Folate food intake and red blood cell folate concentrations in women from Recife, Northeast of Brazil

Folate food intake and red blood cell folate concentrations were assess in women from Recife, Northeast Brazil. Following a two stages sampling procedure, a cross-sectional study was carried out involving 360 women, between 15-45 y, attending in nine health care public unit in 2007-2008. Folate intake was evaluated by a Quantitative Food Frequency Questionnaire, and compared with the values of the dietary reference intakes-DRI's. Folate status was evaluated by red blood cell folate concentrations. Geometric mean of folate intake was 627.1 [IC 95% 600.4-655.0] microg/day. The frequency of women at risk for folate intake below the recommendation was 16.0% for adolescents (<330 microg/day) and 6.3% for young adult (<320 microg/ day). The prevalence of women whose consumption exceeds the maximum tolerable intake was 48.0% (> 800 microg/day) and 13.7% (> 1000 microg/day) for adolescents and adults, respectively. The mean of red blood cell folate concentrations was 1797.8 +/- 357.1 nmol/L. Folate rich-food intake did not show any correlation with red blood cell folate concentrations (r = 0.058 and p = 0.274). Higher red blood cell folate concentrations were observed in adult young women (p = 0.004) and among those with income up to two minimum wages (p = 0.042). Folate rich-food intake as well as red blood cell folate concentrations among women from Recife were above the international recommendations.     

Prevalence of anemia during pregnancy: results of Valencia (Venezuela) anemia during pregnancy study

To determine the prevalence of anemia during pregnancy in Venezuelan pregnant women. By using a cross-sectional study, 630 Venezuelan pregnant women in their third trimester at labor from the Valencia Anemia during Pregnancy Study were studied. Anemia during pregnancy was defined according to WHO guidelines (Hb < 11 g/dl), iron deficiency was considered when serum ferritin level was < 12 ng/ml, and when serum folate level was < 3 ng/ml, it was considered as folate deficiency. 630 pregnant women (mean [+/- SD] age, 24 +/- 6.4 years) having an average of Hb 11.38 +/- 1.47 g/dl [95%CI = 11.27 to 11.50] were studied. No patient had hemolytic anemia nor clinical infections. Almost all patients were from low or very low socioeconomic status. Prevalence of anemia was 34.44% (severe: 1.8%, moderate: 15.2%, and mild: 83%). Iron deficiency anemia (IDA) was present in 39.2% (95%CI = 32.7 to 45.7), prevalence of folate deficiency anemia (FDA) was 11.98% (95%CI = 7.6% to 16.3%). Combined anemia (IDA and FDA) occurred in 11.52% (95%CI = 7.27% to 15.7%). Multivariate analysis showed that multiparous (odds ratio -OR-: 1.95, 95%CI = 1.28 to 2.97, p = .002) and supplement use of iron (OR: .55 (95%CI = .33 to .91, p = .02) are associated with IDA. The factors associated with FDA were: supplement use of folic acid (OR: .37 (95%CI = .19 to .71, p = .003) and appropriate prenatal control (OR: .51 95%CI = .27 to .96, p = .04). Prevalence of anemia during pregnancy was found to be high. Educational efforts should be stressed in order to encourage improvements in the prenatal care visits.     

Body iron reserves of rural and urban Guatemalan women of reproductive age

Body iron reserves (using serum ferritin as an index), hematological status, and other indicators of iron nutrition were evaluated in three groups of non-pregnant nulliparous women with ages comprised between 14 and 29 years (mean = 19 years). The first group (n = 33) included residents of the rural coastal area (less than 750 m above sea level) (group RCG); the second (n = 32) from the rural highlands (751-1,500 m) (group RHG); and the third group (n = 104) from urban Guatemala City (1,500 m) (group UG). The women in the UG group belonged to the middle or high socioeconomic stratum. Median values in serum ferritin levels (ng/ml) for each group were: RCG = 11.5 (undetectable 50.6); RHG = 17.2 (1.9-83.1) and UG = 20.2 (3.9-56.7). The difference between RCG and UG was statistically significant (P less than 0.05). The percentage of women with serum ferritin levels less than or equal to 9 ng/ml (iron deficiency) was 45 in the RCG, 25 in the RHG and 12 in the UG group. In addition, the prevalence of subnormal hemoglobin levels (below mean - 1 SD) was 46% in the RCG, 12% in the RHG and 8% in the UG. There were no cases of subnormal blood folate levels. As results indicate, the women studied had low iron reserves, the rural coastal group being the most affected. They also evidenced the high prevalence of iron deficiency in the region and the need for public health actions to overcome this nutrition problem.     

Requirements of nutrients which participate in erythropoiesis

Proteins, some minerals and vitamins, play important roles in erythropoiesis and the survival of the red blood cell. This article deals specifically with the physiological requirements and recommended intakes of iron, folate and vitamin B12. A comparison of the physiologic iron requirements according to age and sex, and the amount of iron which is actually absorbed from the diets consumed by the lower socioeconomic strata of the Venezuelan population; indicates that these diets do not satisfy the requirements at all ages. Such disparity is most marked in children below three years of age, in adolescents and in women during their reproductive age. Failure to do so leads to varying degrees of iron deficiency. This low bioavailability of the Venezuelan diet is also observed in other Latin American diets consumed by the same low socioeconomic strata, which explains the high prevalence of iron-deficiency anemia in the vulnerable groups. The low intake of fruits and vegetables by the lower socioeconomic strata of the Latin American population prevents these sectors from consuming an adequate intake of folate, failing to fulfill the daily recommended intake (3.3 - 3.6 micrograms/kg body weight). This situation is aggravated in pregnant and lactating women who require an additional intake of 300 micrograms and 100 micrograms, respectively. Prevalence of folate deficiency in the first stage may be in the order of 30% in some regions. In the second stage of deficiency, characterized by megaloblastic changes in the bone marrow and an erythrocyte folate concentration of less than 50 micrograms/lt, it could be as high as 40% in pregnant women. Nutritional vitamin B12 deficiency does not constitute a health problem in Latin America. Various surveys in the lower socioeconomic strata have reported normal or higher than normal serum B12 concentrations, compared to well-nourished populations.     

Prematurity and maternal folate deficiency: anemia during pregnancy study group results in Valencia, Venezuela

The purpose of this study was to determine the association and its magnitude between prematurity and folate deficiency in women in their third trimester of pregnancy, and at labor. An incident case-control study was conducted using 2 controls per case. Data was obtained in a tertiary hospital in Valencia, Venezuela. A total of 543 women who delivered between May and December 1996 entered into the study. Women having a preterm delivery (< 37 weeks of gestation at delivery) were defined as cases (n = 181). Anemia was defined according to WHO as Hb less than 11 g/dL, when a pregnant woman had a folate serum level < 3 microg/ml was considered a folate deficiency. Logistic regression was used to analyze the data and likelihood ratio test was done for model comparison. Folate deficiency was found to be significantly associated with prematurity (Odds Ratio: 1.97; 95%CI = 1.06 to 3.68 P = .032), after adjusting for prior preterm labor, prenatal care visits, prior abortion, prior fetal death, placental abruption, and premature rupture oval membranes. In conclusion, maternal folate deficiency at the end of the third trimester of pregnancy, at labor, was associated with an increased risk of prematurity.     

Nutritional anemia in nursing women in Costa Rica

It is reported the prevalence, magnitude and determinant factors of nutritional anaemia in a sample of nursing women (NW), collected during the National Nutrition Survey, of Costa Rica done in 1996. Nutritional anaemia was determinate through measurements of haemoglobin, and plasma ferritin, folates, cianocobalamin and retinol. Methodologies used were cianometahaemoglobin, solid phase immunoradiometric assay, solid phase radioimmunoassay and high-pressure liquid chromatography. WHO cut-off points were used. Anaemia was present in 22.1% of the women. Iron and folate deficiency were found in 48.7 and 84.2% NW, respectively. The magnitude of anaemia was mild and iron and folate deficiencies were severe. Vitamin B12 and A deficiencies were 5.3 and 4.9%, respectively and did not represent a public health problem in this group. Prevalent deficiency was mixed (iron and folates, 46.6%) followed by exclusive folates deficiency (32%). Anaemia was caused by a combined deficiency of iron and folates (61.1%) and most iron deficiencies were accompanied by folates (92%). The logistic regression analysis demonstrated that low socio-economic level of NW and their families was the principal factor determining the appearance of nutritional anaemia, and educative interventions to the mother are possibly recommended. In conclusion anaemia in NW is a moderate health problem of nutritional type, that is more important when severe folates and iron deficiencies are present in Costa Rica. These problems have remained constant throughout the last three decades; although recently, possibly an improvement has occurred because the prevalence of neural tube defects in the infant population has reduced, maybe due to food iron and folates fortification public health policies implementation.     

Prevalence of nutritional deficiencies in Mexican adolescent women with early and late prenatal care

The objective was to evaluate the prevalence of specific nutritional deficiencies in a group of pregnant adolescents according to the gestational age when they started to receive prenatal care. A group of 163 pregnant adolescents that attended the Instituto Nacional de Perinatología (Mexico City) for the first time to receive prenatal care was evaluated. An anthropometrical evaluation was performed and a blood sample taken to determine hemoglobin, ferritin, erythrocyte folate and plasma zinc to all cases. The mean age was 15 years (11 to 17 years). The mean gestational age when starting prenatal care was 27 +/- 7 gestation weeks and most of them tended to have low weight (97 +/- 12% expected weight for height and gestational age). Eight of every ten adolescents had anemia and iron deficiency. Late prenatal care (> or = 25 weeks) was associated with the risk of presenting anemia OR 5.11 (CI 95% 2.4-10.7) iron deficiency (OR 3.5; CI 95% 1.7 to 7.1) and zinc deficiency (OR 2.9; CI 95% 1.1 a 7.6). In relation to folate deficiency, the opposite effect was observed (OR 0.10; CI 95% 0.02 a 0.48). Lack of opportune prenatal care was associated with the presence of iron and zinc depletion. Probably iron deficiency contributes to an erythrocyte folate accumulation.     

MTHFR Knockdown Assists Cell Defense against Folate Depletion Induced Chromosome Segregation and Uracil Misincorporation in DNA

Folate depletion causes chromosomal instability by increasing DNA strand breakage, uracil misincorporation, and defective repair. Folate mediated one-carbon metabolism has been suggested to play a key role in the carcinogenesis and progression of hepatocellular carcinoma (HCC) through influencing DNA integrity. Methylenetetrahydrofolate reductase (MTHFR) is the enzyme catalyzing the irreversible conversion of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate that can control folate cofactor distributions and modulate the partitioning of intracellular one-carbon moieties. The association between MTHFR polymorphisms and HCC risk is inconsistent and remains controversial in populational studies. We aimed to establish an in vitro cell model of liver origin to elucidate the interactions between MTHFR function, folate status, and chromosome stability. In the present study, we (1) examined MTHFR expression in HCC patients; (2) established cell models of liver origin with stabilized inhibition of MTHFR using small hairpin RNA delivered by a lentiviral vector, and (3) investigated the impacts of reduced MTHFR and folate status on cell cycle, methyl group homeostasis, nucleotide biosynthesis, and DNA stability, all of which are pathways involved in DNA integrity and repair and are critical in human tumorigenesis. By analyzing the TCGA/GTEx datasets available within GEPIA2, we discovered that HCC cancer patients with higher MTHFR had a worse survival rate. The shRNA of MTHFR (shMTHFR) resulted in decreased MTHFR gene expression, MTHFR protein, and enzymatic activity in human hepatoma cell HepG2. shMTHFR tended to decrease intracellular S-adenosylmethionine (SAM) contents but folate depletion similarly decreased SAM in wildtype (WT), negative control (Neg), and shMTHFR cells, indicating that in cells of liver origin, shMTHFR does not exacerbate the methyl group supply in folate depletion. shMTHFR caused cell accumulations in the G2/M, and cell population in the G2/M was inversely correlated with MTHFR gene level (r = −0.81, p < 0.0001), MTHFR protein expression (r = −0.8; p = 0.01), and MTHFR enzyme activity (r = −0.842; p = 0.005). Folate depletion resulted in G2/M cell cycle arrest in WT and Neg but not in shMTHFR cells, indicating that shMTHFR does not exacerbate folate depletion-induced G2/M cell cycle arrest. In addition, shMTHFR promoted the expression and translocation of nuclei thymidine synthetic enzyme complex SHMT1/DHFR/TYMS and assisted folate-dependent de novo nucleotide biosynthesis under folate restriction. Finally, shMTHFR promoted nuclear MLH1/p53 expression under folate deficiency and further reduced micronuclei formation and DNA uracil misincorporation under folate deficiency. In conclusion, shMTHFR in HepG2 induces cell cycle arrest in G2/M that may promote nucleotide supply and assist cell defense against folate depletion-induced chromosome segregation and uracil misincorporation in the DNA. This study provided insight into the significant impact of MTHFR function on chromosome stability of hepatic tissues. Data from the present study may shed light on the potential regulatory mechanism by which MTHFR modulates the risk for hepatic malignancies.     

Prevalence of anemia, iron and folate deficiency in children 7 years smaller. Costa Rica, 1996

In 1996, were studied in Costa Rica 961 children with ages between one and six years, with representation for metropolitan, urban and rural zones of the country. The classification approaches applied were emitted by the Pan-American Health Organization and the World Health Organization. The preschooler population presented in the national environment a prevalence of anemia of 26.3% (children from 1 to 4 years with hemoglobin < 11.0 g/dL and those from 5 to 6 years old with hemoglobin < 12.0 g/dL). The prevalence of Iron depletion (Ferritin < 12 ng/mL) and iron deficiency (Ferritin < 24 ng/mL) were 24.4% and 53.8%, respectively. The folate deficiency (< 6.0 ng/mL) was 11.4%. The iron deficiency was higher in children smaller than 4 years, being the maximum deficiency in the 1 year-old (75%). More than 40% of the preschool children presented sub-clinical deficiency of iron; of them, 10% showed severe deficiency of iron without presence of anemia. The children from the rural area presented the highest prevalence of anemia and iron depletion, while the metropolitan area met more frequency with iron deficiency. The nutritional anemias still constitute a moderate problem of public health in Costa Rica. The main cause is iron deficiency, associated in small proportion with folate deficiency and other factors associated with the erythropoiesis.     

Factors associated with nutritional supplement consumption in Mexican women aged 12 to 49 years

The objectives of this analysis are to identify the types of nutritional supplements (NS) commonly used and explore the associations between NS consumption and socio-demographic characteristics, nutritional status, measured as BMI, and anemia in a nationally representative sample Mexican women aged 12 to 49 years (n = 15,936) who participated in the Mexican National Nutrition Survey in 1999. Data on NS consumption and the other characteristics of interest were collected. We calculated the probability (P) of supplement consumption using logistic regression. For the statistical analysis characteristics at the individual and household level were included in the statistical models, and adjusted for the study design. Interaction effects were also explored. Multiple mixed vitamin and mineral supplements were the most commonly consumed (36.7%) followed by vitamins only (34.3%). Married women were significantly (p < 0.05) more likely (P = 0.16; p < 0.001) to consume NS compared to unmarried women, as were those with more access to public and private health care (P = 0.18; p = 0.010), with higher education level (P = 0.20; p = 0.004) and living in the South region (P = 0.20; p = 0.003). Anemia modified the association between supplement consumption and socioeconomic status (SES) (p = 0.016), non anemic women having greater probabilities of NS consumption. These results suggest that NS use among Mexican women is associated with better living conditions. On the other hand, we also found that women living in the South region, the poorest region of the country, had higher probability of NS consumption compared to the North region. This could be related to participation in food assistance programs; however we were unable to explore this potential explanation. This information will be used to further study trends, risks and health benefits in this population of the use of nutritional supplements.     

Prevalence of nutritional anemia in women of reproductive age. Costa Rica. National nutrition survey, 1996

In 1996, The Ministry of Health and Inciensa conducted the latest National Nutrition Survey, to provide support and guidance to the national policies, plans and programs in the field of food and nutrition. The present paper reports the results for the prevalence of anemia estimated in a total of 884 women of reproductive age, in three areas: metropolitan area, other urban areas and rural areas. Anemia was determined through measurements of hemoglobin, plasma ferritin and plasma folates. In addition, hemoglobin patterns were determined by electrophoresis. The cutt-off points used were those recommended by the WHO. Anemia was present in 18.6% of the women. Severe to moderate deficiency of iron (< 12 ng/dl) and of folates (< 6 ng/dl) were found in 43.2 and 24.7% of women respectively, with statistically significant differences by area of residence. The magnitude of the problem for anemia can be classified as mild, for iron deficiency as severe, and for folate deficiency as moderate. In conclusion, Anemia represents a public health problem for Costa Rica that has remained constant throughout the last decade. In women of reproductive age, iron deficiency is the main cause of Anemia, followed by folates deficiency, and in a small percentage hemoglobinopathies. Intestinal parasites are not longer a mayor cause of Anemia. Prevalence of Anemia is influenced by place of residence, but not by age. In summary, despite the favorable health conditions present in Costa Rica, the prevalence of Anemia and of iron deficiency are similar to those of the Latin-American region. To improve this situation, public health interventions are necessary.     

Plasma folate levels are associated with the lipoprotein profile: a retrospective database analysis

Background

Several studies demonstrated an association of homocysteine plasma levels and the plasma lipoprotein profile. This cross-sectional pilot study aimed at analyzing whether blood levels of the two important cofactors of homocysteine metabolism, folate and vitamin B12, coincide with the lipoprotein profile.

Methods

In a retrospective single center approach, we analyzed the laboratory database (2003-2006) of the University Hospital Bonn, Germany, including 1743 individuals, in whom vitamin B12, folate and at least one lipoprotein parameter had been determined by linear multilogistic regression.

Results

Higher folate serum levels were associated with lower serum levels of low density lipoprotein cholesterol (LDL-C; Beta = -0.164; p < 0.001), higher levels of high density lipoprotein cholesterol (HDL-C; Beta = 0.094; p = 0.021 for trend) and a lower LDL-C-C/HDL-C-ratio (Beta = -0.210; p < 0.001). Using ANOVA, we additionally compared the individuals of the highest with those of the lowest quartile of folate. Individuals of the highest folate quartile had higher levels of HDL-C (1.42 ± 0.44 mmol/l vs. 1.26 ± 0.47 mmol/l; p = 0.005), lower levels of LDL-C (3.21 ± 1.04 mmol/l vs. 3.67 ± 1.10 mmol/l; p = 0.001) and a lower LDL-C/HDL-C- ratio (2.47 ± 1.18 vs. 3.77 ± 5.29; p = 0.002). Vitamin B12 was not associated with the lipoprotein profile.

Conclusion

In our study sample, high folate levels were associated with a favorable lipoprotein profile. A reconfirmation of these results in a different study population with a well defined status of health, diet and medication is warranted.     

Folate-encoded and Fe3O4-loaded polymeric micelles for dual targeting of cancer cells

Diblock copolymers of poly(ethylene glycol) (PEG) and poly(?-caprolactone) (PCL) bearing a tumor-targeting ligand, folate, were self-assembled into micelles. Superparamagnetic iron oxide (SPIO) nanoparticles and an anticancer drug doxorubicin (DOX) were coencapsulated within the micelles less than 100 nm in diameters. These SPIO-DOX-loaded micelles were superparamagnetic at room temperature, but turned ferrimagnetic at 10 K, consistent with magnetic properties of primary SPIO nanoparticles. Cell culture experiments demonstrated the potential of these polymeric micelles as an effective dual targeting nanoplatform for the delivery of anticancer drugs. Folate attachment to micelles resulted in the recognition of the micelles by tumor cells over-expressing folate receptors, leading to facilitation in cellular uptake of micelles, and the transport efficiency of the SPIO-loaded and folate-functionalized micelles into the tumor cells can be further enhanced by applying an external magnetic field to the cells.     

Vitamin B12 and folate in non-institutionalized urban older people

Vitamin B12 and folate deficiencies are the main nutritional determinants of hyperhomocysteinemia, which is an independent risk factor for cardiovascular diseases. There is scarce information about nutritional status on vitamin B12 and serum levels of folate in Mexican older people. The objective was to evaluate the nutritional status of vitamin B12 and folic acid concentration in non-institutionalized, urban elderly men and women subjects. One hundred volunteers over 60 years were included in this cross-sectional study. Serum levels of vitamin B12 and folate were measured. In addition some biochemical and anthropometric indicators were also evaluated. Considering serum values of vitamin, 30% had vitamin B12 deficiency, 52% normal status and 18% with high levels. None subjects had folic acid deficiency, by the contrary, a high proportion (62%) showed elevated levels in serum. There was an effect of sex on vitamin B12 status. Elderly men showed significantly lower levels of vitamin B12, and it was according with significant higher prevalence of vitamin B12 deficiency in this group as compared with the women group. The high proportion of vitamin B12 deficiency found in this study underline a possible public health problem and guarantee further survey-studies about vitamin B12 status and to explore causes and consequences of the deficiency. Finally, due the sample size and the design of the study, the results must be seen with caution and not try to generalize.     

Helicobacter pylori infection (13C-UBT), and its relationship with nutritional and socioeconomic factors in low income school children from Valencia, Venezuela

Helicobacter pylori infection (Hp) is widely spread around the world, and it is considered one of the main causes of chronic gastritis, peptic and duodenal ulcers, and gastric cancer. Recent research has shown that it can be associated with nutritional disorders, mainly with iron and other micronutrient deficiencies. The objective of this study was to assess the prevalence of Hp infection, and infection pattern according to age, sex, nutritional status, and socioeconomic conditions in children who attended the Unidad Educativa "Valentin Espinal" in the city of Valencia. 170 children, between 3 and 14 years of age were studied to assess Hpylori infection (13C-urea breath test), age, nutritional status according to BMI and Height for age, hemoglobin (cianometahemoglobin), serum ferritin (ELISA), socioeconomic status (Graffar-Méndez-Castellano), housing conditions, number of families and of people cohabitating in the same household, and quality of services. 78.8% of the children were infected with Hp, witch was significantly correlated with age but not gender. 25.9% of the sample had undernutrition, and 46.5% were stunted. 98.1% of the families lived in poverty, and 98% of the households showed sanitary deficiencies. A mean of 6.0 +/- 2.4 persons lived in each household (range: 2-15), and an average of 3.2 person shared bedrooms. The odds of being infected were higher in those children who were stunted. Also, socioeconomic status, mother's education level, and poor hosing conditions were significantly associated to being infected. Hpylori is highly prevalent among socially and economically deprived children, and age, overcrowding, and a low education level of the mother increases the risk of being infected.     

The nutritional and health status of the Latin American woman

Latin America is a region where countries have various levels of socioeconomic development. Thus, the living standards and health status of its people differ significantly in the midst of a mosaic of social, ethnic, cultural and economic realities. Social inequalities and extreme poverty determine significant differences, not only in the magnitude of health indicators, but also in the type of pathology prevalent. People in the high socioeconomic levels are affected by nutritional diseases characterized by excessive food intake, while people from the low socioeconomic levels are affected by undernutrition and its associated pathology. Undernutrition occurs fundamentally among the age groups at higher risk in the population segments with low income, low food intake, illiteracy and poor access to the health care and preventive medicine centers. Among families exposed to undernutrition, women are usually in worse condition than men. This is due to the long working hours and the increased nutritional requirements caused by frequent gestations and prolonged lactation. It is estimated that one fourth of newborns in Latin America are affected by low birth weight, which has been associated to adolescent mothers, their excessive physical work, anemia, low maternal pregestational weight, low weight gain during gestation, and frequent maternal infections. Nutritional anemia due to iron deficiency is highly prevalent among pregnant women in Latin America. In some countries, the prevalence of folate deficiency during pregnancy appears to have increased significantly in the past 15 years and is becoming a nutritional problem that needs preferential attention. Diets generally are inadequate and, in the case of pregnant and lactating women, usually deficient in calories, protein, iron and folic acid. It is urgent that the health and nutritional status of Latin American women of low socioeconomic condition be given special attention, particularly mothers during gestation and lactation. Otherwise, women will not be able to altogether fulfill their important role in the home and within the family, nor will they successfully participate in the economic development of their countries.     

Oral HPV Infection and Sexuality: A Cross-Sectional Study in Women

Human Papillomavirus (HPV) is the main risk factor for cervical cancers and is associated with close to 36% of oropharyngeal cancers. There is increasing evidence that oral HPV transmission is related to sexual behavior but to our knowledge studies that involve women who have sex with women have not been performed. We examined the prevalence of oral HPV according to sexual behavior among a population-based sample of 118 women and have made some inferences of possible predictors of oral HPV infection. Women were categorized as heterosexual (history of vaginal sex and/or oral sex with males only, n = 75), bisexual (history of vaginal sex and oral sex with females, n = 32) and other (no history of vaginal sex but oral sex with females [homosexuals], virgins and women with incomplete sexual exposure data, n = 11) The prevalence of oral HPV infection was 12/118 (10.2%) for the overall study population and was not significantly different between heterosexual and bisexual women (10.7% (8/75) vs. 12.5% (4/32), p = 0.784). There was no oral HPV detected among homosexual women, virgins or among women where sexual exposure was unknown. Never smokers were more likely to be oral HPV+ compared to former smokers (Adjusted Odds Ratio (Adj OR) = 0.1, 95% CI, 0.0-1.1) and there was no difference in risk between never smokers and current smokers (Adj OR = 0.7, 95% CI, 0.1-4.6). Twenty-five percent (3/12) of oral HPV+ women had a history of HPV and/or genital warts compared to 9% (10/106) of oral HPV-women (p = 0.104). For the women with a history of vaginal sex (n = 110), oral HPV status was statistically significantly different according to oral sex exposure (p = 0.039). A higher proportion of oral HPV-positive women reported that they had no history of oral sex exposure compared to oral HPV-negative women (4/12, 33% vs. 7/98, 8%). The prevalence of cervical HPV infection did not vary between heterosexuals and bisexuals (35.7% (25/70) vs. 35.5% (11/31), p-value 0.411) and for all other women the cervical HPV prevalence was significantly lower (11.1%, 1/9). Our study suggests that smoking and sexual behavior involving males rather than female partners may be possible predictors of oral HPV infection in women. Further studies with larger sample size are needed to confirm these findings.