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Prevalence and associated factors of betapapillomavirus infections in individuals without cutaneous squamous cell carcinoma

Linda Struijk^2,

¹ DDL Diagnostic Laboratory, Voorburg, The Netherlands
² Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
³ Institute of Virology, University of Cologne, Köln, Germany
⁴ Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy
⁵ Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
⁶ Department of Dermatology, Hospital Edouard Herriot, Lyon, France
⁷ Queensland Institute of Medical Research, Brisbane, Australia
⁸ Centre for Cutaneous Research, Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, UK
⁹ Department of Dermatology and GISED Study Center, Ospedali Riuniti, Bergamo, Italy
¹⁰ DKFZ – Charité, Viral Skin Carcinogenesis, Division Viral Transformation Mechanisms, German Cancer Research Center (DKFZ), Heidelberg, Germany

Correspondence
Mariet C. W. Feltkamp
m.c.w.feltkamp{at}lumc.nl

Betapapillomavirus (betaPV) infections are often associated with squamous-cell carcinoma (SCC) and the prevalence of betaPV infections in (immunosuppressed) SCC patients is known to be high. The distribution and possible associated factors of betaPV infections in the general population, however, are largely unknown. To address this issue, betaPV infection was studied in 1405 SCC-free immunocompetent (n=845) and immunosuppressed (n=560) individuals from six countries of different latitudes. A standard study protocol was used to obtain information about age, sex, UV-irradiation and skin type, and from all participants eyebrow hairs were collected for detection and genotyping of 25 established betaPV types using the PM-PCR reverse hybridization assay (RHA) method. The frequency of betaPV-positive participants ranged from 84 to 91 % in the immunocompetent population with HPV23 as the most prevalent type, and from 81 to 98 % in the immunosuppressed population with HPV23 as the most or the second most prevalent type. The median number of infecting betaPV types ranged from four to six in the immunocompetent and from three to six in the immunosuppressed population. Increasing age in the immunocompetent participants and (duration of) immunosuppression in the immunosuppressed patients were associated with betaPV infection. In both groups, sex, skin phototype, sunburns and sun-exposure were not consistently associated with betaPV infection. This study demonstrates that betaPV infections are also highly prevalent in SCC-free individuals, with similar HPV types prevailing in both immunocompetent and immunosuppressed persons. Age and (duration of) immunosuppression were identified as betaPV infection-associated factors, whereas characteristics related to sun exposure and skin type were not.

Present address: DDL Diagnostic Laboratory, Voorburg, The Netherlands.

Members of the EPI-HPV-UV-CA group are listed in the Acknowledgements.

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