Human papillomavirus (HPV) type 16 E6 seroprevalence among men living with HIV without HPV-driven malignancies

Abstract Individuals living with HIV are at a higher risk for developing human papillomavirus-driven oropharyngeal squamous cell carcinoma (HPV+OPSCC). There are no methods for early detection; however, HPV16 E6 antibodies have been identified as a promising early marker. The objective of this study was to evaluate the prevalence of HPV16 E6 antibodies among men living with HIV, with secondary objectives of analyzing clinical and serologic predictors of HPV16 E6 seropositivity. Banked blood specimens from 2,320 men aged 40+ living with HIV in Tennessee were evaluated for the following HPV16 antibodies: L1, E1, E2, E4, E6, E7. HPV16 E6 antibody levels were further categorized as moderate or high. Demographic, clinical, and serologic determinants of HPV16 E6 seropositivity were evaluated using logistic regression. HPV16 L1 antibodies were most common (22.8%), followed by E4 (10.5%), E6 (5.6%), E2 (4.8%), and E7 (4.0%). Of the 130 HPV16 E6 seropositives, 55 (2.4%) had moderate seropositivity and 75 (3.2%) had high. HPV16 E6 seropositive men had nearly 2-fold greater odds of seropositivity against one additional HPV16 E antigen (OR: 1.67 [95% CI: 1.10-2.52]; P=0.015) and over 3-fold greater odds of seroreactivity against two additional HPV16 E antigens (OR: 3.21 [95% CI: 1.40-7.33]; P=0.006). HPV16 E6 seropositivity was not associated with the clinical or demographic factors evaluated. In the largest study to date, HPV16 E6 seroprevalence was elevated compared to prior studies in HIV populations (range: 1.1% to 3.2%) and likely reflects the high incidence of HPV+OPSCC in the southeast region of the United States.