Correlation of addictive factors, human papilloma virus infection and histopathology of oral submucous fibrosis Ravi Mehrotra 1 , Ajay Kumar Chaudhary 2 , Shruti Pandya 1 , Sharmistha Debnath 1 , Mangal Singh 3 , Mamta Singh 1 1 Department of Pathology, Moti Lal Nehru Medical College, Allahabad; 2 Centre for Biotechnology, University of Allahabad, Allahabad; 3 Otorhinolayngology, Moti Lal Nehru Medical College, Allahabad, India BACKGROUND: Oral submucous fibrosis (OSMF) is a widely prevalent, potentially malignant disorder of the oral cavity in the Indian subcontinent. Areca nut has been incriminated as the main causative factor. However, other factors, including viruses may also play a role in the initiation ⁄ development of these lesions. This study was designed to assess the correlation of addictive factors, human papilloma virus infection and histopathology of OSMF. METHODS: One hundred and thirteen cases of OSMF were studied. Demographic information of each patient, including the patient’s age, sex, addiction habits and his- topathological grading was obtained. Presence of high- risk human papilloma virus (HR-HPV) DNA was detected using the Hybrid Capture II assay. RESULTS: Of 105 cases finally included in the study, 33 (31.4%) patients were found to be positive for HR-HPV, while 72 (68.6%) were negative. A total of 52 ⁄ 105 (49.5%) patients chewed areca nut, of whom 18 (34.6%) patients were found to be positive and 34 (63.5%) were negative (P = 0.08). A total of 18 ⁄ 105 (17.1%) patients were ad- dicted to smoking, of whom five (27.7%) were positive (0.69). Only one (11.1%) patient, who was only habituated to alcohol, was positive (1.08). Of the 105 patients 26 (24.7%) chewed as well as smoked tobacco, of whom, nine (34.6%) were positive and 17(65.3%) were negative (P = 0.67). Thus, there was no significant association be- tween the various addiction habits and the presence of HR-HPV. On correlating the various histopathological grades of the disease with HR-HPV positivity a Pearson correlation of 0.053 was obtained (P = 0.588). Thus, again no significant correlation was observed between the dif- ferent histopathological grades and HR-HPV positivity. CONCLUSION: In conclusion, it was found that there is neither significant correlation between HR-HPV infection and the various addiction habits nor with the different histopathological grades of the disease. To the best of our knowledge, a study of these different factors has never been attempted before in patients with OSMF. J Oral Pathol Med (2010) 39: 460–464 Keywords: habits; histopathology; HR-HPV; oral submucous fibrosis Introduction Oral submucous fibrosis (OSMF) is a potentially malig- nant disorder of the oral cavity – producing changes similar to those of scleroderma. It presents as a whitish-yellow discoloration involving the buccal mucosa, the orophar- ynx and rarely the larynx. It has a chronic, insidious biological course (1). Over the years, the incidence of OSMF has increased manifold in India – especially among the younger generation (2). Areca nut is the main causative factor. Commercially freeze-dried products such as paan masala, dohra, gutka and mava have a high concentration of areca nut and appear to cause OSMF (3). Other factors, including viruses, especially human papilloma virus (HPV), may also play a role in the initiation or development of these lesions. Human papilloma virus belongs to the family Papil- lomaviridae, has a small, non-enveloped DNA and can induce hyperplasia, papillomatosis and verrucous lesions in the stratified squamous epithelium of the skin and mucosa (4). Over 100 different types of HPV have been reported in humans. Some of them, like HPV subtypes 16, 18, 33 and 58 play an important role in the development of various kinds of tumors such as cervical, anogenital and head neck carcinoma (5). High-risk HPV has also been detected in normal oral mucosa (6). At present, there is a paucity of information on the potential role of HPV in potentially malignant oral lesions. As OSMF is a common health problem in this part of India (7), this study was designed to assess the prevalence of high-risk HPV and investigate its possible role in the etiology and development of this disease as well as to correlate the presence of HPV with addictive habits and histopathological grading of the disease. Material and methods One hundred and thirteen patients and 83 age and sex-matched controls from the Department of Otorhino- laryngology, Moti Lal Nehru Medical College, Correspondence: Dr Ravi Mehrotra, Department of Pathology, M.L.N Medical College, Allahabad, India. Tel: +91 532 2256 472, Fax: +91 532 2256 507, E-mail: rm8509@gmail.com Accepted for publication September 1, 2009 J Oral Pathol Med (2010) 39: 460–464 ª 2010 The Authors. Journal compilation ª 2010 John Wiley & Sons A/S Æ All rights reserved interscience.wiley.com/journal/jop doi: 10.1111/j.1600-0714.2009.00849.x