Among concurrent non-oncogenic HPV types found in this population, HPV-3, which has been rarely reported elsewhere, was the most dominant type. However, studies regarding the risk factors for concurrence of oral-genital HPV infections are few in number. Another possible explanation is insufficient statistical power, as oral sex is rare among rural Chinese population whose sexual activity is considerably more conservative as compared with westerners. Specimen and data collection Exfoliated cells from oral cavity and genitalia were collected by an experienced clinician using saline-moistened cotton swabs, as described previously 17 , This low prevalence of coinfection may also have rendered subgroup analysis of carcinogenic HPV impossible. The current investigation was carried out in 6 of the 9 villages composing the parent cohort study in —
A one-on-one computer-aided interview was carried out by a trained interviewer of male gender. Information regarding demographic characteristics, cigarette consumption defined as 1 cigarette or more each day for at least 1 year , alcohol consumption defined as use of Chinese liquor twice each week or more for at least 1 year , characteristics of sexual behavior history of oral sex practices and lifetime number of sexual partners , and self-reported history of oral disease in the preceding 12 months e. The current investigation was carried out in 6 of the 9 villages composing the parent cohort study in — These data provide a basis for further understanding the natural history and transmission dynamics of oral HPV infection. Oral specimens were collected from the buccal mucosa, palate, top and bottom of the tongue, the inner upper and lower lips, and the gingival surfaces by rubbing five times at each site. All participants provided written informed consent, and the study was approved by the Institutional Review Board of the School of Oncology, Peking University. Additionally, despite a large population sample size, the low prevalence of oral-genital coinfection may limit our ability to identify some associations. In conclusion, our data suggested that HPV infections of the oral cavity and the male genitalia in the same individual were type-specifically correlated. Exfoliated cells from the male genital shaft, glans penis, coronal sulcus, and scrotum were collected in the same manner. However, efforts were made to minimize this bias e. Concurrence of oral-genital infections was associated with multiple sexual partners. Compared to hybridization with pre-assigned probes, the method adopted in this study using general primer mediated PCR followed by sequencing may maximize identification of the spectrum of HPV types including HPV The biological mechanism of this correlation is unclear. The cells collected on these swabs were then rinsed in 0. The methods were carried out in accordance with the approved guidelines. As expected, we found that individuals with multiple lifetime sexual partners have a higher likelihood of coinfection. The possibility of self-reporting bias which might lead to exposure misclassification and thus result in dilution of risk estimates to the null cannot be excluded. Specimen and data collection Exfoliated cells from oral cavity and genitalia were collected by an experienced clinician using saline-moistened cotton swabs, as described previously 17 , In addition to partner to partner transmission, it is also possible that HPV infection at one site can be acquired by autoinoculation from the other site e. Prevalence of oral HPV was significantly lower than on the external genitalia in healthy adult Chinese men, similar to what has been observed in other populations 6. Despite this rarity of coinfection, a relatively high level of type-specific concordance Discussion This population-based investigation of the concordance of HPV infections in the oral cavity and on the external genitalia is to our knowledge the first such investigation to be undertaken among Chinese men. Many studies have suggested that both oral and genital HPV infections are mainly sexually transmitted 7 , Given that HPV-related oropharyngeal cancer appears to be on the increase, improved insight into the relationship of HPV infection at the oral cavity and other anatomical sites may help to inform and direct future prevention efforts, such as HPV vaccination. Among concurrent non-oncogenic HPV types found in this population, HPV-3, which has been rarely reported elsewhere, was the most dominant type.
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