This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Human papillomavirus (HPV) is a newly established etiologic agent for Head and Neck Squamous Cell Cancer (HNSCC). HPV is responsible for 20% of the 40,000 annual incident cases of HNSCC in the U.S. Most HPV-HNSCCs are oropharyngeal. Prevalence, risk factors and natural history of oral HPV infection must be determined to evaluate the potential for incorporation of HPV detection into oral cancer screening, as was recently accomplished for cervical cancer screening. We have validated methods for oral HPV detection and an oropharyngeal 'Pap-smear' equivalent. Furthermore, we have delineated an increased risk for oral infection by oncogenic HPV types among HIV-infected patients, consistent with their known 6-fold increased risk for oropharyngeal cancer. The goal of this proposal is to perform the first longitudinal study of oral HPV infection in a high-risk group (HIV-infected patients) to gain insight into the short-term natural history of oral HPV infection. We will study the prevalence, incidence, and clearance patterns of oral HPV infection in 112 HIV-infected patients over 6 months by collecting serial oral rinses, tonsillar brush biopsy samples and behavioral questionnaires at 2-week intervals. These data are necessary for the design of two large, planned cohort studies of the pathological consequences of oral HPV infection in HIV-infected individuals. The benefit of screening will be a reduction in HPV-associated HNSCC through earlier therapeutic interventions.
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