Prevalence of oral human papILLOmavirus infection among adult men and women in Taiwan (PILLOT).

Objective: Persistent oral human papillomavirus (HPV) infection, a key risk factor for head and neck cancers, is well-studied in Western populations but less understood elsewhere. This study aimed to estimate the prevalence of oral HPV infection by genotype among Taiwanese adults, stratified by sex and age, and identify associated risk factors.

Methods: This cross-sectional study included adults aged 20-60 years who visited Otorhinolaryngology departments at six medical centers in Taiwan (September 2021-October 2022). Participants with oral/oropharyngeal cancer, prior HPV vaccination, or other disqualifying conditions were excluded. Oral rinse samples were collected and analyzed for HPV positivity. Participants completed questionnaires on sociodemographic characteristics and general health.

Results: Of 2,545 participants (1,269 men; 1,276 women), oral HPV prevalence was 1.6% in females and 2.1% in males. In men, oral HPV infection was moderately associated with smoking (coefficient: 0.34, 95% CI: 0.05 to 0.63), betel quid chewing (coefficient: -0.41, 95% CI: -0.75 to -0.07), and lifetime number of male oral sex partners (coefficient: 0.39, 95% CI: 0.12 to 0.60). In women, only smoking showed a moderate association (coefficients: 0.59, 95% CI: 0.11 to 1.00). High-risk subtypes were found in 59.6% of HPV-positive cases. Among those tested positive for oral HPV, 59.6% carried high-risk subtypes, with HPV 18 (23.4%) and HPV 52 (17.0%) being the most prevalent.

Conclusions: This study revealed the prevalence of oral HPV, identified most common genotypes, and highlighted smoking, betel quid chewing, and number of male oral sex partners in men as key risk factors in the Taiwanese population.