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Human Vaccines & Immunotherapeutics Volume 15, 2019 - Issue 7-8: HPV vaccination: from seroprevalence to public health policy and everything in between
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Research Paper

Sex differences in HPV immunity among adults without cancer

Melina J. Windona Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USAORCID Iconhttps://orcid.org/0000-0002-0904-2931View further author information
ORCID Icon,
Tim Waterboerb Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, GermanyView further author information
,
Alexander T. Hillela Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USAView further author information
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Wade Chiena Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USAView further author information
,
Simon Besta Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USAView further author information
,
Charles Stewarta Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USAView further author information
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Lee Aksta Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USAView further author information
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Tanya Troyc Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USAView further author information
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Noemi Benderb Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, GermanyView further author information
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Brett Milesd Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USAView further author information
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William R. Ryane Head and Neck Surgery, Department of Otolaryngology, University of California San Francisco, San Francisco, CA, USAView further author information
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Rajarsi Mandala Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USAView further author information
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Karen Pitmana Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USAView further author information
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David W. Eiselea Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USAView further author information
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Carole Fakhrya Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USA;c Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA;f Bloomberg~Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USACorrespondence[email protected] [email protected]
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&
Gypsyamber D’Souzaa Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USA;c Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USACorrespondence[email protected] [email protected]
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Pages 1935-1941 | Received 27 Sep 2018, Accepted 06 Jan 2019, Published online: 19 Mar 2019
 
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ABSTRACT

The incidence of human papillomavirus (HPV)-associated head and neck cancers is rising, particularly among men. Whether observed epidemiological differences in sex are explained by differences in sexual exposure and/or by immune response is unclear. In this cross-sectional, multi-institutional study, seroprevalence of antibodies to HPV L1 capsid antigen was compared by patient characteristics among 374 adult patients without cancer. A significantly higher seroprevalence was observed among women compared with men for HPV16 (OR = 2.96, 95% CI = 1.21–7.21) and HPV18 (OR = 2.84, 95% CI = 1.06–7.60) L1 antibodies. This difference persisted for HPV16 after controlling for lifetime and recent sexual behavior. After controlling for sex, HPV16 and HPV18 L1 seroprevalence was also significantly associated with higher number of lifetime (HPV16 OR = 1.05, 95% CI = 1.01–1.08; HPV18 OR = 1.04, 95% CI = 1.01–1.08) and recent (HPV16 OR = 1.54, 95% CI = 1.15–2.07; HPV18 OR = 1.40, 95% CI = 1.07–1.82) oral but not vaginal sexual partners. These findings potentially suggest a more robust immune response to HPV16/18 among women compared with men that may not be explained by differences in number of sexual partners, and thereby presumably HPV exposure. The independent association of HPV16/18 L1 seroprevalence with higher number of oral sexual partners suggests a possible role for site of mucosal exposure in the HPV immune response.

Disclosure of potential conflicts of interest

No potential conflict of interest were disclosed.

Additional information

Funding

This work was supported by the National Cancer Institute [P30CA006973];National Institute of Dental and Craniofacial Research [P50DE019032];National Institute of Dental and Craniofacial Research [R35DE026631 and NIH 5T32DC000027-29].

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