人乳头瘤病毒（HPV）感染是口咽癌的主要原因。然而，关于中国成年人口腔HPV感染的流行病学知识有限。我们收集了从中国大陆招募参与者的前瞻性队列的数据。2021年在中国典型地区（河北省和广东省）提供口腔拭子标本的参与者总共为9867人，年龄至少为20岁。采用巢式聚合酶链反应和测序检测口腔脱落细胞中的HPV DNA。对亚群体间的患病率进行了比较。采用多变量logistic回归模型评估可能影响口腔HPV感染的因素。口腔HPV感染的总患病率为3.0％（95％置信区间[CI]：2.68％-3.36％）。在感染者中，1.3％（1.08％-1.53％）感染高危HPV型。男性的HPV感染患病率经年龄标准化后较女性同行（3.6％，2.96％-4.29％）更高。河北地区的患病率（经年龄和性别标准化）较广东地区更高（4.1％，3.50％-4.70％对比2.2％，1.80％-2.56％）。总体上，男性（奥比斯比率[OR]和95％CI分别为1.42，1.09-1.85）和河北地区居民（2.01，1.53-2.65）患有任何类型的HPV感染的几率较高。此外，居住在城市地区的人高危HPV感染的几率是农村地区的2.15倍（1.43-3.26倍）。这项研究揭示了中国人群口腔HPV感染的低患病率以及显著的地理和性别差异。这是第一项报告中国成年人不同地理区域口腔HPV感染的流行病学特征的研究，样本规模较大。

Human papillomavirus (HPV) infection is a predominant cause of oropharyngeal squamous cell carcinoma. However, there is limited knowledge about the epidemiology of oral HPV infections among adults in China.We collected data from a prospective cohort that enrolled participants in mainland China. A total of 9867 participants aged at least 20 years provided oral swab specimens in typical areas of China (Hebei and Guangdong provinces) in 2021. HPV DNA in oral exfoliated cells was tested using Nested Polymerase Chain Reaction and sequencing. Prevalence among sub-populations was compared. Multivariable logistic regression models were employed to assess possible factors influencing oral HPV infection.The overall prevalence of oral HPV infection was 3.0% [95% confidence interval (CI):2.68%-3.36%]. Among those infected, 1.3% (1.08%-1.53%) were infected with high-risk HPV types. Men had a higher age-standardized HPV infection prevalence (3.6%, 2.96-4.29%) compared to their female counterparts (2.7%, 2.35-3.12%). People in Hebei had a higher age- and sex-standardized prevalence (4.1%, 3.50%-4.70%) than those in Guangdong (2.2%, 1.80%-2.56%). Generally, men (odds ratio [OR] and 95% CI: 1.42, 1.09-1.85) and people in Hebei (2.01, 1.53-2.65) had higher odds of any type of HPV infection. Additionally, people living in urban areas had a 2.15-fold (1.43-3.26) higher odds of high-risk HPV infection.This study reveals a low prevalence of oral HPV infection with significant geographic and sex differences among Chinese population.This is the first study to report the epidemiological characteristics of oral HPV infection among Chinese adults in diverse geographic areas with large sample size.