Oral and fingernail human papillomavirus (HPV) detection may
be associated with HPV-related carcinoma risk at these nongenital sites and
foster transmission to the genitals. We describe the epidemiology of oral and fingernail
HPV among mid-adult women.
Between 2011 and 2012, 409 women aged 30 to 50 years were
followed up for 6 months. Women completed health and behavior surveys and
provided self-collected oral, fingernail, and vaginal specimens at enrollment and
exit for type-specific HPV DNA testing. Concordance of type-specific HPV
detection across anatomical sites was described with κ statistics. Using
generalized estimating equations or exact logistic regression, we measured the
univariate associations of various risk factors with type-specific oral and
fingernail HPV detection.
Prevalence of detecting HPV in the oral cavity (2.4%) and
fingernails (3.8%) was low compared with the vagina (33.1%). Concordance across
anatomical sites was poor (κ < 0.20 for all comparisons). However,
concurrent vaginal infection with the same HPV type and vaginal HPV viral load were each associated with
fingernail HPV detection. Abnormal Papanicolaou history, lifetime number of male vaginal sex partners at least 10, and lifetime number of open-mouth
kissing partners at least 16 were each associated with oral HPV
detection.
Although our findings support HPV DNA deposition or
autoinoculation between anatomical sites in mid-adult women, the rarity of HPV
in the oral cavity and fingernails suggests that oral/fingernail HPV does not
account for a significant fraction of HPV in genital sites.
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By:
- 1From the Departments of *Epidemiology and †Biostatistics, University of Washington, Seattle, WA; ‡FIDALAB, Seattle, WA; §Fred Hutchinson Cancer Research Center, Seattle, WA; and Departments of ¶Pathology and ∥Global Health, University of Washington, Seattle, WA.
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