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Garolla A, Graziani A, Grande G, Ortolani C, Ferlin A. HPV-related diseases in male patients: an underestimated conundrum. J Endocrinol Invest 2024; 47:261-274. [PMID: 37770654 PMCID: PMC10859347 DOI: 10.1007/s40618-023-02192-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE Human papillomavirus (HPV) infection is the most common sexually transmitted disease, in males and females worldwide. While the role of HPV in female diseases is well known and largely studied, males have negligibly been included in these programs, also because the proportion of women suffering and dying from HPV-related diseases is much larger than men. The aim of this review is to focus on HPV-related diseases in male patients. METHODS We performed a literature analysis on the electronic database PubMed. We considered randomized trials, observational and retrospective studies, original articles having as topic the relationship between HPV male infection and the following items: oral, anal penile cancers, warts, condylomas, male infertility, altered sperm parameters, anti-sperm antibodies (ASA). We also included experimental in vitro studies focused on the effects of HPV infection on oocyte fertilization, blastocyst development, and trophoblastic cell invasiveness. In addition, studies describing the adjuvant administration of the HPV vaccination as a possible strategy to promote HPV clearance from semen in infected males were included. RESULTS Regarding head and neck HPV-related diseases, the most important non-neoplastic disease is recurrent respiratory papillomatosis (RRP). Regarding neoplastic diseases, the proportion of head and neck cancers attributable to HPV has increased dramatically worldwide. In addition, nowadays, it is thought that half of head and neck squamous cell carcinomas (HNSCCs) cases in the United States are caused by infection with high-risk HPV. HPV is noteworthy in andrological practice too. It was described as having a high HPV prevalence, ranging between 50 and 70%, in male penile shaft, glans penis/coronal sulcus, semen as well as in scrotal, perianal, and anal regions. Moreover, in male patients, HPV infection has been associated, among other diseases, with penile cancers. HPV semen infection has been reported in about 10% in men from the general population and about 16% in men with unexplained infertility, although these data seem widely underestimated according to clinical experience. In particular, HPV semen infection seems to be most related to asthenozoospermia and to anti-sperm antibodies (ASAs). CONCLUSIONS HPV infection represents a health problem with a detrimental social and public impact. Despite this evidence, little has been done to date to widely promote vaccination among young males.
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Affiliation(s)
- A Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy.
| | - A Graziani
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - G Grande
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - C Ortolani
- Section of Otolaryngology, Department of Neurosciences, University of Padova, Padua, Italy
| | - A Ferlin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
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da Silva LL, Teles AM, Santos JMO, Souza de Andrade M, Medeiros R, Faustino-Rocha AI, Oliveira PA, dos Santos APA, Ferreira Lopes F, Braz G, Brito HO, da Costa RMG. Malignancy Associated with Low-Risk HPV6 and HPV11: A Systematic Review and Implications for Cancer Prevention. Cancers (Basel) 2023; 15:4068. [PMID: 37627099 PMCID: PMC10452364 DOI: 10.3390/cancers15164068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/28/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
High-risk human papillomavirus (HPV) is etiologically related to cervical cancer, other anogenital cancers and oropharyngeal carcinomas. Low-risk HPV, especially HPV6 and HPV11, cause genital warts and laryngeal papillomas. However, the accumulating data suggests that HPV6 and HPV11 may cause malignant lesions at non-cervical anatomic sites. This review aims to estimate the proportions of single and dual HPV6/11 infections in multiple cancers reported in the last 10 years in the Cochrane, Embasa and PubMed databases. Secondly, the genomes of HPV6/11 were compared with the most common high-risk genotype, HPV16, to determine the similarities and differences. A total of 11 articles were selected, including between one and 334 HPV+ cancer patients. The frequencies of single or dual HPV6/11 infections ranged between 0-5.5% for penile and 0-87.5% for laryngeal cancers and were null for vulvar, vaginal and oral cancers. The genomic similarities between HPV6/11 and HPV16 mainly involved the E7 gene, indicating a limited ability to block cell differentiation. The presence of single or dual HPV6/11 infections in variable proportions of penile and laryngeal cancers support the vaccination strategies that cover these genotypes, not only for preventing genital warts but also for cancer prevention. Other risk factors and co-carcinogens are likely to participate in epithelial carcinogenesis associated with low-risk HPV.
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Affiliation(s)
- Leandro Lima da Silva
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Amanda Mara Teles
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Post-Graduate Program in Animal Health, State University of Maranhão, São Luís 65099-110, MA, Brazil
| | - Joana M. O. Santos
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
| | - Marcelo Souza de Andrade
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
| | - Ana I. Faustino-Rocha
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Paula A. Oliveira
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Ana Paula Azevedo dos Santos
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Post-Graduate Program in Health Sciences, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil
| | - Fernanda Ferreira Lopes
- Post-Graduate Program in Odontology, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil;
| | - Geraldo Braz
- Post-Graduate Program in Computing Sciences, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil;
| | - Haissa O. Brito
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Rui M. Gil da Costa
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Associate Laboratory in Chemical Engineering (ALiCE), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
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Clanner-Engelshofen BM, Marsela E, Engelsberger N, Guertler A, Schauber J, French LE, Reinholz M. Condylomata acuminata: A retrospective analysis on clinical characteristics and treatment options. Heliyon 2020; 6:e03547. [PMID: 32190761 PMCID: PMC7068618 DOI: 10.1016/j.heliyon.2020.e03547] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 02/29/2020] [Accepted: 03/03/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Anogenital HPV is the most frequent sexually transmitted disease (STD) worldwide. There is no obligation to officially register HPV infections in Germany and thus the epidemiology of condylomata acuminata (CA) is not well characterized. OBJECTIVES To provide a better understanding of the epidemiology of CA and outline the treatment options that are available to patients with this disease. METHODS Data of 1124 patients with a confirmed diagnosis of CA, presenting in our university hospital outpatient consultation between 2011 and 2015 were retrospectively evaluated and the efficacy of various types of treatments was addressed. RESULTS A large patient cohort of 1124 predominately young (mean age 36.5 years old), male (83.9 %), single (50.2 %), heterosexual (92.8 %) Germans (62.5 %) received consults in our outpatient clinic for STDs. Nearly 60 % of the diagnosed patients presented with first-time CA, indicating a considerable proportion of roughly 40 % recurrent infections as well. Only 13.7 % of patients were previously immunized against HPV. CONCLUSIONS The evaluation of a large patient cohort provided a better understanding of the present epidemiology of CA in an outpatient hospital setting in Germany. An effective three-scale therapeutic regime and preventive measures were outlined.
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Affiliation(s)
| | | | | | | | | | | | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany
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Feisthammel J, Mössner J. [Proctology for internists]. Internist (Berl) 2019; 58:1053-1064. [PMID: 28884323 DOI: 10.1007/s00108-017-0318-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In proctology patients can often be helped with very little effort. With knowledge of the most common disease symptoms the treating physician can in many cases correctly recognize the cause of the complaints and initiate the appropriate therapy or arrange referral to a proctological institution. This article aims to briefly and succinctly present the most common diseases in proctology (e.g. mariscae, hemorrhoids, anal fissures, perianal venous thrombosis, abscesses and fistulas, condyloma acuminatum and anal carcinoma) and to provide the treating internist, even outside of gastroenterology, assistance with the management of proctological symptoms.
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Affiliation(s)
- J Feisthammel
- Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland.
- Proktologische Sprechstunde, Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103, Leipzig, Deutschland.
| | - J Mössner
- Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland
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Abstract
Proctology is a medical subspecialty that encompasses diseases of the perianal region, anal canal, and rectum. Dermatologists play a pivotal role in this realm, as inflammatory perianal disorders, infectious and sexually transmitted diseases, as well as perianal tumors and their precursor lesions fall within the core competency of dermatology. In a concise manner, the present article highlights all relevant disease groups in the field of proctology. With a particular focus on aspects pertinent to dermatologists, this includes inflammatory disorders, "classic" proctologic diseases, sexually transmitted diseases, malignancies of the anal region, as well as pathogen-induced diseases. Despite the wide variety of disorders, there are only five key symptoms prompting patients to consult a proctologist, including anal pruritus and burning, discharge, bleeding, pain, and foreign body sensation. A simple algorithm, which incorporates these symptoms as well as key clinical features, may assist in quickly establishing the correct diagnosis in everyday clinical practice.
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Affiliation(s)
- Alexander Kreuter
- Department of Dermatology, Venereology, and Allergology, HELIOS St. Elisabeth Hospital, Oberhausen, Germany
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