Human Papillomavirus Type 16 E6 Seroprevalence among Men Living with HIV without HPV-Driven Malignancies

Individuals living with human immunodeficiency virus (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 ages ≥40 years living with HIV in Tennessee were evaluated for the following HPV16 antibodies: L1, E1, E2, E4, E6, and 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 and 75 (3.2%) had high seropositivity. HPV16 E6 seropositive men had nearly twofold greater odds of seropositivity against one additional HPV16 E antigen [OR: 1.67 (95% CI, 1.10-2.52); P = 0.015] and more than threefold 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 with prior studies in HIV populations (range: 1.1%-3.2%) and likely reflects the high incidence of HPV + OPSCC in the Southeast region of the United States. Prevention Relevance: Our findings fill an important gap, given that our study is the largest to date to evaluate HPV antibodies among men living with HIV and is the first study to do so in the Southeastern United States, the region with the highest prevalence of both HIV and HPV + OPSCC in the nation.