Oral human papillomavirus infection and oral lesions in HIV-positive and HIV-negative dental patients

Katia Muller, Julie Kazimiroff, Mahnaz Fatahzadeh, Richard V. Smith, Mauricio Wiltz, Jacqueline Polanco, Robert M. Grossberg, Thomas J. Belbin, Howard D. Strickler, Robert D. Burk, Nicolas F. Schlecht

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


We evaluated the risk factors associated with oral human papillomavirus (HPV) infection and oral lesions in 161 human immunodeficiency virus (HIV)-positive patients and 128 HIV-negative patients presenting for oral examination at 2 urban healthcare centers. Patients were interviewed on risk factors and provided oral-rinse samples for HPV DNA typing by polymerase chain reaction. Statistical associations were assessed by logistic regression. Oral HPV was prevalent in 32% and 16% of HIV-positive patients and HIV-negative patients, respectively, including high-risk HPV type 16 (8% and 2%, respectively; P = .049) and uncommon HPV types 32/42 (6% and 5%, respectively; P = .715). Among HIV-negative patients, significant risk factors for oral HPV included multiple sex partners (≥21 vs ≤5; odds ratio [OR], 9.1; 95% confidence interval [CI], 1.7-49.3), heavy tobacco smoking (>20 pack-years vs none; OR, 9.2; 95% CI, 1.4-59.4), and marijuana use (OR, 4.0; 95% CI, 1.3-12.4). Among HIV-positive patients, lower CD4+ T-cell count only was associated with oral HPV detection (≤200 vs ≥500 cells/ mm3; OR, 4.5; 95% CI, 1.3-15.5). Detection of high-risk HPV was also associated with concurrent detection of potentially cancerous oral lesions among HIV-negative patients but not among HIV-positive patients. The observed risk factor associations with oral HPV in HIV-negative patients are consistent with sexual transmission and local immunity, whereas in HIV-positive patients, oral HPV detection is strongly associated with low CD4+ T-cell counts.

Original languageEnglish (US)
Pages (from-to)760-768
Number of pages9
JournalJournal of Infectious Diseases
Issue number5
StatePublished - Sep 1 2015

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Infectious Diseases


  • HIV
  • Human papillomavirus (HPV)
  • Immunity
  • Oral lesions
  • Sexual activity


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