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Int. braz. j. urol ; 38(3): 411-418, May-June 2012. tab
Article in English | LILACS | ID: lil-643041

ABSTRACT

OBJECTIVES: To determine the prevalence of precursor lesions of penile cancer, to establish the concordance of diagnostic techniques (PCR, Hybrid Capture (HC) and peniscopy with acetic acid 5%) in the diagnosis of Human Papilloma Virus (HPV) of the penis of men infected with HIV and to evaluate the influence of the immune status. PATIENTS, METHODS AND RESULTS: 276 men were studied, with a median age of 34.6 years. Prevalence of High Risk HPV, Low Risk HPV and infection with both, according to HC, was 43%, 32% and 22%, respectively. PCR showed 50% of positivity for HPV DNA. Peniscopy was positive in 27% of individuals. Peniscopy showed good specificity and low sensitivity for the detection of penile HPV, and low concordance with PCR. Men with white lesions had a 3.6 higher relative risk of positivity for HPV. The most common clinical lesion observed was vegetation, identified in 29% of patients. PCR and HC techniques showed high sensitivity for HPV DNA and there was an excellent correlation between them. Immunosuppressed individuals with CD4< 200 cells/mm3 had the highest prevalence of pre-malignant lesions that were observed in 10% of the studied individuals. CONCLUSIONS: Peniscopy was important for identification and treatment of subclinical lesions. PCR and HC techniques were sensitive methods for the detection of HPV DNA with high concordance. Severely immunosuppressed individuals showed a higher prevalence of pre-malignant lesions of the penis.


Subject(s)
Adolescent , Adult , Humans , Male , Middle Aged , Young Adult , HIV Infections/epidemiology , Penile Neoplasms , Papillomavirus Infections/diagnosis , Papillomavirus Infections/epidemiology , Precancerous Conditions/diagnosis , Precancerous Conditions/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , DNA Probes, HPV , Endoscopy , Penis , Polymerase Chain Reaction , Prevalence , Reproducibility of Results , Risk Factors , Sensitivity and Specificity , Socioeconomic Factors
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