High-Risk-HPV-Infektionen im Kopf-Hals-Bereich – Welche Bedeutung hat das Sexualverhalten?

Der Anstieg an Nachweisraten HPV-positiver Oropharynxkarzinome in den letzten 20 Jahren wurde insbesondere mit einer erhöhten Zahl an Oralsexpartnern in Zusammenhang gebracht. In der Regel verläuft eine HPV-Infektion nur über einige Monate und ohne Symptome. Eine Viruspersistenz ist onkogen und wird durch Rauchen begünstigt, weshalb die Kombination von Rauchen und Oralsex mit ≥ 5 Partnern einen besonderen Risikofaktor darstellt.

Abstract

In the second half of the 20^th century, the sexual revolution went hand in hand with changes in common sexual practices. At the turn of the millennium, an increase in the detection rate of HPV-positive oropharyngeal carcinomas (OPC) in the USA was observed for the first time. An increase in the OPC was also observed in Europe. It was shown that this increase was due to HPV-positive OPC. However, the detection rate of the HPV-positive OPC has national and regional differences. Within Europe, the highest detection rate is in Northern Europe (56,5 %), followed by Central Europe (37,6 %). An association between patients with OPC and ≥ 6 sexual partners (OR = 1,25) and ≥ 4 oral sex partners (OR = 2,25) has been described. An HPV infection is usually asymptomatic and eliminated by the immune system within a few months. The persistence of the virus is oncogene. Smoking favors virus persistence, which is why the combination of smoking and oral sex with ≥ 5 partners is a particular risk factor. It was also examined whether partners from patients with cervical cancer have an increased oropharyngeal HPV infection rate. There was no definite declaration on this, but further investigations are required. Oral condoms or dental dams are suitable for the prevention of an oral HPV infection. The studies regarding the effectiveness of HPV vaccination for the prevention of an OPC are poor. Authors described a significantly lower detection rate of oral HPV infection in vaccinated people than in non-vaccinated people (0,11 % vs. 1,61 %; p = 0,008).

Schlüsselwörter

Oropharynxkarzinom - Rachenkrebs - HPV - Humanes Papillomavirus - Impfung

Key words

oropharyngeal carcinoma - oropharyngeal cancer - HPV - human papilloma virus - vaccination

Publication History

Article published online:
26 August 2020

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