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Rates of oropharyngeal cancer associated with human papillomavirus (HPV) infection are increasing in men, and Dr. Brittney Dickey wants to know why.

Dickey, an applied research scientist at Moffitt Cancer Center, is part of a team researching why some men present with an oral HPV infection that clears on its own when others do not. She presented her team’s work at the American Association for Cancer Research Annual Meeting. She discussed how persistent infections of HPV lead to oropharyngeal cancer when a person’s immune system is unable to suppress it.

“The pilot study we conducted looked at whether co-infection with another common virus that occurs in the oral cavity called Epstein Barr Virus may help us determine which HPV infections will become persistent,” she said.

Dickey explained that Epstein Barr Virus is an infection most people have been exposed to but are able to control with their immune system. In fact, this virus is often acquired during childhood, and most who have had Epstein Barr Virus don’t show symptoms.

“It is known that when someone has a reduced immune response, an Epstein Barr Virus infection can more frequently become active, and we can find EBV DNA shedding from cells in the oral cavity when this happens,” Dickey said.

But why some men in the study had better immune responses than others is still unclear. Dickey said that everyone’s immune system works a little differently and some are better at fighting infections than others.

It is our hope that identification of someone who cannot control an EBV infection may also provide some clues as to whether they are at risk of a persistent oral HPV infection.
Dr. Brittney Dickey, Cancer Epidemiology Program

“It is our hope that identification of someone who cannot control an EBV infection may also provide some clues as to whether they are at risk of a persistent oral HPV infection,” she said. “We are currently conducting larger studies to expand on the results of our pilot study.”

So other than immune system response, are there other factors at play with persistent oral HPV infections? Dickey says sexual behaviors, regardless of sexual orientation, are an important risk factor for acquiring an oral HPV infection.

“This data has taught us that there may be potential for presence of an active oral EBV infection to be related to whether or not someone’s oral HPV infection persists,” she said

She added, however, that since this is a pilot study, more work needs to be done with a larger group of participants to understand the association better.