Human Papillomavirus (HPV) 6, 11, 16, and 18 Seroprevalence Is Associated with Sexual Practice and Age: Results from the Multinational HPV Infection in Men Study (HIM Study)

Abstract

Background Few human papillomavirus (HPV) serology studies have evaluated type-specific seroprevalence of vaccine HPV types in men. This study investigates seroprevalence of HPV 6, 11, 16, and 18, and associated risk factors in men residing in three countries (United States, Mexico, and Brazil). Methods Data from 1,477 men aged 18 to 70 enrolled in the HPV Infection in Men Study (HIM Study) were analyzed. Serum antibody testing was performed with virus-like particle-based ELISA. Potential risk factors were assessed for individual HPV types by the use of logistic regression. Results Overall, HPV-6, 11, 16, and 18 seroprevalence was 14.8%, 17.3%, 11.2%, and 5.8%, respectively. Thirty-four percent of men were seropositive to one or more HPV types. When examined by sexual practice, 31.2% of men who had sex with women, 65.6% of men who had sex with men (MSM), and 59.4% of men who had sex with both men and women (MSMW) were seropositive to one or more HPV types. Seroprevalence increased with age among young-to-middle-aged men with significant upward age trends observed for HPV 11, 16, and 18. Men with multiple lifetime male anal sex partners were 2 to 4 times more likely to be HPV 6 or 11 seropositive and 3 to 11 times more likely to be HPV 16 or 18 seropositive. Conclusion Our data indicate that exposures to vaccine HPV types were common in men and highly prevalent among MSM and MSMW. Impact Our study provides strong evidence that the practice of same-sex anal intercourse is an independent risk factor for seroprevalence of individual vaccine HPV types. Examination of antibody responses to HPV infections at various anatomic sites in future studies is needed to elaborate on the mechanism.

Seroepidemiology of High-Risk HPV in HIV-Negative and HIV-Infected MSM: The H2M Study

“…This age-related pattern has consistently been described in serology studies among men (16,39,40,46) and may reflect cumulative lifetime HPV exposure in combination with age-related changes in immunity. An increasing number of lifetime male sex partners is a well-known risk factor for HPV infection (6), and showed a strong and significant association with HPV seropositivity in HIV-negative but not in HIV-infected MSM.…”

“…Prevalence of antibodies against HPV-16, which is the most carcinogenic and therefore most important HPV type, was high compared to other studies among (mostly heterosexual) males (16,17,34,41), but comparable to data reported for MSM specifically (40,42). However, comparisons between HPV serology studies are hampered by major differences in characteristics of the study population and in serology methods.…”

“…GEE was applied to account for the analysis of multiple HPV types within the same individual; an exchangeable correlation structure was assumed. In this multivariable model we a priori adjusted for age, tobacco smoking, and lifetime male sex partners (39,40). In addition, we included other potential confounders based on a P < 0.05 in univariable analyses, and subsequently obtained a parsimonious model through backward selection.…”

Low Prevalence of HPV in Male Sexual Partners of HR-HPV Infected Females and Low Concordance of Viral Types in Couples in Eastern Guangdong

“…However, the prevalence of genital HR-HPV in male sexual partners of HR-HPV infected women was lower than that expected, and the concordance of high risk viral types between couples was extremely low. Based on our current knowledge, high risk sexual behaviors were strong determinants of HR-HPV infection in men, and the male patients with HPV 6/11 infection from STD outpatient clinic mostly had high frequency of sexual intercourse with multiple sexual partners, even prostitutes over lifetime (Lu et al, 2011) . But there was no statistical significance in the incidence of genital HR-HPV infection between men with (6.85%) and without (8.16%) HPV 6/11 in our study.…”

HPV Seroconversion Following Anal and Penile HPV Infection in HIV-Negative and HIV-Infected MSM

“…HPV seropositivity has been associated with both virus-related (e.g., regarding persistence of infection, viral load, and viral type) and host-related factors (e.g., increasing age, HIV-induced immunosuppression, anatomic site of infection, and sexual risk behavior; refs. 7,9,11,12). The very high antibody concentrations observed after HPV vaccination confer protection against incident HPV infection (13,14), but to what extent naturally induced antibodies also confer protection is still a matter of debate (9).…”