Prevalence of HPV genitalia and oral infection in an unvaccinated population of MSM-HIV in Northwest Spain / Prevalencia de la infección genital y oral por VPH en población no vacunada de HSH-VIH en el noroeste de España

Introduction: Human papillomavirus (HPV) infection is the most common sexually transmitted infection (STI), and it is a major risk factor for penile, oropharyngeal and anal cancer. HPV anal infection is common in men-whohave-sex-with-men (MSM), especially in patients living with HIV (MSM-HIV). HPV can also be detected in genitalia and oral tissues. The objective of this cross-sectional study is to analyze the prevalence of HPV genital and oral infection in a HIV-MSM cohort. Methods: This cross-sectional study of HPV infection included 107 HIV-MSM subjects recruited in a HIV follow-up unit of Northwest Spain. HPV-vaccinated subjects were excluded. HPV-DNA was detected with Anyplex™ II HPV28 method. Participants completed a questionnaire on lifestyle and sexual behavior. Results: Median age was 43 years (range 35-54 years); 97 patients received antiretroviral treatment (ART); 81 (75.7%) had undetectable HIV-RNA; median CD4-lymphocyte count was 746 cell/mm3; 70 (65.4%) participants had a previous STI. Genitalia HPV-DNA was detected in n=37 (34.6%) subjects and oral HPV-DNA was detected in 26 (24.3%). In 12 (11.2%) patients, HPVDNA was detected in both locations. High risk HPV (hrHPV) genotypes were detected in 24 (22.4%) and 15 (14%) patients in genitalia and oral samplesrespectively. Genitalia HPV-DNA isolation was more common in HIV virologically non-suppressed patients (65.4% vs 24.7%; p<0.001). Conclusions: HPV genitalia and oral infection is common in unvaccinated HIV-MSM patients. Detectable HIV-RNA was associated with higher HPV prevalence in genitalia. High oncogenic risk HPV genotypes were more common in genitalia than in oral cavity. (AU)

Introducción: La infección por el virus del papiloma humano (VPH) es la infección de transmisión sexual (ITS) más común; y es factor de riesgo para el desarrollo de cáncer de pene, orofaringe y ano. La infección por VPH es frecuente en hombres-que-tienen-sexo-con-hombres (HSH), especialmente en pacientes infectados por VIH (HSH-VIH). Asimismo, el VPH puede infectar genitales y cavidad oral. El objetivo de este estudio transversal es estimar la prevalencia de la infección orogenital por VPH en una cohorte HSH-VIH. Métodos: se incluyeron 107 pacientes de una Unidad de VIH del noroeste de España. Los pacientes vacunados fueron excluidos. El material genético del VPH (ADN-VPH) fue detectado mediante Anyplex™-II HPV-28. Los participantes completaron un cuestionario sobre hábitos sexuales. Resultados: la mediana de edad fue 43 años (rango 35-54); 97 pacientes recibían tratamiento antirretroviral (TAR); 81 (75,7%) presentaban carga viral del VIH suprimida, la mediana de linfocitos-CD4 era de 746 células/mm3, 70 (65,4%) habían padecido una ITS. Se detectó VPH en los genitales de 37 (34.6%) sujetos, en la cavidad oral de 26 (24.3%) y en 12 (11,2%) en ambas localizaciones. Se detectaron genotipos de alto riesgo oncogénico (AR-VPH) en 24 (22,4%) y 15 (14%) sujetos en genitales y cavidad oral respectivamente. El aislamiento del VPH fue más común en pacientes virológicamente no-suprimidos (65.4% vs 24.7%). Conclusiones: la infección orogenital por VPH es frecuente en pacientes HSH-VIH no vacunados. La no-supresión virológica del VIH se asoció con mayor prevalencia de infección genital por VPH. La detección de genotipos AR-VPH fue más común en genitales que cavidad oral. (AU)

Correction: Lifestyle factors and oncogenic papillomavirus infection in a high-risk male population.

[This corrects the article DOI: 10.1371/journal.pone.0184492.].

Lifestyle factors and oncogenic papillomavirus infection in a high-risk male population.

BACKGROUND: High risk human papillomavirus (HR-HPV) infection in males is a health issue with implications for HPV-related lesions in their partners. The identification of risk factors for male infection may improve our understanding of HR-HPV transmission and prevention. The aim of this study was to evaluate the relationships between lifestyle, genital warts and HR-HPV infection. The study was focused on men with an increased risk of HR-HPV infection: male sexual partners of women diagnosed with high-grade squamous intraepithelial cervical lesions. METHODS: Men were enrolled and prospectively recruited within the first six months after diagnosis of cervical lesions in their female partners (n = 175, 2013-2016). Epidemiological and sexual behaviour data were obtained. The presence of genital warts was established by visual inspection. Detection and genotyping of HR-HPV infection in genital samples were performed with a Linear Array HPV Genotyping Test. All HR-HPV positive men were offered a follow-up exam at 12 months. SPSS version 19 was used for statistical analysis. RESULTS AND DISCUSSION: The prevalence of HR-HPV infection in men was 45.1% (79/175). Genital warts were observed in 10.3% (18/175) of the subjects. Detection of genital warts (OR 3.5, p = 0.015), smoking habits (OR 2.3, p = 0.006) and sexual debut before 16 years old (OR 2, p = 0.035) were associated with an increased risk for HR-HPV infection (univariate analysis). This association was also observed for genital warts and smoking status in a multivariate analysis. The same genotype was found after one year in 71.4% (20/28) of subjects. CONCLUSIONS: The presence of genital warts and smoking habits seem to be associated with a higher risk of HR-HPV infection in males. Earlier sexual debut may increase this risk. Extensive knowledge of the natural history of HR-HPV infection in males is an absolute requirement for the design and implementation of prevention strategies for the general population as well as for specific populations such as couples after treatment for high-grade cervical lesions.

Prevalence and concordance of high-risk papillomavirus infection in male sexual partners of women diagnosed with high grade cervical lesions / Prevalencia y concordancia de infección por papilomavirus de alto riesgo en las parejas sexuales masculinas de mujeres diagnosticadas de lesiones cervicales de alto grado

BACKGROUND: Little is known about the characteristics of high-risk papillomavirus (HR-HPV) infection in men. The aims of this cross-sectional study were: (a) to investigate HR-HPV prevalence and genotype distribution in men, sexual partners of women presenting with high-grade cervical intraepithelial neoplasia (HG-CIN), according to epidemiological characteristics, and (b) to assess type-specific concordance between partners. METHODS: A total of 125 men were recruited within the first 6 months after HG-CIN diagnosis of their partner. Samples from the coronal sulcus, glans penis shaft, and scrotum were tested with linear array HPV genotyping assay (Roche Diagnostics, Mannheim, Germany). Type-specific concordance within 120 couples was studied. Epidemiological factors were evaluated by multivariate logistic regression analysis. SPSS 19 (IBM, Chicago, USA). RESULTS: The prevalence of HR-HPV infection in males was 50.4% (63/125). HPV16/53/52/51/66/31 were the most frequent genotypes (24/10.4/9.6/8.8/8/7.2%, respectively). Current smoking was associated with an increased risk for HR-HPV infection in men (38.2% (21/55) vs 60% (42/70), OR 2.4, p = 0.025). Among 60 infected couples, 62% shared at least one genotype: 41.7% couples were concordantly HPV16 positive and 18.3% were HPV16 negative (kappa value: 0.21). The proportion of women with the same genotype as their male partner was higher than the proportion of men sharing the same genotype as their female partner: 58.7% (37/63) vs 30.8% (37/120), p < 0.0001. CONCLUSIONS: Sexual partners of women with HG-CIN are a significant reservoir and vector of HPV infection, a fact that could contribute to making viral clearance more difficult to achieve in their partners after treatment of their HG-CIN lesions

INTRODUCCIÓN: Las características de la infección por papilomavirus de alto riesgo (VPH-AR) en el varón apenas se conocen. Los objetivos de este estudio transversal fueron: (a) investigar la prevalencia de VPH-AR y la distribución de genotipos en varón pareja sexual de mujer con neoplasia intraepitelial cervical de alto grado (CIN-AG) y su epidemiología, y (b) evaluar la concordancia tipo-específica entre parejas. MÉTODOS: Se seleccionaron hombres (n=125) en los primeros 6 meses tras el diagnóstico de CIN-AG de su pareja. Se genotiparon muestras del surco coronario, base del glande y escroto (Linear Array, Roche Diagnostics, Mannheim, Alemania). Se estudió la concordancia tipo-específica entre parejas (n=120). Los factores epidemiológicos se evaluaron mediante regresión logística multivariante, SPSS 19 (IBM, Chicago, USA). RESULTADOS: La prevalencia de VPH-AR en el hombre fue del 50,4% (63/125). VPH16/53/52/51/66/31 fueron los genotipos más frecuentes (24/10,4/9,6/8,8/8/7,2%, respectivamente). El tabaquismo se asoció con un mayor riesgo de infección por VPH-AR en el hombre (38,2% [21/55] vs 60% [42/70], OR 2,4, p = 0,025). Entre 60 parejas infectadas, el 62% compartieron al menos un genotipo: el 41,7% fueron concordantes VPH16 positivas y el 18,3% VPH16 negativas (valor kappa: 0,21). La proporción de mujeres con el mismo genotipo que su pareja fue mayor que la de hombres con el mismo genotipo que su pareja: 58,7% (37/63) vs 30,8% (37/120), p < 0,0001. CONCLUSIONES: Las parejas sexuales de mujeres con CIN-AG constituyen un importante reservorio y vector de infección por VPH; esto podría contribuir a que el aclaramiento viral de sus parejas tras el tratamiento de CIN-AG fuese más difícil de alcanzar

Prevalence and concordance of high-risk papillomavirus infection in male sexual partners of women diagnosed with high grade cervical lesions.

BACKGROUND: Little is known about the characteristics of high-risk papillomavirus (HR-HPV) infection in men. The aims of this cross-sectional study were: (a) to investigate HR-HPV prevalence and genotype distribution in men, sexual partners of women presenting with high-grade cervical intraepithelial neoplasia (HG-CIN), according to epidemiological characteristics, and (b) to assess type-specific concordance between partners. METHODS: A total of 125 men were recruited within the first 6 months after HG-CIN diagnosis of their partner. Samples from the coronal sulcus, glans penis shaft, and scrotum were tested with linear array HPV genotyping assay (Roche Diagnostics, Mannheim, Germany). Type-specific concordance within 120 couples was studied. Epidemiological factors were evaluated by multivariate logistic regression analysis. SPSS 19 (IBM, Chicago, USA). RESULTS: The prevalence of HR-HPV infection in males was 50.4% (63/125). HPV16/53/52/51/66/31 were the most frequent genotypes (24/10.4/9.6/8.8/8/7.2%, respectively). Current smoking was associated with an increased risk for HR-HPV infection in men (38.2% (21/55) vs 60% (42/70), OR 2.4, p=0.025). Among 60 infected couples, 62% shared at least one genotype: 41.7% couples were concordantly HPV16 positive and 18.3% were HPV16 negative (kappa value: 0.21). The proportion of women with the same genotype as their male partner was higher than the proportion of men sharing the same genotype as their female partner: 58.7% (37/63) vs 30.8% (37/120), p<0.0001. CONCLUSIONS: Sexual partners of women with HG-CIN are a significant reservoir and vector of HPV infection, a fact that could contribute to making viral clearance more difficult to achieve in their partners after treatment of their HG-CIN lesions.