Methods: Whole saliva was collected from 173 HIV+ men and women from attending an HIV outpatient clinic in New Orleans. Swabs and/or biopsies of clinically apparent oral warts were taken from 13 individuals. Saliva, swabs and biopsies were screened for HPV infection by PGMY09/11 PCR, and genotyped by Roche reverse line blot assay.
Results: Using a robust test for genital mucosatropic genotypes, the overall prevalence of HPV infection of the normal oral cavity of HIV+ individuals was 37%. HPV 16 was most prevalent, followed by 83 and 55. The genotype of 80% of all HPV+ specimens could be identified using this method. In stark contrast, swabs and biopsies from oral wart-like lesions were predominately HPV+ (90%) but the genotype was identified in only 33% of lesions (HPV 6, 16, 18, 53, MM8 and MM9 were seen). Sequencing analysis demonstrated that the oral lesions contained HPV types 7 and 32, which are not commonly detected in the genital tract.
Conclusions: While genital-tropic types are often seen in the normal oral mucosa of HIV infected individuals, these genotypes appear not to be responsible for a large proportion of the oral condylomas seen in this population. Development of a robust assay to detect the HPV genotypes found in oral warts is essential to conduct informative studies on the role of HAART therapy on genotype prevalence of HPV in the oral cavity of HIV infected individuals.