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Persistence of Betapapillomavirus Infections as a Risk Factor for Actinic Keratoses, Precursor to Cutaneous Squamous Cell Carcinoma

¹ Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands; ² Cancer and Population Studies, QIMR, Brisbane, Australia; and ³ DDL Diagnostic Laboratory, Voorburg, The Netherlands

Requests for reprints: Mariet C.W. Feltkamp, Department of Medical Microbiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands. Phone: 31-71-5261652; Fax: 31-71-5266761; E-mail: M.C.W.Feltkamp{at}lumc.nl.

Human papillomaviruses from the β genus (βPV) are a possible cause of cutaneous squamous cell carcinoma (SCC). We assessed the extent to which βPV infections persisted long-term in a subtropical Australian community and whether βPV persistence is positively associated with actinic keratoses, precursor for SCC. Eyebrow hairs were collected from 171 participants of the community-based Nambour Skin Cancer Study in 1996 and 2003. Hair samples were tested for the presence of DNA from 25 different βPV types and assessed in relation to actinic keratosis presence in 2007. In 1996, a total of 413 βPV infections were found in 73% of participants, increasing to 490 infections among 85% in 2003. Of the total βPV infections detected, 211 (30%) were found to persist. Age was significantly associated with βPV persistence: those ages >60 years had 1.5-fold (95% confidence interval, 1.1-1.9) increased risk of type-specific viral persistence than those ages <40 years. After accounting for actinic keratoses at baseline, persistence of βPV DNA resulted in a 1.4-fold (95% confidence interval, 1.0-1.9) increase in risk of having actinic keratoses on the face in 2007. In conclusion, persistent βPV infections in this population were associated with an increased occurrence of actinic keratosis. Additional studies are needed to determine the possible association of βPV persistence with SCC. [Cancer Res 2009;69(23):OF1–6]

Key Words: betapapillomavirus • persistence • actinic keratoses • cutaneous squamous cell carcinoma