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Prevalence of and Risk Factors for Oral Human Papillomavirus Infection among HIV-Positive and HIV-Negative People Who Inject Drugs

BACKGROUND: Human papillomavirus (HPV) causes most oropharyngeal cancers in the United States. Oral HPV prevalence is associated with immunosuppression, and drug use can be immunosuppressive, but the epidemiology of oral HPV among people who use drugs is not well described. METHODS: We enrolled men...

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Autores principales: Robbins, Hilary A., Fennell, Christina E., Gillison, Maura, Xiao, Weihong, Guo, Yingshi, Wentz, Alicia, Kirk, Gregory D., Mehta, Shruti H., D’Souza, Gypsyamber
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657972/
https://www.ncbi.nlm.nih.gov/pubmed/26600158
http://dx.doi.org/10.1371/journal.pone.0143698
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author Robbins, Hilary A.
Fennell, Christina E.
Gillison, Maura
Xiao, Weihong
Guo, Yingshi
Wentz, Alicia
Kirk, Gregory D.
Mehta, Shruti H.
D’Souza, Gypsyamber
author_facet Robbins, Hilary A.
Fennell, Christina E.
Gillison, Maura
Xiao, Weihong
Guo, Yingshi
Wentz, Alicia
Kirk, Gregory D.
Mehta, Shruti H.
D’Souza, Gypsyamber
author_sort Robbins, Hilary A.
collection PubMed
description BACKGROUND: Human papillomavirus (HPV) causes most oropharyngeal cancers in the United States. Oral HPV prevalence is associated with immunosuppression, and drug use can be immunosuppressive, but the epidemiology of oral HPV among people who use drugs is not well described. METHODS: We enrolled men and women with a current or prior history of injection drug use in this cross-sectional sub-study within the AIDS Linked to the Intravenous Experience (ALIVE) cohort. We tested oral rinse samples for 37 types of HPV DNA and collected self-reported risk factor information. We compared oral HPV prevalence across categories using chi-squared statistics and multivariable logistic regression. RESULTS: Among 199 subjects, 32% were HIV-positive (median CD4 count 384 cells/μL), 90% were Black, 56% had less than a high school education, 17% had recently used injection drugs, and the median age was 54 years. Most had performed oral sex (82%) but had fewer than 5 lifetime partners (58%). The prevalence of any oral HPV was 29%, and of any oncogenic oral HPV was 13%. Oral HPV prevalence was high among both heterosexual men (30%) and women (20%). After adjustment, odds of oral HPV were increased among HIV-positive individuals with a low CD4 count (<350 cells/μl, aOR = 2.7, 95%CI = 1.2–6.4, vs. HIV-negative individuals), but not among HIV-positive individuals with a higher CD4 cell count. Odds were also elevated for those who had recently performed oral sex on a woman (aOR = 2.2, 95%CI = 1.01–4.6) and, even after this adjustment, among bisexual/lesbian females (aOR = 5.6, 95%CI = 1.4–23, vs. heterosexual females). Oral HPV prevalence was not associated with vaginal sex, performing oral sex on a man, or recent drug use. CONCLUSIONS: Recent drug use was not associated with oral HPV prevalence in our study. However, despite modest numbers of sexual partners, the prevalence of oral HPV among this largely Black population with lower socioeconomic status was high.
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spelling pubmed-46579722015-12-02 Prevalence of and Risk Factors for Oral Human Papillomavirus Infection among HIV-Positive and HIV-Negative People Who Inject Drugs Robbins, Hilary A. Fennell, Christina E. Gillison, Maura Xiao, Weihong Guo, Yingshi Wentz, Alicia Kirk, Gregory D. Mehta, Shruti H. D’Souza, Gypsyamber PLoS One Research Article BACKGROUND: Human papillomavirus (HPV) causes most oropharyngeal cancers in the United States. Oral HPV prevalence is associated with immunosuppression, and drug use can be immunosuppressive, but the epidemiology of oral HPV among people who use drugs is not well described. METHODS: We enrolled men and women with a current or prior history of injection drug use in this cross-sectional sub-study within the AIDS Linked to the Intravenous Experience (ALIVE) cohort. We tested oral rinse samples for 37 types of HPV DNA and collected self-reported risk factor information. We compared oral HPV prevalence across categories using chi-squared statistics and multivariable logistic regression. RESULTS: Among 199 subjects, 32% were HIV-positive (median CD4 count 384 cells/μL), 90% were Black, 56% had less than a high school education, 17% had recently used injection drugs, and the median age was 54 years. Most had performed oral sex (82%) but had fewer than 5 lifetime partners (58%). The prevalence of any oral HPV was 29%, and of any oncogenic oral HPV was 13%. Oral HPV prevalence was high among both heterosexual men (30%) and women (20%). After adjustment, odds of oral HPV were increased among HIV-positive individuals with a low CD4 count (<350 cells/μl, aOR = 2.7, 95%CI = 1.2–6.4, vs. HIV-negative individuals), but not among HIV-positive individuals with a higher CD4 cell count. Odds were also elevated for those who had recently performed oral sex on a woman (aOR = 2.2, 95%CI = 1.01–4.6) and, even after this adjustment, among bisexual/lesbian females (aOR = 5.6, 95%CI = 1.4–23, vs. heterosexual females). Oral HPV prevalence was not associated with vaginal sex, performing oral sex on a man, or recent drug use. CONCLUSIONS: Recent drug use was not associated with oral HPV prevalence in our study. However, despite modest numbers of sexual partners, the prevalence of oral HPV among this largely Black population with lower socioeconomic status was high. Public Library of Science 2015-11-24 /pmc/articles/PMC4657972/ /pubmed/26600158 http://dx.doi.org/10.1371/journal.pone.0143698 Text en © 2015 Robbins et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Robbins, Hilary A.
Fennell, Christina E.
Gillison, Maura
Xiao, Weihong
Guo, Yingshi
Wentz, Alicia
Kirk, Gregory D.
Mehta, Shruti H.
D’Souza, Gypsyamber
Prevalence of and Risk Factors for Oral Human Papillomavirus Infection among HIV-Positive and HIV-Negative People Who Inject Drugs
title Prevalence of and Risk Factors for Oral Human Papillomavirus Infection among HIV-Positive and HIV-Negative People Who Inject Drugs
title_full Prevalence of and Risk Factors for Oral Human Papillomavirus Infection among HIV-Positive and HIV-Negative People Who Inject Drugs
title_fullStr Prevalence of and Risk Factors for Oral Human Papillomavirus Infection among HIV-Positive and HIV-Negative People Who Inject Drugs
title_full_unstemmed Prevalence of and Risk Factors for Oral Human Papillomavirus Infection among HIV-Positive and HIV-Negative People Who Inject Drugs
title_short Prevalence of and Risk Factors for Oral Human Papillomavirus Infection among HIV-Positive and HIV-Negative People Who Inject Drugs
title_sort prevalence of and risk factors for oral human papillomavirus infection among hiv-positive and hiv-negative people who inject drugs
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657972/
https://www.ncbi.nlm.nih.gov/pubmed/26600158
http://dx.doi.org/10.1371/journal.pone.0143698
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