The human papillomavirus (HPV) is best known as the main cause of cervical cancer. But HPV is also responsible for most cases of oropharyngeal cancers, which are increasing at an alarming rate, especially in people living with HIV. By altering the composition of the oral microbiome, HIV likely makes people more susceptible to oral HPV infections that persist and progress to oropharyngeal cancers.

Robert D. Burk, M.D., has received a five-year, $4.1 million grant from the National Institute of Dental & Craniofacial Research (part of the National Institutes of Health) to study the natural history of oral HPV in people living with HIV and to assess how oral bacteria (microbiome) and fungi (mycobiome) influence HPV persistence. He and his colleagues will analyze oral samples collected from more than 2000 men and women living with HIV and from more than 1,000 HIV-negative individuals, all of whom are enrolled in the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study (MWCCS)—the largest HIV cohort study in the United States. The researchers are interested in whether the oral microbiome and mycobiome change over time in response to factors including the cohort participants’ CD4 T-cell counts, levels of HIV RNA, and smoking. These studies should reveal the combined effects of HIV and smoking on the risk for persistent oral HPV infections as well as signaling pathways involving oral inflammation and the immune response that may enable oral HPV to persist. The findings may reveal strategies for reduce the risks for HPV-associated oral and oropharyngeal cancers in people living with HIV.

Dr. Burk is professor of pediatrics, of microbiology & immunology, of obstetrics & gynecology and women’s health, and of epidemiology & population health at Einstein, and an attending physician at Montefiore. (1R01DE032242-01)