Oral HPV in HIV+ and HIV- Populations: Preliminary Results

T.B. Thomas*1, A.C. Morris*1, T.S. Nair1, B.M. Jewell1, H.M. Walline1, R.L. Delinger2, L.P. Campredon2, A.F. Brouwer2, M.C. Eisenberg2, R. Meza2, T.E. Carey1
1. Department of Otolaryngology, University of Michigan, Ann Arbor, MI 2. Department of Epidemiology, University of Michigan, Ann Arbor, MI

Figure 2: Distribution of HPV types

Background
Two studies within our lab, MHOC and OHIP, were created to recruit dif- A HPV # of # of samples
ferent populations. The MHOC study investigates oral HPV prevalence in
University of Michigan students as well as individuals recruited from the
Type positives from each group B HPV11
HPV59
Ann Arbor area. The OHIP study investigates oral HPV prevalence in HIV+ HPV18 24 18 HIV-, 6 HIV+ HPV51 HPV52
individuals and their partners, as well as head and neck cancer patients. HPV6* 17 13 HIV-, 4 HIV+ HPV35
The OHIP study is a consortium of five different partner sites (University
of Michigan, Johns Hopkins, Emory University, Einstein College of Medi- HPV16 14 9 HIV-, 5 HIV+ HPV39
cine, and University of Pittsburgh). Individuals from these two studies
HPV56 10 7 HIV-, 3 HIV+
were sorted by HIV status to determine HPV prevalence within each
population. The goal is to understand the natural history of HPV infection, HPV33 7 2 HIV-, 5 HIV+ HPV90 HPV18
persistence, and clearance in both HIV- and HIV+ groups.
HPV31 5 2 HIV-, 3 HIV+ HPV73
HPV45 5 1 HIV-, 4 HIV+
Methods
HPV58 5 3 HIV-, 2 HIV+ HPV66
HPV66 5 2 HIV-, 3 HIV+ HPV58
5 HPV6
Saliva samples were obtained in collection kits at study visits every 3-4
months. Participants are asked to complete up to eight study visits. During
HPV73 4 HIV-, 1 HIV+
study visits, participants completed a detailed questionnaire which asks HPV90* 5 3 HIV-, 2 HIV+ HPV45
about demographics, sexual behavior, vaccination status, and other fac-
tors. DNA was isolated from each saliva sample, following manufacturer
HPV39 4 1 HIV-, 3 HIV+ HPV31
instructions. DNA was quantified using the Invitrogen quant-iT PicoGreen HPV35 3 2 HIV-, 1 HIV+
assay, which compares absorbance readings of known DNA concentra-
HPV51 3 1 HIV-, 2 HIV+ HPV33 HPV16
tions to our unknown saliva sample DNA concentration. Samples were
HPV genotyped using PCR-MassArray, which tests for 15 high-risk HPV HPV52 3 3 HIV- HPV56
types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 73) and 3 low-
risk HPV types (6, 11, 90). RNA will be isolated from HPV+ saliva samples
HPV11* 1 1 HIV+
to potentially identify alternatively-spliced HPV E6 and E7 transcripts HPV59 1 1 HIV+
Figure 2A: The number of occurrences of each HPV type, as well as the populations that each type is found in. 17 different HPV types have been found
in our study population. Low-risk HPV types are denoted with an asterisk.
Results Figure 2B: The three most common types (HPV18, HPV6, HPV16) make up nearly half of all occurences. 2 of the 3 most common HPV types (HPV16,
HPV18) have proven, frequent association with head and neck cancer.

Figure 1: Follow-up data of study participants Figure 3: HPV prevalence in samples and individuals

Study visits completed per participant A All Samples HIV+ Samples HIV- Samples
Conclusions
300 274
Negative 658 Negative 112 Negative 546
• Recruitment has been successful, with many study participants
Positive 92 Positive 37 Positive 55
Number of Participants

250 returning for multiple additional visits. One participant has even
202 % HPV+ 12.3% % HPV+ 25.0% % HPV+ 9.2% come in for eight study visits.
200 • There is a statistically significant difference in HPV prevalence be
150
113
B All Individuals HIV+ Individuals HIV- Individuals
tween HIV+ samples and HIV-samples (p < 0.01).
• The difference in HPV prevalence is less drastic when assessing
100 74 Negative 382 Negative 88 Negative 294 individuals rather than samples, but still statistically significant (p
= 0.01).
50
42
27
Positive 83 Positive 30 Positive 53 • 17 different HPV types have been found in our study population.
14
1 % HPV+ 17.8% % HPV+ 25.4% % HPV+ 15.3% The three most common types (HPV18, HPV6, HPV16) make up
0
1 2 3 4 5 6 7 8 nearly half of all occurrences.
Study Visits Completed Figure 3A: The prevalence of HPV in samples for the two populations, sorted
by HIV status. There is a statistically significant difference in HPV prevalence
between HIV+ samples and HIV- samples (p < 0.01).
Figure 3B: The number of HPV+ and HPV- individuals found in our two popu- Acknowledgements
Figure 1: The number of study visits completed per participant. Study par- lations, sorted by HIV status. The difference in HPV prevalence is less drastic
ticipants visit every 3-4 months. Since this is an ongoing study, the de- when assessing individuals rather than samples, but still statistically signifi- • Sources of funding: NIH Grant U01CA182915,
creases in samples between study visits does not necessarily mean those cant (p = 0.01). Individuals are considered “positive” if they were HPV+ at NIH Grant P50DE019032
participants were lost to follow up. any point during their participation in the study. • We would like to thank our study participants.