Journal of Clinical Virology 43 (2008) 250–252 Contents lists available at ScienceDirect Journal of Clinical Virology journal homepage: www.elsevier.com/locate/jcv Short communication Human papillomavirus infection in Barrett’s oesophagus in the UK: An infrequent event N. Rai a , G.J.S. Jenkins b , E. McAdam b , S.J. Hibbitts a , A.N. Fiander a , N.G. Powell a,* a Department of Obstetrics and Gynaecology, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, United Kingdom b School of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom article info Article history: Received 26 March 2008 Received in revised form 26 June 2008 Accepted 2 July 2008 Keywords: HPV Barrett’s oesophagus Adenocarcinoma Squamous cell carcinoma abstract Background: Human papillomavirus (HPV) infection has been reported in squamous cell carcinomas of the oesophagus and has been recently described in Barrett’s oesophagus, a premalignant condition which may give rise to oesophageal adenocarcinoma. Objectives: To investigate HPV infection in Barrett’s oesophagus in a UK population. Study design: DNA was extracted from 73 Barrett’s oesophagus biopsies and examined for the presence of DNA for 14 high risk (HR) and 6 low risk (LR) HPV types. Results: HPV DNA was present in only 1 of 73 samples; genotyping indicated this was a high risk type 51 infection. Conclusions: HPV infection appears unlikely to be a significant factor in the aetiology of Barrett’s oesoph- agus in the UK. © 2008 Elsevier B.V. All rights reserved. 1. Introduction Infection with sexually transmitted human papillomavirus (HPV) is a cause of virtually all squamous cell carcinomas and adenocarcinomas of the cervix. 1 HPV DNA is also detected in the majority of cancers of the vagina and anus, and in signifi- cant numbers of vulval and penile tumours. 2 Among extragenital malignancies proposed to be associated with HPV infection, the data for head and neck cancers are most compelling. Case con- trol studies have now confirmed a strong association between HPV infection and oropharyngeal cancers 3 and the International Agency for Research on Cancer has concluded that HPV is likely to play a role in cancers of the oropharynx, tonsil, oral cavity and larynx. 4 Several studies have suggested that HPV may play a role in the aetiology of non-melanoma skin cancer 5 and conjunctival squa- mous cell carcinomas. 6 Isolated reports have linked HPV infection with prostate, breast, lung and bladder cancers (reviewed in Ref. 7). The role of HPV infection in oesophageal cancer is controver- sial. Such a role is biologically plausible; the oesophagus is lined with squamous epithelium that could be exposed to HPV in the same manner as the oral cavity and pharynx, but there is lim- Abbreviations: HPV, human papillomavirus; HR, high risk; LR, low risk. * Corresponding author. Tel.: +44 29 2074 4742; fax: +44 29 2074 4399. E-mail address: powellng@cf.ac.uk (N.G. Powell). ited data to support such a hypothesis. In a review of PCR based investigations, HPV infection was present in 308 of 2020 (15.2%) oesophageal carcinomas, but a strong geographical bias was noted, with HPV more frequent in carcinomas from China, South Africa and Japan than Europe and the USA. 8 HPV DNA has recently been detected in the premalignant condition, Barrett’s oesophagus in a Mexican population. Among 28 cases, 27 (96%) were positive for HPV DNA, compared with 15 of 17 oesophageal cancers (88%). 9 Barrett’s oesophagus is a condition affecting the lower oesophagus in which normal stratified squamous epithelium undergoes meta- plasia and is replaced by polarised columnar epithelium. 10 This process takes place in the context of chronic gastro–oesophageal reflux disease and is associated with a 0.5–1% annual conversion rate to oesophageal adenocarcinoma. 11,12 The incidence of Bar- rett’s oesophagus is around 23 per 100,000 person years and is increasing. 13 There are several parallels between Barrett’s oesopha- gus and HPV associated conditions, including increased expression of proliferation markers such as minichromosome maintenance proteins, 14,15 and the involvement of a transformation zone where squamous epithelia meets columnar epithelia (i.e. the oesophageal junction for Barrett’s oesophagus, the dentate line for anal carci- noma, and the transformation zone for cervical cancers). Given the biological plausibility of a role for HPV infection in the development of Barrett’s oesophagus, we have investigated this possibility in a UK cohort. DNA was extracted from biopsies taken from 73 patients with histologically confirmed disease and investigated for the presence of HPV DNA. 1386-6532/$ – see front matter © 2008 Elsevier B.V. All rights reserved. doi:10.1016/j.jcv.2008.07.004