Genotyping HPV 16 and 18 in Oral and Oropharyngeal Cancer: Uncovering HIV as a Key Risk Factor in a Ugandan Cohort

Abstract

<title>Abstract</title> Background Human Papillomavirus (HPV) has been associated with oral (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC) involving several risk factors in different parts of the world. The aim of this study was to determine the prevalence and factors associated with high-risk HPV 16 and HPV 18 among patients with oral and oropharyngeal squamous cell carcinoma who attended Mulago Hospital, Uganda from 2010–2015. Methods This was a retrospective study in which 174 tissue blocks confirmed with oral and oral pharyngeal squamous cell carcinoma were retrieved from the archives. The corresponding medical charts of the patients were reviewed for demographic and clinical data. Sections of the tissue blocks were reconfirmed for OSCC&amp; OPSCC by staining with H&amp;E. The samples were genotyped for HPV 16, 18 using Multiplex PCR techniques. The data was analyzed using SPSS version 21. Results All 174 samples were confirmed positive for OSCC &amp; OPSCC. HPV DNA was positive in 128 individuals, 46 tested negative. HPV 16 occurred in 55 (32%) subjects and HPV 18 occurred in 37 (21%). Double infection was present in 36 individuals (21%). HIV was the only risk factor significantly associated with HPV 16 associated OSCC&amp; OPSCC (p = 0.018). The overall HPV prevalence was 74%. Conclusions Overall, HPV 16 and 18 are key etiological factors in oral and oral pharyngeal squamous cell carcinoma pathogenesis in the Ugandan population, with a high prevalence. The results suggest that HIV positive individuals are at a higher risk of acquiring HPV 16 associated OPSCC. Alcohol consumption and cigarette smoking are not factors associated with HPV associated OPSCC in this study population.