Incidence and clearance of oral and cervicogenital HPV infection: longitudinal analysis of the MHOC cohort study

BMJ Open. 2022 Jan 3;12(1):e056502. doi: 10.1136/bmjopen-2021-056502.

Abstract

Objectives: The Michigan HPV and Oropharyngeal Cancer study aimed to evaluate patterns of oral and cervicogenital human papillomavirus (HPV) infection prevalence, incidence, and clearance as well as their relationship to sexual behaviours.

Design: Cohort SETTING: General public in and around Ann Arbor, Michigan.

Participants: 394 college-age and older-adult participants of both sexes provided oral samples, and 325 completed at least 2 visits. 130 who provided a cervicogenital samples, and 127 completed at least 2 visits.

Outcomes: Incidence and clearance rates as well as HRs for oral and cervicogenital HPV.

Results: Oral HPV infections were transient, with only 16% of genotypes persisting to the next visit. The mean time to clearance of a genotype was 46 days (95% CI 37 to 58). In contrast, cervicogenital infections were more persistent, with 56% of genotypes persisting to the next visit. The mean time to clearance of a genotype was 87 days (95% CI 74 to 102). HPV vaccination was associated with reduced incidence of cervicogenital HPV infection (HR 0.63; 95% CI 0.47 to 0.83) but not oral HPV infection. Incidence of oral HPV infection was associated with 2+ recent deep kissing partners (HR 2.00; 95% CI 1.13 to 3.56). Incidence of both oral (HR: 1.70; 95% CI 1.08 to 2.68) and cervicogenital (HR 2.46; 95% CI 1.69 to 3.59) was associated with 2+ recent sexual partners.

Conclusions: Detection of oral HPV was highly transient, but incidence was associated with recent deep kissing and sexual partners. Detection of cervicogenital HPV was more persistent, and incidence was positively associated with recent sexual partners and negatively associated with HPV vaccination.

Keywords: epidemiology; gynaecology; otolaryngology; public health; sexual medicine.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Male
  • Oropharyngeal Neoplasms* / epidemiology
  • Papillomaviridae / genetics
  • Papillomavirus Infections* / diagnosis
  • Papillomavirus Infections* / epidemiology
  • Papillomavirus Infections* / prevention & control
  • Prevalence
  • Risk Factors
  • Sexual Behavior