Secretory IgA contributes towards the protection of mucosal surfaces against invading microorganisms. Objectives: Quantify secretory IgA titers in the saliva of women with HPV in the oropharynx and/or in the genital area. Subjects and methods: Seventy women with clinical genital HPV lesions and 70 women without HPV infection were tested for oral HPV DNA and the levels of total IgA in their saliva. One millilitre of saliva was collected, centrifuged and stored at -80 degrees C for the measurement of secretory IgA by nephelometry technique. A pool of oral pharyngeal cells was collected for HPV identification by polymerase chain reaction. Results: Oral HPV PCR was positive in 29 (21%) women (26 women with genital HPV and only 3 women without genital HPV). Titers of secretory IgA were extremely lower in-patients with HPV DNA in the oropharynx when compared to HPV negative women (P < 0.0001). Genital HPV and smoking were also associated to low levels of total sIgA in saliva (p < 0.01). After multivariable analyses only the presence of HPV in the oral cavity and/or in genital area, but not smoking, was related to low levels of total secreton IgA. Conclusion: Women with low levels of total secretory IgA could be more susceptible to having their oral mucosa colonized by HPV. (c) 2005 Elsevier Ireland Ltd. All rights reserved.1242227231