Oral human papillomavirus infection in England and associated risk factors: a case-control study

Vanessa Hearnden; Craig Murdoch; Katy D'Apice; Susan Duthie; Nicholas J Hayward; Hilary Jane Powers

doi:10.1136/bmjopen-2018-022497

Oral human papillomavirus infection in England and associated risk factors: a case-control study

Vanessa Hearnden (Corresponding Author), Craig Murdoch, Katy D'Apice, Susan Duthie, Nicholas J Hayward, Hilary Jane Powers

Rowett Institute

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Abstract

OBJECTIVES: This study was conducted to determine the prevalence of and associated risk factors for infection with oral high-risk human papillomavirus (HR-HPV) in adult participants within England, and to explore any association with oral mucosal buccal epithelial cell and whole blood folate concentration.

DESIGN: This was an observational study to determine oral HR-HPV prevalence in the study population. A case-control study was performed to explore the association between infection and folate status.

SETTING: This study was conducted in Sheffield, UK, between April 2013 and August 2014.

PARTICIPANTS: Seven hundred participants, aged 18-60 years, were recruited from university students (n=179), university and hospital staff (n=163), dental hospital patients (n=13), Sexual Health Sheffield patients (n=122) and the general public (n=223).

INTERVENTIONS: Participants completed a lifestyle and sexual behaviour questionnaire, provided an oral rinse and gargle sample for the detection of oral HR-HPV and an oral mucosal buccal epithelial cell sample for the measurement of oral mucosal buccal epithelial cell folate. A blood sample was collected for measurement of whole blood folate concentration.

OUTCOME MEASURES: The prevalence of oral HR-HPV infection in the study population was the primary outcome measure. Secondary outcome measures included associations between risk factors, folate status and infection.

RESULTS: The prevalence of oral HR-HPV infection in this cohort was 2.2% (15/680) with 0.7% (5/680) positive for HPV16 or HPV18. Twenty samples were excluded due to insufficient material for HPV detection. Participants with oral HR-HPV infection were more likely to be a former smoker, and have a greater number of sexual and oral sexual partners. Folate status was not linked to likelihood of HPV infection.

CONCLUSIONS: The prevalence of oral infection with HR-HPV in adult men and women in Sheffield in the North of England was low. Smoking and sexual behaviour were associated with HR-HPV positivity.

TRIAL REGISTRATION NUMBER: ID14106.

Original language	English
Article number	e022497
Journal	BMJ Open
Volume	8
Issue number	8
Early online date	19 Aug 2018
DOIs	https://doi.org/10.1136/bmjopen-2018-022497
Publication status	Published - Nov 2018

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Hearnden, V., Murdoch, C., D'Apice, K., Duthie, S., Hayward, N. J., & Powers, H. J. (2018). Oral human papillomavirus infection in England and associated risk factors: a case-control study. BMJ Open, 8(8), [e022497]. https://doi.org/10.1136/bmjopen-2018-022497

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title = "Oral human papillomavirus infection in England and associated risk factors: a case-control study",

abstract = "OBJECTIVES: This study was conducted to determine the prevalence of and associated risk factors for infection with oral high-risk human papillomavirus (HR-HPV) in adult participants within England, and to explore any association with oral mucosal buccal epithelial cell and whole blood folate concentration.DESIGN: This was an observational study to determine oral HR-HPV prevalence in the study population. A case-control study was performed to explore the association between infection and folate status.SETTING: This study was conducted in Sheffield, UK, between April 2013 and August 2014.PARTICIPANTS: Seven hundred participants, aged 18-60 years, were recruited from university students (n=179), university and hospital staff (n=163), dental hospital patients (n=13), Sexual Health Sheffield patients (n=122) and the general public (n=223).INTERVENTIONS: Participants completed a lifestyle and sexual behaviour questionnaire, provided an oral rinse and gargle sample for the detection of oral HR-HPV and an oral mucosal buccal epithelial cell sample for the measurement of oral mucosal buccal epithelial cell folate. A blood sample was collected for measurement of whole blood folate concentration.OUTCOME MEASURES: The prevalence of oral HR-HPV infection in the study population was the primary outcome measure. Secondary outcome measures included associations between risk factors, folate status and infection.RESULTS: The prevalence of oral HR-HPV infection in this cohort was 2.2{\%} (15/680) with 0.7{\%} (5/680) positive for HPV16 or HPV18. Twenty samples were excluded due to insufficient material for HPV detection. Participants with oral HR-HPV infection were more likely to be a former smoker, and have a greater number of sexual and oral sexual partners. Folate status was not linked to likelihood of HPV infection.CONCLUSIONS: The prevalence of oral infection with HR-HPV in adult men and women in Sheffield in the North of England was low. Smoking and sexual behaviour were associated with HR-HPV positivity.TRIAL REGISTRATION NUMBER: ID14106.",

author = "Vanessa Hearnden and Craig Murdoch and Katy D'Apice and Susan Duthie and Hayward, {Nicholas J} and Powers, {Hilary Jane}",

note = "{\circledC} Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2018",

month = "11",

doi = "10.1136/bmjopen-2018-022497",

language = "English",

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T1 - Oral human papillomavirus infection in England and associated risk factors

T2 - a case-control study

AU - Hearnden, Vanessa

AU - Murdoch, Craig

AU - D'Apice, Katy

AU - Duthie, Susan

AU - Hayward, Nicholas J

AU - Powers, Hilary Jane

PY - 2018/11

Y1 - 2018/11

N2 - OBJECTIVES: This study was conducted to determine the prevalence of and associated risk factors for infection with oral high-risk human papillomavirus (HR-HPV) in adult participants within England, and to explore any association with oral mucosal buccal epithelial cell and whole blood folate concentration.DESIGN: This was an observational study to determine oral HR-HPV prevalence in the study population. A case-control study was performed to explore the association between infection and folate status.SETTING: This study was conducted in Sheffield, UK, between April 2013 and August 2014.PARTICIPANTS: Seven hundred participants, aged 18-60 years, were recruited from university students (n=179), university and hospital staff (n=163), dental hospital patients (n=13), Sexual Health Sheffield patients (n=122) and the general public (n=223).INTERVENTIONS: Participants completed a lifestyle and sexual behaviour questionnaire, provided an oral rinse and gargle sample for the detection of oral HR-HPV and an oral mucosal buccal epithelial cell sample for the measurement of oral mucosal buccal epithelial cell folate. A blood sample was collected for measurement of whole blood folate concentration.OUTCOME MEASURES: The prevalence of oral HR-HPV infection in the study population was the primary outcome measure. Secondary outcome measures included associations between risk factors, folate status and infection.RESULTS: The prevalence of oral HR-HPV infection in this cohort was 2.2% (15/680) with 0.7% (5/680) positive for HPV16 or HPV18. Twenty samples were excluded due to insufficient material for HPV detection. Participants with oral HR-HPV infection were more likely to be a former smoker, and have a greater number of sexual and oral sexual partners. Folate status was not linked to likelihood of HPV infection.CONCLUSIONS: The prevalence of oral infection with HR-HPV in adult men and women in Sheffield in the North of England was low. Smoking and sexual behaviour were associated with HR-HPV positivity.TRIAL REGISTRATION NUMBER: ID14106.

AB - OBJECTIVES: This study was conducted to determine the prevalence of and associated risk factors for infection with oral high-risk human papillomavirus (HR-HPV) in adult participants within England, and to explore any association with oral mucosal buccal epithelial cell and whole blood folate concentration.DESIGN: This was an observational study to determine oral HR-HPV prevalence in the study population. A case-control study was performed to explore the association between infection and folate status.SETTING: This study was conducted in Sheffield, UK, between April 2013 and August 2014.PARTICIPANTS: Seven hundred participants, aged 18-60 years, were recruited from university students (n=179), university and hospital staff (n=163), dental hospital patients (n=13), Sexual Health Sheffield patients (n=122) and the general public (n=223).INTERVENTIONS: Participants completed a lifestyle and sexual behaviour questionnaire, provided an oral rinse and gargle sample for the detection of oral HR-HPV and an oral mucosal buccal epithelial cell sample for the measurement of oral mucosal buccal epithelial cell folate. A blood sample was collected for measurement of whole blood folate concentration.OUTCOME MEASURES: The prevalence of oral HR-HPV infection in the study population was the primary outcome measure. Secondary outcome measures included associations between risk factors, folate status and infection.RESULTS: The prevalence of oral HR-HPV infection in this cohort was 2.2% (15/680) with 0.7% (5/680) positive for HPV16 or HPV18. Twenty samples were excluded due to insufficient material for HPV detection. Participants with oral HR-HPV infection were more likely to be a former smoker, and have a greater number of sexual and oral sexual partners. Folate status was not linked to likelihood of HPV infection.CONCLUSIONS: The prevalence of oral infection with HR-HPV in adult men and women in Sheffield in the North of England was low. Smoking and sexual behaviour were associated with HR-HPV positivity.TRIAL REGISTRATION NUMBER: ID14106.

U2 - 10.1136/bmjopen-2018-022497

DO - 10.1136/bmjopen-2018-022497

M3 - Article

C2 - 30122664

VL - 8

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 8

M1 - e022497

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Oral human papillomavirus infection in England and associated risk factors
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