Multiple-type human papillomavirus infection in younger uncircumcised men

The role of circumcision, tobacco, and alcohol use in genital human papillomavirus infection among men from Denmark

It is crucial to understand the natural history of genital human papillomavirus (HPV) infection in men to prevent the increasing male HPV-related disease burden. We evaluated the associations between HPV infection and circumcision, smoking, and alcohol use after accounting for sexual behavior. The study included 2331 male personnel from Danish barracks. Penile swabs were tested for HPV DNA with a polymerase chain reaction assay, INNO-LiPA. All men completed a self-administered questionnaire providing data on potential risk factors for HPV such as lifestyle and sexual habits. Using multivariable logistic regression, associations between potential risk factors and HPV infection were estimated and expressed as odds ratios (ORs) with 95% confidence intervals (CI). Current cigarette smoking was associated with increased odds of HPV detection (OR = 1.2; 95% CI: 1.0-1.4), but we found no association with alcohol use in the analysis adjusted for sexual behavior. Circumcision reduced the odds of a prevalent HPV infection (OR = 0.7; 95% CI: 0.5-1.0) although not statistically significantly. Strong associations with lifetime and recent number of female sex partners were observed, but in contrast to uncircumcised men, increasing number of sex partners was not associated with higher HPV prevalence in circumcised men. In conclusion, smoking was associated with increased odds of penile HPV in men from the general population in Denmark, whereas circumcision seemed to reduce the risk. Moreover, our results indicated that there might be differences in the viral susceptibility between circumcised and uncircumcised men.

Binge drinking, HIV/HPV co-infection risk, and HIV testing: Factors associated with HPV vaccination among young adults in the United States

Human papillomavirus (HPV) is a common sexually transmitted infection. Binge drinkers often engage in HIV/HPV co-infection high-risk behaviors. We examined the association between binge drinking, HIV/HPV co-infection risk, HIV testing and HPV vaccination among young adults. Data from the 2017 Behavioral Risk Factor Surveillance System survey were examined. Participants (N = 430/450,016; 0.11%) were HPV vaccine-eligible young adults ages 18-26 years. Multivariable logistic regression examined the association between binge drinking in the past 30 days, HIV/HPV co-infection high-risk risk behaviors, HIV testing, and HPV vaccination (initiated/completed, unvaccinated) among young adults. Respondents were primarily cisgender (99.8%), non-Hispanic White (41.4%), employed (46.2%) or student (35.4%), and insured (68.2%). Most did not binge drink (55.2%). The majority did not engage in HIV/HPV co-infection high-risk risk behaviors (78.2%). More than one-half had never been tested for HIV (59%) nor vaccinated against HPV (60.6%). Although binge drinkers (44.8%) were significantly more likely to engage in HIV/HPV co-infection high-risk behaviors (OR = 2.1; 95% CI: 1.0-4.5), binge drinking was not positively associated with HIV testing (OR = 0.98; 95% CI: 0.63-1.53). After adjusting for demographics and HIV/HPV co-infection high-risk behaviors, one (aOR = 2.71; 95% CI: 1.11-6.65) and two episodes (aOR = 3.05; 95% CI: 1.26-7.41) of binge drinking in the past 30 days were significantly associated with HPV vaccination uptake. Positive associations between HPV vaccination and participants having an HIV test in 2017 (aOR = 3.86; 95% CI: 1.42-10.55) and before 2017 (aOR = 2.62; 95% CI: 1.23-5.56) were also statistically significant. Because young adult binge drinkers are more likely to engage in HIV/HPV co-infection high-risk behaviors, promoting HPV vaccination and HIV testing are important public health objectives.

Distribution of human papillomavirus genotypes (2014–2016) in women with genital warts at a sexually transmitted disease clinic in Beijing, China

Aim: The aim of this study was to analyze the distribution of human papillomavirus (HPV) genotypes among women with genital warts in the Beijing region of China. Methods: A total of 350 women diagnosed with genital warts between 2014 and 2016 were analyzed by real-time polymerase chain reaction (PCR) to test for high-risk and low-risk HPV subtypes. Results: The results show that 52.6% (184/350) of cases were positive for HPV6+11. The three most common high-risk HPVs detected were HPV52, HPV16 and HPV58, detected in 12.0% (42/350), 10.6% (37/350) and 10.0% (35/350) of all cases, respectively. Conclusion: These results indicate that vaccines targeting HPV subtypes 6, 11, 16, 52 and 58 would have the greatest impact among sexually active women living in Beijing.

Human Papillomavirus Infection Among 2460 Men in Denmark: Prevalence in Relation to Age Using 2 Human Papillomavirus DNA Testing Methods

BACKGROUND

It is crucial to understand the epidemiology and natural history of human papillomavirus (HPV) infection in both men and women, to prevent the increasing HPV-related disease burden in men. Data on HPV prevalence among men in the general population are limited. In this cross-sectional population-based study, we aimed to estimate genital HPV infection prevalence in Danish men using 2 different test methods.

METHODS

Penile swab samples from 2460 male employees and conscripts at military barracks in Denmark were tested for HPV DNA with the hybrid capture 2 (HC2) method, and a polymerase chain reaction (PCR) assay, Inno-LiPA. The overall and age- and type-specific prevalence of HPV infection with 95% confidence intervals (CIs) were estimated, and the correlation between the 2 assays was assessed.

RESULTS

The overall HPV prevalence was 22.2% (95% CI, 20.6-23.9) in the HC2 test and 41.8% (95% CI, 39.9-43.8) with PCR. Of the PCR-positive samples, 50.9% were negative in the HC2 test. Of 183 PCR-positive samples that could not be genotyped (HPVX), 88.0% (95% CI, 83.2-92.7) were HC2 negative. The most prevalent types were HPV-51, HPV-16, HPV-66, HPV-53, and HPV-6. The prevalence of high-risk and low-risk HPV peaked among men aged 20 to 29 years, whereas the HPVX prevalence increased with age.

CONCLUSIONS

Human papillomavirus is highly prevalent in the general male population of Denmark, with HPV-16 and HPV-51 being the most prevalent. Polymerase chain reaction detects twice as many positive samples as HC2 but includes HPVX, possibly representing cutaneous HPV types found on normal genital skin.

Alcohol consumption and prevalence of human papillomavirus (HPV) infection among US men in the HPV in Men (HIM) study

OBJECTIVES

Moderate alcohol consumption can impair host defence against viral infections. The objective of this cross-sectional analysis was to assess the association between alcohol intake and prevalent human papillomavirus (HPV) infection among US men enrolled in the HPV in Men (HIM) study using quantitative alcohol intake measured from a Food Frequency Questionnaire.

METHODS

The HIM study is a prospective, multinational study of the natural history of HPV infection. For this report, we restricted our analyses to men from the US cohort (N = 1313). Samples from the corona of glans penis, penile shaft and scrotum were combined for HPV DNA testing. Self-reported alcohol intake was quantified by grams of alcohol intake per day. Multivariable prevalence ratios (mPRs) were used to assess the association between alcohol intake and HPV infections.

RESULTS

Prevalent infections were significantly higher among men in the highest quartile of alcohol intake and multivariable models revealed that the highest quartile of alcohol intake was associated with significantly increased risks for any (mPR = 1.13; 95% CI 1.00 to 1.27) HPV types and oncogenic (mPR = 1.35; 95% CI 1.08 to 1.68) HPV types. The fourth quartile of alcohol intake was associated with elevated risks for prevalent HPV infection across all strata of number of sexual partners and among never-smokers and current smokers, but not among former smokers.

CONCLUSIONS

These results demonstrate that high intake of alcohol is associated with an increased risk for prevalent HPV infections among men. The biological role that alcohol plays in genital HPV infection remains understudied and limited epidemiological data exist, especially among men.

Prevalence of genital human papillomavirus among men in Europe: systematic review and meta-analysis

INTRODUCTION

Human papillomavirus (HPV) is the commonest sexually transmitted infection worldwide and causes substantial morbidity in both sexes. Most European countries offer HPV vaccination for girls, but vaccine recommendations for boys are warranted.

AIMS

The aims of this study were to investigate the prevalence of genital HPV, identify parameters that affect the prevalence, and describe the type-specific prevalence among men in Europe.

METHODS

A systematic review and meta-analysis of the published literature in PubMed and Embase.

MAIN OUTCOME MEASURES

Genital HPV prevalence and factors influencing prevalence in general and high-risk male populations in Europe.

RESULTS

We included 31 articles that gave the prevalence of genital HPV DNA among men in northern, southern and western Europe; no studies from eastern Europe were identified. The pooled HPV prevalence among 1,863 men representing the general population (nine studies) was 12.4%, with large heterogeneity between studies (I(2)  = 96.3%, P < 0.0001). The pooled HPV prevalence among 6,428 men in the high-risk population (22 studies) was 30.9%, also with substantial heterogeneity (I(2)  = 95.6%, P < 0.0001). In unadjusted meta-regression analysis, the HPV prevalence in the general population was significantly higher in studies published after 2000 (28.5%) than in earlier studies (8.8%) (P = 0.0179). In the meta-regression analysis adjusted by publication year, the heterogeneity in the two population groups could not be explained by geographical region, anatomical sampling site, or HPV detection method. HPV16 was the most prevalent high-risk type in both populations.

CONCLUSIONS

HPV prevalence differs in male general and high-risk populations, but HPV16 and HPV18 are among the most common HPV types detected in both groups. Our findings contribute knowledge that may be useful as a baseline measure before the introduction of HPV vaccination for boys in Europe, and add to understanding of the epidemiology of HPV infection in men.