Men and Women Offering Understanding of Throat HPV (MOUTH)
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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT03644563 |
Recruitment Status :
Active, not recruiting
First Posted : August 23, 2018
Last Update Posted : March 9, 2023
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Condition or disease |
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Oropharyngeal Cancer Human Papilloma Virus |
This study will provide one of the first estimates of long-term oral HPV natural history, and the effect of biologic and behavioral risk factors, including HIV, on this natural history. Phase 1 of the study will screen approximately 1500 people for oncogenic oral HPV biomarkers. Phase 2 of the study will follow only those subjects with oncogenic oral HPV infection and/or HPV serum oncogene antibodies from Phase 1 (and those previously identified as having oncogenic oral HPV infection in a previous study) with annual follow-up for oncogenic oral HPV persistence.
Understanding persistent oncogenic oral HPV infection is the focus of this study. Understanding which factors drive oral HPV infection to become persistent or progress to malignancy is critical to determine who is at high risk for oropharyngeal cancer and may benefit from screening and prevention. It is presumed that persistent oncogenic oral HPV infections are necessary for progression to HPV-OPC.
The study is led by Dr. Amber D'Souza and Dr Carole Fakhry (Johns Hopkins) and participants are being enrolled in Baltimore MD (Johns Hopkins) and in New York (Mt. Sinai).
Study Type : | Observational [Patient Registry] |
Estimated Enrollment : | 1500 participants |
Observational Model: | Cohort |
Time Perspective: | Prospective |
Target Follow-Up Duration: | 4 Years |
Official Title: | Impacting the Oral HPV Continuum: MOUTH Study (Men and Women Offering Understanding of Throat HPV) |
Actual Study Start Date : | April 3, 2017 |
Estimated Primary Completion Date : | April 2024 |
Estimated Study Completion Date : | June 2025 |
Group/Cohort |
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Follow-up
Those subjects with oncogenic oral HPV infection and/or HPV oncogene serum antibodies from screening.
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- Oncogenic oral HPV infection present or absent in oral rinse sample [ Time Frame: Baseline to end of four year follow-up and data abstraction/linkage. ]To explore the effects of biologic (microbiome, oral immune response, biologic sex) risk factors for oncogenic oral HPV persistence
- HPV16 E6 antibodies present or absent in serum sample [ Time Frame: Baseline to end of four year follow-up and data abstraction/linkage. ]To explore whether E6 and E7 seropositivity (to HPV16 or any oncogenic HPV) are markers for oncogenic oral HPV persistence among high-risk groups
Biospecimen Retention: Samples With DNA
Oral rinse sample: a sample of oral exfoliated cells will be collected using 10 mL of saline.Oral rinse samples will be tested for HPV DNA and/or RNA.
Saliva sample: Saliva sampling kits designed to preserve HPV (OraGene RNA kit from DNA Genotek) will be used to collect oral samples from all participants.
Urine sample: Urine will be tested for HPV DNA as a surrogate for genital HPV infection.
Blood collection: Each sample will be tested for HPV antibodies. Capsid antibodies will be measured using virus like particle-based ELISA assays. Antibodies to the E6 and E7 proteins will be measured in a glutathione capture ELISA assays.

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | Yes |
Sampling Method: | Non-Probability Sample |
Participants in the Phase 1 Screening
Inclusion criteria:
In order to be eligible to participate in this study, an individual must meet all of the following criteria:
- 18 and older (enrollment at most sites will be restricted to 30 and older since this demographic has the highest prevalence of infection; however, individuals and/or partners of someone with an HPV-related cancer, for example, are at increased risk so will be enrolled in the larger age range).
- Willing to be contacted to arrange follow-up visits, if determined to be eligible for phase 2
- Ability to understand and the willingness to sign a written informed consent document
In addition, individuals must meet at least one of the following criteria:
- Male, aged 30 and older, with 2 or more lifetime oral sex
- History of anal or genital dysplasia or cancer
- Partners of someone with an HPV-related cancer (HPV-positive OPC, anal cancer or genital cancer)
- Known oncogenic HPV-positive biomarker from prior studies or testing, regardless of number of partners.
Exclusion criteria:
An individual who meets any of the following criteria will be excluded from participation in this study:
- Presence of medical or psychiatric condition affecting ability to give voluntary, informed consent.
- Participants who do not speak English cannot enroll because the consent and study survey are only available in English. However, if there is a hearing, literacy or minor fluency issue and the participant requests assistance from a family member or the study coordinator, this individual may still enroll and receive this assistance to ensure they fully hear and understand everything being asked.
- History of head and neck cancer
Participants in the Phase 2 Follow-Up
Inclusion criteria:
- Oncogenic oral HPV infection and/or HPV serum oncogenic antibodies detected in phase 1
- Willingness to complete annual follow up visits
Exclusion criteria:
• Unable to complete annual follow up visits

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03644563
United States, Maryland | |
Johns Hopkins Hospital | |
Baltimore, Maryland, United States, 21205 |
Principal Investigator: | Amber D'Souza, PhD | Bloomberg Johns Hopkins School of Public Health |
Publications of Results:
Responsible Party: | Johns Hopkins Bloomberg School of Public Health |
ClinicalTrials.gov Identifier: | NCT03644563 |
Other Study ID Numbers: |
IRB00119537 R35DE026631 ( U.S. NIH Grant/Contract ) |
First Posted: | August 23, 2018 Key Record Dates |
Last Update Posted: | March 9, 2023 |
Last Verified: | March 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Oral HPV Persistent infection Oropharyngeal cancer (OPC) HPV antibody HPV Screening Study |
Papilloma Oropharyngeal Neoplasms Neoplasms, Squamous Cell Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Pharyngeal Neoplasms |
Otorhinolaryngologic Neoplasms Head and Neck Neoplasms Neoplasms by Site Pharyngeal Diseases Stomatognathic Diseases Otorhinolaryngologic Diseases |