RESUMEN
Human papillomavirus (HPV) causes anal, penile and oropharyngeal cancers in men. Genital HPV prevalence in men appears to vary by world region with men residing in Asia having among the lowest prevalence. Unfortunately, there is little information on prevalence of HPV infection in men by race. The purpose of this study was to examine HPV prevalence by race across three countries. 3,909 men ages 18-70 years enrolled in an ongoing prospective cohort study of the natural history of HPV in men (The HIM Study) were included in the analysis. Participants completed risk factor questionnaires and samples were taken from the penile epithelium and scrotum for HPV detection. HPV testing of the combined DNA extract was conducted using PCR and genotyping. Asian/Pacific Islanders had the lowest HPV prevalence of 42.2% compared to Blacks (66.2%), and Whites (71.5%). The Asian/Pacific Islander race was strongly protective in univariate analysis (prevalence ratio (PR) = 0.59; 95% confidence interval (CI): 0.48-0.74) and multivariate analysis for any HPV infection (PR = 0.65; 95% CI: 0.52-0.8). Stratified analysis by lifetime number of female partners also showed strong inverse associations with the Asian/Pacific Islander race. We consistently observed the lowest prevalence of HPV infection among Asian/Pacific Islanders with moderate inverse associations even after various adjustments for potential confounding factors. Unmeasured behavioral factors, sexual mixing with low risk women, and/or race-specific differences in the frequency of germline variations among immune regulating genes may underlie these associations. Further studies among Asian populations that incorporate measures of immuno-genetics are needed to understand this phenomenon.
Asunto(s)
Enfermedades de los Genitales Masculinos/etnología , Infecciones por Papillomavirus/etnología , Grupos Raciales , Adolescente , Adulto , Anciano , Alphapapillomavirus/genética , Alphapapillomavirus/aislamiento & purificación , Brasil/epidemiología , Estudios de Cohortes , ADN Viral/análisis , ADN Viral/genética , Femenino , Enfermedades de los Genitales Masculinos/epidemiología , Enfermedades de los Genitales Masculinos/virología , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Pene/virología , Prevalencia , Factores de Riesgo , Escroto/virología , Conducta Sexual , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto JovenRESUMEN
BACKGROUND: Comparative studies of genital human papillomavirus (HPV) among men having sex with men (MSM), men having sex with women and men (MSWM), and men having sex with women (MSW) have not been conducted so far; however, such comparisons may be important for planning prevention strategies like vaccination. METHODS: Men, aged 18 to 70 years, were enrolled in a study of genital HPV in São Paulo, Brazil; Cuernavaca, Mexico; and Tampa, FL. Men were classified as MSM (n = 170), MSWM (n = 214), and MSW (n = 3326) based on self-reported sexual behavior. Genotyping for HPV was conducted on cells from the penis and scrotum. Prevalence data were adjusted by country. Factors potentially associated with genital HPV were assessed using multivariable Poisson regression. RESULTS: Genital HPV prevalence was typically higher among MSWM than among MSM or MSW for groups of HPV genotypes including nononcogenic types (51%, 36%, and 42%, respectively), and multiple types (37%, 24%, and 29%, respectively). Age and alcohol consumption in the past month were associated with oncogenic HPV among both MSM and MSWM; however, there were no statistically significant associations between sexual behaviors and genital HPV among MSM or MSWM. CONCLUSIONS: Prevalence of genital HPV may be higher among MSWM than among MSW or MSM. Number of female sex partners was associated with genital HPV among MSW, but number of male anal sex partners was not associated with genital HPV among MSM and MSWM.
Asunto(s)
Bisexualidad , Heterosexualidad , Homosexualidad Masculina , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Consumo de Bebidas Alcohólicas , Bisexualidad/estadística & datos numéricos , Brasil/epidemiología , Femenino , Florida/epidemiología , Genotipo , Heterosexualidad/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Papillomaviridae/clasificación , Papillomaviridae/genética , Infecciones por Papillomavirus/virología , Pene/virología , Prevalencia , Factores de Riesgo , Escroto/virología , Conducta Sexual , Adulto JovenRESUMEN
There is growing interest in understanding human papillomavirus (HPV) infection and related disease among men. To date there have been numerous studies reporting HPV DNA prevalence among men from several different countries, however, few have incorporated multivariable analyses to determine factors independently associated with male HPV detection. The purpose of this study was to assess the factors independently associated with HPV detection in men ages 18-70 years residing in Brazil (n = 343), Mexico (n = 312), and the United States (US) (n = 333). In samples combined from the coronal sulcus, glans penis, shaft, and scrotum, we evaluated factors associated with any, oncogenic, and nononcogenic HPV infections. In multivariable analyses, detection of any HPV infection was significantly associated with reported race of Asian/Pacific Islander, lifetime and recent number of sexual partners, and having sex in the past 3 months. Oncogenic HPV detection was independently associated with lifetime and recent number of sexual partners, and having sex in the past 3 months. NonOncogenic HPV infection was independently associated with lifetime number of sexual partners. Circumcision, assessed by clinical examination, was associated with reduced risk of HPV detection across all categories of HPV evaluated. HPV detection in men in the current study was strongly related to sexual behavior and circumcision status. Interventions such as circumcision may provide a low-cost method to reduce HPV infection.
Asunto(s)
Alphapapillomavirus/aislamiento & purificación , Gammapapillomavirus/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/transmisión , Conducta Sexual , Adolescente , Adulto , Anciano , Brasil/epidemiología , Circuncisión Masculina , Condones , Florida/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Infecciones por Papillomavirus/prevención & control , Pene/virología , Factores de Riesgo , Escroto/virología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: To assess Human Papillomavirus (HPV) type distribution among men ages 18 years and older recruited from three different countries utilizing a common protocol for sampling HPV detection, and to evaluate whether HPV detection differs by age and country. MATERIAL AD METHODS: The study protocol includes a pre-enrollment run-in visit, a baseline (enrollment) visit, and nine additional visits after enrollment scheduled six months apart. For this analysis, the first 1160 men who completed both the run-in and baseline visit were included. To maximize sampling and prevent fraying of applicators, three different applicators were utilized to sample the external genitalia of participants among different anatomic sites. These samples were later combined to form a single sample for the detection of HPV using polymerase chain reaction (PCR) for amplification of a fragment of the HPV L1 gene. RESULTS: Among 1160 men from Brazil, Mexico, and the United States (U.S.), overall HPV prevalence was 65.2%; with 12.0% oncogenic types only, 20.7% non-oncogenic types only, 17.8% both oncogenic and non-oncogenic, and 14.7% unclassified infections. Multiple HPV types were detected in 25.7% of study participants. HPV prevalence was higher in Brazil (72.3%) than in the U.S. (61.3%) and Mexico (61.9%). HPV 16 (6.5%), 51 (6.5%), and 59 (5.3%) were the most commonly detected oncogenic infections, and HPV 84 (7.7%), 62 (7.3%), and 6 (6.6%) were the most commonly detected non-oncogenic infections. Overall HPV prevalence was not associated with age. However, significant associations with age were observed when specific categories of oncogenic, non-oncogenic, and unclassified HPV infections were considered. CONCLUSIONS: Studies of HPV type distribution among a broad age range of men from multiple countries is needed to fill the information gap internationally with respect to our knowledge of HPV infection in men.
Asunto(s)
Alphapapillomavirus/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Pene/virología , Escroto/virología , Adolescente , Adulto , Factores de Edad , Anciano , Alphapapillomavirus/clasificación , Brasil/epidemiología , Florida/epidemiología , Estudios de Seguimiento , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Infecciones por Papillomavirus/transmisión , Infecciones por Papillomavirus/virología , Prevalencia , Muestreo , Conducta Sexual , Factores Socioeconómicos , Adulto JovenRESUMEN
OBJECTIVE: To assess Human Papillomavirus (HPV) type distribution among men ages 18 years and older recruited from three different countries utilizing a common protocol for sampling HPV detection, and to evaluate whether HPV detection differs by age and country. MATERIAL AD METHODS: The study protocol includes a pre-enrollment run-in visit, a baseline (enrollment) visit, and nine additional visits after enrollment scheduled six months apart. For this analysis, the first 1160 men who completed both the run-in and baseline visit were included. To maximize sampling and prevent fraying of applicators, three different applicators were utilized to sample the external genitalia of participants among different anatomic sites. These samples were later combined to form a single sample for the detection of HPV using polymerase chain reaction (PCR) for amplification of a fragment of the HPV L1 gene. RESULTS: Among 1160 men from Brazil, Mexico, and the United States (U.S.), overall HPV prevalence was 65.2 percent; with 12.0 percent oncogenic types only, 20.7 percent non-oncogenic types only, 17.8 percent both oncogenic and non-oncogenic, and 14.7 percent unclassified infections. Multiple HPV types were detected in 25.7 percent of study participants. HPV prevalence was higher in Brazil (72.3 percent) than in the U.S. (61.3 percent) and Mexico (61.9 percent). HPV 16 (6.5 percent), 51 (6.5 percent), and 59 (5.3 percent) were the most commonly detected oncogenic infections, and HPV 84 (7.7 percent), 62 (7.3 percent), and 6 (6.6 percent) were the most commonly detected non-oncogenic infections. Overall HPV prevalence was not associated with age. However, significant associations with age were observed when specific categories of oncogenic, non-oncogenic, and unclassified HPV infections were considered. CONCLUSIONS: Studies of HPV type distribution among a broad age range of men from multiple countries is needed to fill the information gap internationally ...
OBJETIVO: Evaluar la distribución tipo específica de infección por Virus del Papiloma Humano (VPH) entre hombres de 18 años o más de tres países con un protocolo común para el muestreo de la detección de VPH, y evaluar si la detección de VPH varía de acuerdo con la edad y el país. MATERIAL Y MÉTODOS: El estudio incluye diversas etapas que inician con la identificación de hombres susceptibles, una medición basal (visita de enrolamiento) y nueve visitas adicionales programadas cada seis meses. En este artículo, se presenta el análisis de los primeros 1160 hombres que fueron incluídos en el estudio. Para maximizar la posibilidad de detección de VPH se utilizó un cepillo de dacrón que muestreó en forma combinada diferentes sitios anatómicos. Para la determinación de ADN de VPH se utilizó ión en cadena de polimerasa (PCR) por amplificación de un fragmento del gen de VPH L1. RESULTADOS: Entre 1160 hombres de Brasil, México y EUA, la prevalencia global de VPH fue de 65.2 por ciento, con solamente 12 por ciento de tipos oncogénicos, 20.7 por ciento de tipos de VPH no oncogénicos, 17.8 por ciento de muestras positivas a tipos oncogénicos y no oncogénicos; y finalmente 14.7 por ciento de infecciones no clasificadas. Múltiples tipos de VPH fueron detectados en 25.7 por ciento de los participantes en el estudio. La prevalencia de VPH fue más alta en Brasil (72.3 por ciento), comparada con la observada en EUA (61.3 por ciento) y México (61.9 por ciento). Los tipos de VPH 16 (6.5 por ciento), 51 (6.5 por ciento) y 59 (5.3 por ciento) fueron los más comúnmente observados con poder oncogénico. El VPH 84 (7.7 por ciento), 62 (7.3 por ciento) y 6 (6.6 por ciento) fueron las infecciones no oncogénicas más comunes. CONCLUSIONES: Son necesarios estudios de la distribución de VPH en un amplio margen de edad entre hombres de múltiples países, para establecer con mayor precisión, el conocimiento de la historia natural de la infección por VPH en hombres.
Asunto(s)
Adolescente , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Alphapapillomavirus/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Pene/virología , Escroto/virología , Factores de Edad , Alphapapillomavirus/clasificación , Brasil/epidemiología , Florida/epidemiología , Estudios de Seguimiento , México/epidemiología , Infecciones por Papillomavirus/transmisión , Infecciones por Papillomavirus/virología , Prevalencia , Muestreo , Conducta Sexual , Factores Socioeconómicos , Adulto JovenRESUMEN
OBJECTIVES: To determine the prevalence of human papillomavirus (HPV) DNA in the male partners of HPV-infected women, assess the concordance of the viral group in the infected pair, define the most affected sites in the male genitalia, and compare diagnostic methods in men. METHODS: Fifty male, stable sexual partners of women positive for HPV DNA by the Hybrid Capture 2 (hc2) test had material brushed from six different anogenital areas for hc2 testing. One week later, patients underwent classic peniscopy, and the lesions were biopsied for histologic analysis and hc2 testing. RESULTS: The brushings were HPV DNA positive in 35 (70%) of the 50 men: 32% in the high-risk HPV group, 14% in the low-risk HPV group, and 24% in both groups. HPV detection per anatomic site was 24% in the glans, 44% in the prepuce internal surface, 30% in the distal urethra, 24% in the prepuce external surface, 12% in the scrotum, and 8% in the anus. Acetowhite lesions were seen in 44 (88%) of the 50 patients. Overall, HPV DNA was detected in 27 (26%) of the 104 biopsy specimens, but histologic examination showed evidence of HPV infection in only 14 (13.5%) of 104 biopsy specimens. In 3 (6%) of 50 patients, hc2 was positive only in the histologic examination. Overall, the prevalence of detectable high-risk HPV DNA among male partners was 60% (30 of 50). CONCLUSIONS: Of the 50 male partners studied, 76% were HPV DNA positive. Histologic examination was an inaccurate method to diagnose HPV DNA infection in men; however, brushings detected HPV in 92.1% of the infected men.