Prevalence of human papillomavirus infection in Pakistani patients with oral cancer

Document Type



Otolaryngology, Head and Neck Surgery


Background: The aim of this study was to determine the prevalence and types of human papillomavirus (HPV) in a high-risk Pakistani population, and to investigate the correlation of HPV infection with overall survival (OS), disease-free survival (DFS), habit of betel quid chewing, and histological variables.

Methods: This study included samples retrospectively collected from 140 patients with primary oral squamous cell carcinoma (OSCC) who were diagnosed and treated at The Aga Khan University Hospital, Karachi, Pakistan, from January 2014 to December 2015. General HPV, HPV16, and HPV18 were investigated with PCR.

Findings: HPV was detected in samples of 95 patients, of whom 85 had HPV16, two had HPV18, two were co-infected with both HPV16 and HPV18, and six were positive for HPV by the general primer but could not be specified. Positive PCR results were confirmed by gene sequencing. A 99% compatibility was found between our PCR results and gene sequencing results. HPV-positive patients had prolonged OS compared with HPV-negative patients, but this difference was not significant (p = 0.97). HPV presence did not have a significant association with DFS (p = 0.58). Cross-tabulations analysis showed that the male sex had a significant association with HPV infection (odds ratio [OR] 2.34, p = 0.02). Betel quid chewers were more prone to HPV infection (OR 2, p = 0.049). No significant association was found between HPV infection and age, site of involvement, size of the tumour, American Joint Committee on Cancer stages, histological differentiation, and lymph node status.

Interpretation: The prevalence of HPV infection is high in Pakistani patients with OSCC. However, there is no significant association between HPV infection, survival, and histological variables.

Publication (Name of Journal)

European Journal of Cancer