Association Between Salivary and Cervical Human Papillomavirus in Women With a History of Oral Sex

OBJECTIVE: Human papillomavirus (HPV) is a sexually transmitted DNA virus implicated in both cervical and oral squamous cell carcinomas (SCC). While HPV's role in cervical cancer is well established, the prevalence of oral HPV in women with genital infection-particularly in relation to sexual practices-remains underexplored in Iran. This study aimed to investigate the presence of HPV DNA in the saliva of Iranian women with confirmed genital HPV infection and a history of oral-genital contact. METHODS: In this cross-sectional study, 111 women aged 15-65 with diagnosed genital HPV were recruited between 2021 and 2024. Saliva samples were collected and analyzed using polymerase chain reaction (PCR) to detect HPV DNA. Demographic and behavioral data were obtained using a questionnaire. The association between salivary HPV presence and sexual practices, HPV genotype, and clinical variables was statistically assessed. RESULTS: HPV DNA was detected in the saliva of 25 participants (22.1%). High-risk genotypes, particularly HPV-16, were significantly more prevalent among those with concurrent oral and genital infections (p=.03). No statistically significant association was found between salivary HPV and smoking, alcohol use, or contraceptive method. Oral examinations in HPV-positive patients revealed no premalignant lesions. CONCLUSIONS: These findings indicate a notable prevalence of oral HPV in women with genital HPV, particularly those with high-risk genotypes; however, the clinical significance of salivary HPV detection remains uncertain, and routine oral HPV screening cannot currently be recommended. Further multicenter studies are warranted.