Your Family Physician

Oral sex and open-mouthed kissing increase the risk of acquiring oral infections of human papillomavirus (HPV), according to a report in the May 1st issue of The Journal of Infectious Diseases.

"Performing oral sex is not without risks," Dr. Maura L. Gillison commented to Reuters Health. "It is associated with sexually transmitted infections, such as gonorrheal pharyngitis, that are immediately symptomatic, and now is associated with oral HPV infections that are asymptomatic yet may lead to oral cancer 10-20 years later."

Dr. Gillison from The Ohio State University, Columbus, and colleagues explored whether sexual behaviors were associated with the odds of oral HPV infection in adult 332 outpatients and in 210 college-aged men. Oral samples were collected and purified DNA was analyzed for 37 HPV types.

The investigators found that 4.8% of adult outpatients and 2.9% of college-aged men had oral HPV infection.

Among adult outpatients, the odds of oral HPV infection were significantly elevated among current tobacco smokers and among individuals who reported having either more than 10 oral or more than 25 vaginal sex partners during their lifetime.

Similar risk factors applied to the college-aged men. For them, having at least 6 recent oral sex or open-mouthed kissing partners and being older were independently associated with increased odds of developing oral HPV infection.

For the 28% of college-aged men who reported never having performed oral sex, having at least 10 lifetime or at least 5 recent open-mouthed kissing partners was associated with a significantly higher risk of developing oral HPV infection.

"Our data suggest that oral HPV infections that could predispose to cancer may be transmitted by very common behaviors such as open-mouth or 'French' kissing," Dr. Gillison concluded.

"Given that the (HPV) vaccine does not have any therapeutic value against pre-existing infections, this may be relevant to the timing of administration of vaccination," Dr. Gillison said. "Although the CDC recommends that the vaccine be administered between the ages of 9 and 12 ideally, in practice it is often administered to girls between the age of 14-16. Oral exposure may have occurred prior to that age."

J Infect Dis 2009;199:1263-1269.

Source : http://www.medscape.com/viewarticle/702692