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Background  Human papillomavirus (HPV) prevalence in head and neck squamous cell carcinomas (HNSCC) diverges geographically. The reliability of using p16 INK4a  expression as a marker of viral infection is controversial in HNSCC. We evaluated HPV types and HPV-16 variants prevalence, and p16 INK4a  expression in HNSCC specimens provided by two different Institutions in São Paulo.    Methods  HPV DNA from formalin-fixed specimens was accessed by Inno-LiPA, HPV-16 variants by PCR-sequencing, and p16 INK4a  protein levels by immunohistochemistry.    Results  Overall, HPV DNA was detected among 19.4 % of the specimens (36/186). Viral prevalence was higher in the oral cavity (25.0 %, 23/92) then in other anatomical sites (oropharynx 14,3 %, larynx 13.7 %) when samples from both Institutions were analyzed together. HPV prevalence was also higher in the oral cavity when samples from both Institutions were analyzed separately. HPV-16 was the most prevalent type identified in 69.5 % of the HPV positive smaples and specimens were assigned into Asian-American (57.2 %) or European (42.8 %) phylogenetic branches. High expression of p16 INK4a  was more common among HPV positive tumors.    Conclusion  Our results support a role for HPV-16 in a subset of HNSCC.

Prevalence of human papillomavirus types and variants and p16INK4a expression in head and neck squamous cells carcinomas in São Paulo, Brazil