Oral HPV Subtypes Common in Women, Children With HIV

Mother-child pairs living with HIV in Nigeria had a higher prevalence of oral human papillomavirus (HPV), with a wide range of both high- and low-risk subtypes found among the cohort, according to new study findings published in JAMA Network Open.¹

HPV infection and its associated cancers are more prevalent in people living with HIV. Cancers associated with HPV infection include cervical, oropharyngeal, anal, penile, vaginal, and vulvar.² Places with an increased burden of HIV, such as sub-Saharan Africa, are more likely to have a higher burden of HPV but little is known about the prevalence of oral HPV subtypes in women with HIV in this area. This study aimed to evaluate the prevalence of oral HPV in mother and child dyads according to their history of HIV.

A wide range of oral HPV subtypes were found in women living with HIV and their children. | Image credit: Naeblys - stock.adobe.com

All mother and child pairs were part of a larger cohort from the University of Benin Teaching Hospital in Nigeria. They were enrolled between May and November of 2019. All children were split into groups: perinatally infected with HIV and receiving antiretroviral treatment (ART) (infection), exposed to HIV but not infected (exposed group), and children without HIV exposure or infection who were matched based on age and sex.

HPV DNA detection was done through an oral rinse specimen, and genotyping was performed for 25 subtypes of HPV. The prevalence and distribution of oral HPV were compared across the study groups.

There were 96 participants in this study. The median (IQR) age of the mothers was 44 (41-48) years and the median age for the children was 10 (10-11) years. Oral HPV was more prevalent in women with HIV compared with women living without HIV (high risk HPV, 17% vs 8%; low-risk HPV, 31% vs 25%).

The exposed group of children had a higher prevalence of high-risk HPV compared with those in the infection group and the matched group (33% vs 21% and 8%, respectively). Children in the infection group had a greater prevalence of low-risk HPV compared with the other 2 groups. HPV81 was the most prevalent subtype of HPV in children with HIV and in children who were not exposed or infected, whereas HPV16 was the most common form of HPV in children in the exposed group.

There were some limitations to this study. It had an observational design, so the investigators could not establish a causal effect. Statistically significant differences also could not be detected due to a lack of power.

“Nevertheless, findings highlight the need for larger longitudinal studies in high-risk populations to elucidate factors associated with oral HPV infection and persistence,” the authors wrote. “This is particularly important in sub-Saharan Africa, where HPV vaccine uptake is suboptimal.”

The prevalence of HPV81 needs to be confirmed in larger studies but could have implications on HPV vaccination, as HPV81 is not covered in the vaccine that is currently available. Postnatal transmission in also possible due to the high prevalence of oral HPV subtypes in women and their children.

References

1. Coker MO, Schlecht NJ, Osagie E, et al. Baseline prevalence of oral human papillomavirus in mother-child pairs with and without HIV infection. JAMA Netw Open. 2024;7(12):e2451512. doi:10.1001/jamanetworkopen.2024.51512

2. HPV and Cancer. National Cancer Institute. Updated October 18, 2023. Accessed December 18, 2024. https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer