03 / THINK HIV: A QUALITY IMPROVEMENT PROJECT PROMOTING HIV TESTING IN A CLINICAL ASSESSMENT UNIT OF A LARGE TEACHING HOSPITAL

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Background: Oral Human Papillomavirus (HPV) infection is rare in the general population (7%), whereas is common in high-risk individuals. Infection by carcinogenic HPVs, in particular HPV16, plays a role in the development of oropharyngeal cancer. We aimed to estimate the prevalence of Oral HPV in Men At Risk (OHMAR Project) enrolled in a longitudinal study.Methods: Oral HPV infection was evaluated in oral rinse and gargles of HIV-infected and uninfected men who have sex with men (MSM) attending an STI/HIV centre in Rome (Italy). The Linear Array HPV Genotyping Test was used to detect HPV DNA. Results: 193 HIV-uninfected and 117 HIV-infected MSM (94.0% under cART, 93.6% with undetectable HIV-1-RNA) participated. Oral HPV was detected in 17.1% and 23.9% of the subjects, respectively (p=0.14). Carcinogenic HPVs were found in 10.9% and 10.3% of the HIV-uninfected and infected MSM, respectively (p=0.86). Prevalence of the genotypes included in the quadrivalent vaccine was 5.7% and 6.0%, respectively (p=0.92).HIV-infected MSM with >50 receptive oral sex lifetime partners (vs. u226450) were significantly more likely to be HPV-positive (AOR: 6.84, 95% CI: 2.12-22.06, p<0.0001). For HIV-uninfected individuals, oral HPV infection increased with age (AOR: 1.05, 95% CI: 1.01-1.09, p=0.013), number of any sex lifetime partners (AOR: 2.46, 95% CI: 1.00-6.05 for 26-100 vs. u226425 partners; p=0.049), history of ano-genital warts (AOR: 3.27, 95% CI: 1.38-7.78, p= 0.007). Oral HPV prevalence in HIV-infected subjects varied significantly with the CDC stage (33.3% vs. 8.3% for C vs. A/B stage, respectively; p=0.018).Conclusions: Oral HPV infection among MSM is more frequent than in the general population. HIV status does not seem to affect the prevalence rate or HPV type distribution. Sexual behavior appears as the main determinant of infection in both groups.

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