Human papillomavirus detection and histopathological findings in potentially premalignant oral lesions among people living with HIV in a sub-Saharan population

Background: Although human papillomavirus (HPV) is associated with oncogenic processes, a correlation between viral oncoproteins and a dysfunctional p16 tumor suppressor protein in oral premalignant lesions is questionable. Aim: We embarked on a study to determine p16 positivity in clinically suspicious oral premalignant lesions seen in people living with human Immunodeficiency virus (HIV). Materials and Methods: We examined 9/24 oral biopsy specimens with dysplastic or papillomatous histopathological changes, as well as normal specimens, using hematoxylin and eosin staining to assess HPV presence via polymerase chain reaction (PCR) and p16 expression by immunohistochemistry. Results: Six specimens (66.7%) were HPV-positive. Various HPV types, including 16, 18, 35, 45, and 68, were detected. All papillomas had mixed infections except one. Varying degrees of immunohistochemical positivity on all tissues, including those that did not demonstrate the presence of HPV DNA on PCR, were seen. Study results showed that in this population, HPV shed in saliva differed from that seen in tissue. Conclusions: In this small exploratory descriptive study, high-risk HPVs were detected in tissue showing p16 overexpression. These findings suggest a possible role for HPV and p16 in oral lesions among PLWHIV, but larger studies are needed to confirm these observations.