Clustering of Human Papillomavirus (HPV) Types in the Male Genital Tract: The HPV in Men (HIM) Study

Vaccarella, Salvatore; Plummer, Martyn; Franceschi, Silvia; Gravitt, Patti E.; Papenfuss, Mary; Smith, Danélle; Villa, Luisa L.; Ponce, Eduardo; Giuliano, Anna R.

doi:10.1093/infdis/jir595

Cited by 23 publications

(30 citation statements)

References 25 publications

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“…These results are consonant with previous published data showing prevalence ranging from 1.3 to 72.9% (3,(8)(9)(10)(11)(12)(13). Our high number of infected men is probably due to selection, as our sample is composed by men already referred for HPV testing with some degree of suspicious.…”

Section: Discussionsupporting

confidence: 90%

Genital prevalence of HPV types and co-infection in men

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Introduction: HPV infection is a highly prevalent sexually transmitted disease and there is evidence of the relationship of HPV infection and the development of genital warts, penile intraepitelial neoplasia, invasive penile carcinoma and cervical cancer. However, there is sparse data regarding the prevalence of HPV types and co-infection of different HPV types among men. Objectives: To assess the prevalence of HPV subtypes infections and rates of co-infection among men. Materials and Methods: 366 men were evaluated from March to October 2010. Men were referred to our institution for HPV diagnostic evaluation based on the following criteria: 1. presence of a genital wart; 2. presence of an atypical genital lesion; 3. absence of symptoms and a partner with a HPV diagnosis; 4. absence of symptoms and a desire to undergo a full STD diagnostic evaluation. Genital samples were collected from the urethra, penile shaft, scrotum and anus with Digene® collection and preservation kit and submitted to HPV genotype microarray detection (Papillocheck®). All men were tested for the low-risk HPV types 6-11-40-42-43-44 and for the high-risk HPV types 16-18-31-33-35-39-45-51-52-53-56-58-59-66-68-70-73-82. Results: Of the 366 men, 11 were tested inconclusive and were excluded from the analysis. 256 men (72.1% of the men from the cohort referred to our institution) tested positive with genotype micro-array detection and 99 tested negative. The most prevalent HPV-subtypes in the studied population were 6, 42, 51 and 16. Co-infection was found in 153 men. Of those, 70 (19.7%) had a co-infection by 2 types, 37 (10.4%) by 3 types; 33 men (9.2%) by 4 types; 8 men (2.2%) by 5 types; 1 man (0.3%) by 6 types; 1 man (0.3%) by 7 types; 2 men (0.6%) by 8 types and 1 man (0.3%) by 9 types. Conclusion: The most frequent HPV types were 6, 16, 42 and 51. Co-infection was found in 59% of our patients. This information is vital to drive future public health policies including massive public vaccination campaign.

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Section: Discussionsupporting

confidence: 90%

Genital prevalence of HPV types and co-infection in men

et al. 2014

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“…Several recent studies have shown convincingly that the presence of one HPV type does not increase the likelihood of acquiring a second, and that the natural competition between different HPV types might not occur in the uterine cervix (9,(29)(30)(31)(32)(33). In the present study, this is supported by the high variety of different HPV genotypes found with high viral loads in a single sample.…”

Section: Discussionsupporting

confidence: 84%

Multiple Human Papillomavirus Infections with High Viral Loads Are Associated with Cervical Lesions but Do Not Differentiate Grades of Cervical Abnormalities

Schmitt

Depuydt²,

Benoy³

et al. 2013

J Clin Microbiol

110

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Multiple human papillomavirus (HPV) genotypes often coexist within cervical epithelia and are frequently detected together in smears of different grades of cervical neoplasia. Describing the association between multiple infections and cervical disease is important in generating hypotheses regarding its pathogenesis. We analyzed the prevalence of multiple HPV infections and their attribution to cervical disease in a screening population of 999 consecutive BD SurePath liquid-based cervical cytology samples enriched with atypical squamous cells of undetermined significance (ASCUS) (n ‫؍‬ 100), low-grade squamous intraepithelial lesions (LSIL) (n ‫؍‬ 100), and high-grade squamous intraepithelial lesions (HSIL) (n ‫؍‬ 97). HPV genotyping was performed only on cytology specimens using a broad-spectrum GP5 ؉ /6 ؉ -PCR/multiplex HPV genotyping (BSGP5 ؉ /6 ؉ -PCR/MPG) assay that detects and quantifies 51 HPV genotypes and 3 subtypes. Using a recently defined high viral load cutoff, the quantitative data were scored as high or low viral load. In the 36-month follow-up, 79 histologically confirmed cervical intraepithelial neoplasia grade 2 or greater (CIN2؉) cases were identified. In the screening population, there was a trend of having more multiple infections at a younger age. Multiple HPV infections were common. Multiple HPV types were most prevalent in LSIL (75.9% of HPV positives), followed by HSIL (65.5%), ASCUS (64.6%), and negative for intraepithelial lesion or malignancy (NILM) (36.8%). On average, 3.2 and 2.5 HPV types were detected per LSIL and HSIL sample, respectively. Multiple HPV types with high viral loads were most prevalent in LSIL (62.6% of high viral load positives), followed by HSIL (51.9%), ASCUS (40.7%), and NILM (19.3%). Patients with multiple high viral loads showed a 4-to 6-fold-higher risk of having cervical precancerous cytological lesions than did patients with single high viral loads. Compared to NILM, multiple infections, especially with multiple high viral loads, were significantly associated with cytological precancerous lesions. However, the presence of multiple infections did not distinguish low-grade from high-grade cytological lesions. Human papillomaviruses (HPV) are DNA viruses that infect cutaneous and mucosal epithelia. Until now, 120 HPV genotypes have been characterized based on sequence information (1), with evidence that even more exist (2). There are 51 mucosal HPV types that have been recognized, and these are further divided into three groups based on their epidemiological association with cervical cancer (CxCa): 14 high-risk HPV (Hr-HPV) types (HPV16, -18, -31, -33, -35, -39, -45, -51, -52, -56, -58, -59, -66, -68), 6 possibly high-risk HPV (pHr-HPV) types (HPV26, -53, -67, -70, -73, and -82), and 31 low-risk HPV (Lr-HPV) types (HPV6, (3, 4). Recently, HPV types HPV55 and HPV64 have been removed from the list of distinct HPV types, as they share 93% sequence homology to HPV44 and HPV34, respectively (5). By definition, these types are referred to as subtypes, as is also the...

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“…Some studies reported that co-infections with certain HPV types occurred more often than what was expected, but this was explained by diagnostic artefacts due to limitations of the HPV detection method used [2], [16]. Overall, multiple co-infections show no specific pattern by HPV type.…”

Section: Introductionmentioning

confidence: 94%

“…Previous analyses on the frequency of individual HPV types in co-infections with multiple types suggest that they do not tend to cluster together selectively in either sex [2], [3], [7], [8], [11], [16], [19]. Some studies reported that co-infections with certain HPV types occurred more often than what was expected, but this was explained by diagnostic artefacts due to limitations of the HPV detection method used [2], [16].…”

Section: Introductionmentioning

confidence: 95%

Patterns of Human Papillomavirus Types in Multiple Infections: An Analysis in Women and Men of the High Throughput Human Papillomavirus Monitoring Study

et al. 2013

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BackgroundTo evaluate the pattern of co-infection of human papillomavirus (HPV) types in both sexes in Sweden.MethodsCell samples from genital swabs, first-void urine, and genital swabs immersed in first-void urine were collected in the present cross-sectional High Throughput HPV Monitoring study. Overall, 31,717 samples from women and 9,949 from men (mean age 25) were tested for 16 HPV types using mass spectrometry. Multilevel logistic regression was used to estimate the expected number of multiple infections with specific HPV types, adjusted for age, type of sample, and accounting for correlations between HPV types due to unobserved risk factors using sample-level random effects. Bonferroni correction was used to allow for multiple comparisons (120).ResultsObserved-to-expected ratio for any multiple infections was slightly above unity in both sexes, but, for most 2-type combinations, there was no evidence of significant departure from expected numbers. HPV6/18 was found more often and HPV51/68 and 6/68 less often than expected. However, HPV68 tended to be generally underrepresented in co-infections, suggesting a sub-optimal performance of our testing method for this HPV type.ConclusionsWe found no evidence for positive or negative clustering between HPV types included in the current prophylactic vaccines and other untargeted oncogenic types, in either sex.

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Clustering of Human Papillomavirus (HPV) Types in the Male Genital Tract: The HPV in Men (HIM) Study

Abstract: Our study showed that, despite obvious anatomical differences, HPV coinfections do seem to occur at random in the male external genitalia as in the female cervix.

Cited by 23 publications

References 25 publications

Genital prevalence of HPV types and co-infection in men

Genital prevalence of HPV types and co-infection in men

Multiple Human Papillomavirus Infections with High Viral Loads Are Associated with Cervical Lesions but Do Not Differentiate Grades of Cervical Abnormalities

Patterns of Human Papillomavirus Types in Multiple Infections: An Analysis in Women and Men of the High Throughput Human Papillomavirus Monitoring Study

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