HPV-related external genital lesions among men residing in Brazil

Abstract

The aims of this study were to determine the incidence of external genital lesions (EGLs), specifically histologically confirmed condyloma (genital warts) and Penile Intraepithelial Neoplasia (PeIN), and genital HPV infection progression to EGLs among healthy men aged 18-73 residing in Brazil. Subjects included 1118 men enrolled in the HPV Infection in Men (HIM) study between July 2005 and June 2009. At each visit, EGLs were biopsied and subjected to pathological evaluation. HPV status in genital swabs and biopsies was determined by Linear Array and INNO-LiPA, respectively. Age-specific EGLs incidence and the proportion and median time to EGL development were estimated. Kaplan-Meier cumulative incidence rates at 6, 12, and 24 months were determined. During follow-up, 73 men developed an incident EGL. Men could develop multiple EGLs and there were 36 men with condyloma, 27 men with lesions suggestive of condyloma, six men with PeIN, and 20 men with non-HPV lesions. HPV-positive men who developed EGLs were younger (p=0.002) than men that did not develop lesions. Among the 815 men with HPV infection, 4% progressed to EGL with the same HPV detected in the swab. During follow up, 15.7% of genital HPV-6 and HPV-11 infections progressed to condyloma (median progression time of nine months for HPV-6 versus 6.8 months for HPV-11). Approximately 1% of HPV-16 infections progressed to PeIN with a median progression time of 25 months. HPV types covered by the 4-valent HPV vaccine were detected in 82.3% and 83.3% of condyloma and PeIN, respectively. The high burden of HPV and high frequency of progression to disease underscores the need to offer HPV prophylactic vaccination to men to reduce the overall burden of infection and diseases caused by HPV.

Sex differences in the prevalence and determinants of HPV-related external genital lesions in young adults: a national cross-sectional survey in Brazil

“…The rate of HPV infection in the participants with EGL (67.79%) was similar to that reported in other studies (72.3% in Brazil, 61.3% in the USA, and 61.9% in Mexico - HIM Study), but lower than the results obtained in Thailand (88.3%), Turkey (75.8%), Colombia (88.9%), China (97.0%) and Ireland (78%) [ 13 , 14 , 33 – 36 ]. The discrepancy between these results could be due to differences in the sampling techniques or methods, misdiagnoses or true differences among the populations.…”

<b> Eletrocauterização de verrugas venéreas: presença de bioaerossóis na fumaça cirúrgica/Eletrocauterization of venerealwarts: presence of bioaerosols in surgical smoke

“…As características sociodemográficas encontradas neste estudo se assemelham aos resultados encontrados em uma coorte brasileira que acompanhou 1.118 homens, com idade inferior a 30 anos, e com maior desenvolvimento de verrugas genitais (12) .…”

Human Papillomavirus and Genital Disease in Men: What We Have Learned from the <b><i>HIM Study</i></b>

“…Men who tested positive for HPV at baseline had nearly 12 times the risk of developing GWs [15], with highest incidence among men aged 18–30 years [67, 69, 72]. GW incidence in Brazil and the United States decreased with age, while the incidence remained constant across the lifespan in Mexico [71].…”

“…HPV-16 infections had a relatively slow rate of progression with 50% of PeIN taking more than 19 months to be detected [20]. There were no differences by country and age for PeIN incidence [71, 72]. …”