Concordance of Beta-papillomavirus across anogenital and oral anatomic sites of men: The HIM Study

Abstract

We evaluated the concordance between β-HPVs detected in external genital skin, anal canal, and oral cavity specimens collected simultaneously from 717 men that were participating in the multinational HIM Study. Viral genotyping was performed using the Luminex technology. Species- and type-specific concordance was measured using kappa statistics for agreement. Overall, concordance of β-HPVs across sites was low and mainly observed among paired genital/anal canal samples. When grouped by species, solely β-4 HPVs showed moderate concordance in genital/anal pairs (κ = 0.457), which could be attributed to the substantial concordance of HPV-92 in men from Brazil and Mexico (κ > 0.610). β-HPV type concordance was higher in Mexico, where HPV-19 was consistently concordant in all anatomic site combinations. Our analysis indicates that type-specific concordance across sites is limited to few viral types; however, these infections seem to occur more often than would be expected by chance, suggesting that although rare, there is agreement among sites.

Why Human Papillomavirus Acute Infections Matter

“…Also, viral and cellular genomes will not accumulate similar genetic and/or epigenetic modifications during genuine and apparent chronic infections, thus allowing for molecular tests to differentiate between them. Testing the meta-population hypothesis will require HPV research to engage in spatial ecology studies, sampling between various macro/microscopic sites within the same individual (e.g., [ 52 , 53 , 54 , 55 ]), to study ‘auto-inoculation’ [ 56 ], and to systematically resort to microdissection studies to investigate the details of infected patches within sites [ 34 , 57 , 58 , 59 ].…”

Beta Human Papillomavirus and Associated Diseases

“…It was further reported that whereas β-3 HPVs are more abundant in the nasal cavity than in the skin [35], β-1 and β-2 HPVs are more prevalent in all other cutaneous and non-cutaneous regions. However, scarce reports in which the prevalence and distribution of β-HPVs were analyzed simultaneously at different anatomical sites indicate that concurrent type-specific β-HPV infections are rather rare [36-39], although they seem to be higher across keratinized tissues than through mucosal sites [40]. …”

“…Interestingly, the prevalence of specific cutaneous HPVs varies across diseases: α-4 HPVs 2, 27 and 57, γ-1 HPV-4 and µ-1 HPV-1 are the most prevalent types in common warts [17], α-8 HPV-7 is frequently detected in common warts of individuals working in humid and cold environments (e.g., butchers) [45], γ-1 HPV-4 and µ-1 HPV-1 predominate in plantar warts, and α-2 HPVs 3 and 10 are the most commonly detected in flat warts [7]. However, the etiological role of β-HPVs in cutaneous malignancies has proven difficult to delineate not only due to the high heterogeneity of this group of viruses but also because these infections are ubiquitously disseminated throughout the healthy skin, oral cavity, nasal mucosa and anogenital region, hindering the definition of infections that may be clinically relevant [29, 34, 36, 46, 47]. …”

Human Papillomavirus and Genital Disease in Men: What We Have Learned from the <b><i>HIM Study</i></b>

“…These infections include HPV PCR-positive specimens for which hybridization to any type-specific probe was not observed. However, using a very sensible bead-based multiplex HPV genotyping methodology, a high prevalence of cutaneous β-HPVs was observed in most of these specimens [50, 54, 58, 62]. The lack of association between β-HPVs DNA detection and sexual behavior variables suggested other routes of transmission of these infections such as autoinoculation [54, 58].…”

“…The lack of association between β-HPVs DNA detection and sexual behavior variables suggested other routes of transmission of these infections such as autoinoculation [54, 58]. Nevertheless, concordance of β-HPVs across different anatomic sites assessed was low [62], although higher across keratinized tissue sites (31.0%; genital skin, eyebrow hairs, forearm skin) compared to mucosal sites (6.9%; anal and oral mucosa) [60]. The clinical consequences of the presence of β-HPVs at the male genitals require further research.…”