No Increased Risk of Infection for Long-Term Partners of People with HPV-Related Oral Cancers

Spouses and long-term partners of patients with mouth and throat cancers related to infection with the human papilloma virus (HPV) appear to have no increased prevalence of oral HPV infections, according to results of a multicenter, pilot study led by Johns Hopkins investigators. The study's results suggest that long-term couples need not change their sexual practices, say the scientists.

"While we can't guarantee that the partners of patients will not develop oral HPV infections or cancers, we can reassure them that our study found they had no increased prevalence of oral infections, which suggests their risk of HPV-related oral cancer remains low," says Gypsyamber D'Souza, PhD, MPH, associate professor of epidemiology at the Johns Hopkins University Bloomberg School of Public Health. She was expected to present the results of her study June 1 at the 2013 American Society of Clinical Oncology annual meeting.

HPV-related oral cancers are rising in prevalence among white men in the United States, and fear of transmitting the virus can lead to anxiety, divorce, and curtailing of sex and intimacy among couples, says D'Souza. Persistent oral HPV infections are a risk for developing oropharyngeal cancers, located at the base of the tongue, tonsils, pharynx and soft palate.

At the Johns Hopkins Hospital and three other hospitals, researchers conducted surveys and took oral rinse samples from 166 male and female patients with HPV-related oropharyngeal cancers and 94 spouses and partners. The scientists also studied patients' tumor samples and performed visual oral examinations of spouses/partners. Of the 94 spouses/partners, six were male.

More than half of patients had at least one type of HPV DNA detectable in their oral rinses, including HPV16, the viral type most commonly associated with oral and other cancers. After a year, only seven patients (six percent) still had oral HPV16 DNA detectable.

Of the 94 spouses/partners, six had oral HPV infections (6.5 percent). Among the six, none of the men and two of four females (2.3 percent) had HPV16 infections at very low levels. These infections were not detectable one year later. No oral cancers were detected among 60 spouses/partners who underwent a visual oral exam.

One spouse and one patient reported a history of cervical cancer. Two spouses reported a history of cervical pre-cancer, and three patients said they had previous spouses with cervical cancers, but these were self-reported, unconfirmed cases.

"The oral HPV prevalence among partners who participated in this study are comparable to rates observed among the general population," says D'Souza. "We suspect that long-term spouses and partners have been exposed to HPV, like most of us, and appear to have cleared the virus."

D'Souza and her colleagues recommend that long-term couples need not change their sexual practices. "Certainly, with new sexual partners, caution is always advised."

More research is needed to determine the timeline of progression for HPV-related oral cancers and how HPV is transmitted and suppressed by the immune system, adds D'Souza.

Funding for the study was provided by the Johns Hopkins Innovation Fund and the Richard Gelb Cancer Prevention Award.

Scientists contributing to the research include Neil Gross from the Oregon Health & Science University; Maura Gillison from the Ohio State University; Sara Pai from Johns Hopkins; Robert Haddad from the Dana Farber Cancer Center; and Marshall Posner from Mount Sinai Medical Center.

ASCO Abstract #6031: Oral HPV infection in HPV-positive oropharyngeal cancer cases and their spouses.