# Comparing In Vitro Virucidal Efficacy of Commercially Available Mouthwashes Against Native High-Risk Human Papillomavirus Types 16 and 18

## TL;DR

This study tests how well common mouthwashes can kill high-risk HPV types 16 and 18 in the mouth, finding that hydrogen peroxide-based rinses are most effective.

## Contribution

The study is the first to evaluate the virucidal efficacy of over-the-counter mouthwashes against native HPV16 and HPV18 virions in vitro.

## Key findings

- Mouthwashes with hydrogen peroxide showed the best efficacy against HPV16 and HPV18.
- Essential oils/alcohol and cetylpyridinium chloride mouthwashes had lower efficacy, especially against HPV18.
- Prophylactic virucidal rinses could help reduce oral HPV infections and transmission.

## Abstract

The rising incidence of oropharyngeal cancer caused by high-risk Human Papillomavirus (HPV) type 16 and HPV18 in the U.S and other developed countries is an important public health issue. This has been attributed to changes in sexual behavior, including the practice of oral sex, which may expose individuals to increased risk of acquiring oral HPV infection. The incidence of oral HPV infections highlights the role of the oral cavity as an important anatomical site in the acquisition and transmission of high-risk HPVs. Generally, the use of mouthwash/oral rinses have focused on targeting the oral bacteriome, and could additionally be formulated for managing the oral virome. Here, we examined virucidal properties of common over-the-counter antibacterial mouthwash products against native HPV16 and HPV18 virion in vitro, and downstream modification of virus infectivity. We tested oral rinses containing essential oils/alcohol, hydrogen peroxide, and cetylpyridinium chloride. Our results demonstrated greater than 90% efficacy against HPV16 inactivation, but comparatively with less efficacy against HPV18. Overall, hydrogen peroxide containing oral rinses demonstrated the best efficacy against both high-risk types, albeit with lower efficacy against HPV18. Prophylactic virucidal oral rinses targeted towards high-risk HPVs could be beneficial in reducing incidental oral HPV load, prevalence, and persistent infections.