Oral HPV infection may be linked to oral leukoplakia (OL), a potentially cancerous condition that appears as white patches or plaque inside the mouth. This study was recently published in the International Dental Journal.
However, additional research is needed to clarify the specific role that high-risk HPV plays in the development of OL, the authors wrote.
“Our systematic review and meta-analysis provide a comprehensive and up-to-date assessment of the association between HPV and OL, suggesting a significant association between HPV infection and an increased risk of developing OL,” wrote the authors, led by Joud Taha of the Ajman University College of Dentistry in the United Arab Emirates (Int Dent J, October 18, 2025, Vol. 76:6, 103944).
The review sought to assess how common HPV was in OL lesions compared to healthy controls. Researchers conducted a literature search using electronic databases to examine studies published up to March 2025. The meta-analysis focused on case-control observational studies that compared HPV prevalence in OL tissue samples and controls using HPV-specific markers, they wrote.
If studies reported associations between HPV and OL or other oral potentially malignant disorders (OPMDs), provided subgroup data on OL, or listed proportions of HPV-positive samples in OL and control groups, they were included in the analysis. In the end, 32 studies were included in the review.
From 1,236 cases and 2,916 controls, the pooled analysis showed a significant association between HPV detection and OL (odds ratio [OR] = 3.16; 95% confidence interval [CI], 2.06 to 4.95). Additionally, high-risk HPV showed an even stronger link with OL (OR = 5.42; 95% CI, 2.52 to 11.69) compared to low-risk HPV (OR = 1.9; 95% CI, 1.1 to 3.29), with moderate heterogeneity (I² = 68.6%), they wrote.
Subgroup analysis revealed a stronger association in European populations (OR = 3.42; 95% CI, 1.62 to 7.43) than in Asian populations (OR = 1.82; 95% CI, 1.02 to 3.24). Sensitivity analyses confirmed the stability of the results, even after excluding smaller studies (OR = 2.17; 95% CI, 1.46 to 3.23). When limited to studies using DNA sequence detection, findings remained consistent (OR = 3.45; 95% CI, 2.02 to 5.91).
Nevertheless, the study had limitations. Most studies used cross-sectional or case-control designs, which restricted the ability to draw causal conclusions, the authors added.
“These findings contribute to a more refined understanding of HPV's association with OL and lay the groundwork for future studies to further elucidate the role of HPV in OPMDs,” they concluded.
