Human Papillomavirus Infection in Men Attending a Sexually Transmitted Disease Clinic

Abstract

Human papillomavirus (HPV) is the main etiologic agent of anogenital cancers, including cervical cancer, but little is known about the type-specific prevalence of HPV in men. Participants were men aged 18-70 years attending a sexually transmitted disease clinic. Penile skin swabs were assessed for HPV DNA using polymerase chain reaction with reverse line-blot genotyping. Of 436 swabs collected, 90.1% yielded sufficient DNA for HPV analysis. Men with inadequate swab samples were significantly more likely to be white and circumcised than men with adequate swab samples. The prevalence of HPV was 28.2%. Oncogenic HPV types were found in 12.0% of participants, nononcogenic types were found in 14.8% of participants, multiple types were found in 6.1% of participants, and unknown types were found in 5.9% of participants. The most prevalent subtypes were nononcogenic 6, 53, and 84. HPV positivity was not associated with age. These results indicate that HPV infection among men at high risk is common but that characteristics of male HPV infection may differ from those of female infection.Human papillomavirus (HPV) infection is the necessary, sexually transmitted cause of invasive cervical cancer and its precursor lesion, cervical intraepithelial neoplasia [1][2][3]. HPV has also been closely linked with other anogenital cancers, including anal cancer and certain penile cancers [4][5][6]. HPV infection in men is over- whelmingly subclinical, which has resulted in a potentially large number of asymptomatic carriers who serve as reservoirs and vectors for the virus.Although HPV has been studied extensively in women, data on male infection are limited. Studies of HPV in men are necessary to improve our understanding of HPV transmission and HPV-related carcinogenesis and to prevent disease in both men and women. The success of future cancer prevention strategies, such as prophylactic HPV vaccination, will be limited without a basic epidemiological understanding of HPV in men.Earlier studies of papillomavirus infection in men used a variety of clinical and histological techniques to establish a diagnosis of HPV, but polymerase chain reaction (PCR) has emerged as the most sensitive method available for the detection of latent HPV [7][8][9]. Among studies that have used PCR to detect penile HPV DNA in healthy men, sampling methodologies have been inconsistent. Nonetheless, results from these diverse investigations have suggested that penile HPV in sexually active men is at least as prevalent as cervical HPV is among women [10][11][12][13][14][15].HPV prevalence in men has been shown to vary by

Prevalence and determinants of human papillomavirus genital infection in men

“…As in a few previous reports (Hippelaïnen et al, 1993c;Baldwin et al, 2001), the husbands in our study did not show, overall or in specific countries, clear variations in the prevalence of HPV penile infection by age. We were not able, however, to exclude the presence of an early peak of HPV infection (30 -40%) in very young men at sexual debut (e.g., among conscripts in Denmark and Mexico) (Kjaer et al, 2001;Lazcano-Ponce et al, 2001).…”

“…Conversely, progress in understanding the prevalence and natural history of genital HPV infection in men has been limited. Most surveys of penile HPV infection so far have included a few hundred men at most and have generally been restricted to young individuals (Hippeläinen et al, 1993a,b,c;Baldwin et al, 2001;Kjaer et al, 2001;Lazcano-Ponce et al, 2001). …”

Prevalence and determinants of human papillomavirus infection in men attending vasectomy clinics in Mexico

“…13 The overall prevalence of HPV positivity was 8.7%, and the prevalence among the most sexually active men ( 4 sexual partners) was 14.9%. The age-standardized HPV prevalence based on the world standard population was 9.5%, similar to the age-standardized prevalence (10.8%) found among cytologically normal women of the same age group (i.e., <55 years) in the state of Morelos, Mexico.…”

“…9,10 However, contrary to the relatively large amount of information on genital HPV infection in women, 2,11 large studies on HPV prevalence in the general male population are few. Furthermore, the majority of studies in men have focused on young individuals 12 or high-risk populations [e.g., men attending sexually transmitted disease (STD) clinics 9,13,14 or enrolled in military service [15][16][17].…”

The Viral Etiology of AIDS‐Associated Malignancies

“…An analogous cell type apparently does not exist in men. However, despite lack of studies on the subject, it would be assumed that men are transmitters of HPVs (Baldwin et al, 2003;Dunne et al, 2006;Giuliano et al, 1999). Predictably, the incidence of penile cancers increases dramatically in individuals who are HIV positive (Aboulafia and Gibbons, 2001;Arany and Tyring, 1998;Laurence, 2003;Palefsky and Barrasso, 1996;Sirera et al, 2006;von Krogh et al, 1995), which likely reflects the overall increase incidence of HPV infections detected in women.…”