Prevalence of and risk factors for oral human papillomavirus among youngwomen in costa rica

Krystle A.Lang Kuhs, Paula Gonzalez, Linda Struijk, Felipe Castro, Allan Hildesheim, Leen Ja Van Doorn, Ana Cecilia Rodriguez, Mark Schiffman, Wim Quint, Douglas R. Lowy, Carolina Porras, Corey Delvecchio, Hormuzd A. Katki, Silvia Jimenez, Mahboobeh Safaeian, John Schiller, Diane Solomon, Sholom Wacholder, Rolando Herrero, Aimée R. Kreimer

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Background. Little is known about the epidemiology of oral human papillomavirus (HPV) in Latin America. Methods. Women (N = 5838) aged 22-29 in the control and vaccine arms of an HPV-16/18 vaccine trial in Costa Rica had oral, cervical, and anal specimens collected. Samples were tested for alpha mucosal HPV types (SPF10/LiPA25 version 1); a subset of oral samples (n = 500) was tested for cutaneous HPV types in the genera alpha, beta, gamma, mu, and nu. Results. In the control arm (n = 2926), 1.9% of women had an oral alpha mucosal HPV detected, 1.3% had carcinogenic HPV, and 0.4% had HPV-16; similar patterns for non-16/18 HPV types were observed in the vaccine arm. Independent risk factors for any oral alpha mucosal HPV among women in the control arm included marital status (adjusted odds ratio [AOR], 3.2; 95% confidence interval [CI], 1.8-5.7 for single compared to married/living as married), number of sexual partners (AOR, 2.4; 95% CI, 1.0-6.1 for ≥4 partners compared to 0-1 partners), chronic sinusitis (AOR, 3.1; 95% CI, 1.5-6.7), and cervical HPV infection (AOR, 2.6; 95% CI, 1.4-4.6). Detection of beta HPV was common (18.6%) and not associated with sexual activity. Conclusions. Unlike cutaneous HPV types, alpha mucosal HPV types were uncommon in the oral region and were predominately associated with sexual behavior. Clinical Trials Registration. NCT00128661.

Original languageEnglish
Pages (from-to)1643-1652
Number of pages10
JournalJournal of Infectious Diseases
Issue number10
StatePublished - Nov 15 2013

Bibliographical note

Funding Information:
Financial support. This work was supported by the NCI (contract N01-CP-11005), with funding support from the National Institutes of Health Office of Research on Women’s Health. Vaccine was provided for our trial by GlaxoSmithKline Biologicals (GSK), under a Clinical Trials Agreement with the NCI. Cervarix is a registered trademark of the GlaxoS-mithKline Biologicals group of companies. GSK also provided support for aspects of the trial associated with regulatory submission needs of the company under Food and Drug Administration BB-IND 7920.


  • Costa rica
  • Guanacaste
  • Hpv
  • Human papillomavirus vaccine
  • Oral HPV dna
  • Oropharynx cancer

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases


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