire. Results: We found a high oral HPV prevalence of 22.79%, with a dominance of high-risk viral type HPV-16 (prevalence 19.12%; abundance average 1.08 × 105 copies/million cells) detected within healthy young adults. Frequent smoking (p = .05), masturbation (p = .029), and engagement in multiple sexual activities (p = .057), were found to be associated with oral HPV prevalence, and HPV-16 prevalence, whilst behaviours traditionally associated with genital HPV were not. Conclusions: Our results strengthen the link between sexual practices and oral HPV transmission. We suggest that young adults should be considered high-risk for the contraction of oral HPV, although acknowledge that this sample of HE students may not be representative of the wider population. We show that high-risk HPV-16 is prevalent in the healthy population, as well as dominating within OPSCC; this study is one of the first to determine the dominance of oral HPV-16 prevalence and abundance within this population, presenting a clear need for greater awareness of oral HPV infections, and the risk factors for HPV-positive OPSCC within young adults.

Citation

Whitton, A. F., Knight, G. L., & Marsh, E. K. (2024). Risk factors associated with oral Human Papillomavirus (HPV) prevalence within a young adult population. BMC Public Health, 24(1), Article 1485. https://doi.org/10.1186/s12889-024-18977-x

Journal Article Type Article
Acceptance Date May 28, 2024
Online Publication Date Jun 3, 2024
Publication Date Jun 3, 2024
Deposit Date Jun 3, 2024
Publicly Available Date Jun 3, 2024
Journal BMC Public Health
Electronic ISSN 1471-2458
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 24
Issue 1
Article Number 1485
DOI https://doi.org/10.1186/s12889-024-18977-x
Keywords Prevalence, Human papillomavirus, Risk factors, Sexual behaviour, Viral load
Public URL https://nottingham-repository.worktribe.com/output/35718070
Publisher URL https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-18977-x
Additional Information Received: 6 December 2023; Accepted: 28 May 2024; First Online: 3 June 2024; : ; : Ethical approval was given by the College of Life and Natural Sciences Research Ethics Committee at University of Derby (LSREC_1516_10). All participants gave full informed written consent to participate in the study.; : Not applicable.; : The authors declare no competing interests.

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