Chronic pelvic pain syndrome/chronic prostatitis: Is it related to human papillomavirus infection? A case-control study from Eastern India

Abstract

Introduction: Relationship between human papillomavirus infection and chronic prostatitis/chronic pelvic pain syndrome is not clear in the Indian population. The present study evaluated human papillomavirus infection as a risk factor in the development of chronic prostatitis/chronic pelvic pain syndrome. Methods: Patients between the age group of 18 and 50 years, diagnosed with chronic prostatitis/chronic pelvic pain syndrome (Cases) or sexually active asymptomatic men with primary infertility (Controls), were recruited. Recording of the personal and/or family history and National Institute of Health-chronic prostatitis symptom index scoring (pain score, urinary score, and quality-of-life score) was done in all prostatitis patients. Seminal fluids of all study patients were evaluated for genomic sequences of human papillomavirus including oncogenic subtypes human papillomavirus-16 and -18. Results: Study participants were divided in cases (n = 50) and controls (n = 50). The mean age of cases and controls were 30.72 and 32.48 years, respectively. Among the cases, the mean duration of symptoms was 9.98 months and mean total National Institute of Health-chronic prostatitis symptom index scoring score and mean International Prostate Symptom Score were 20.52 and 5.8, respectively. Among cases, 26 (52%) were found positive for human papillomavirus infection compared to only 6 (12%) in control group (risk ratio = 0.43; 95% confidence interval = 0.3–0.62; p < 0.001). Infection with human papillomavirus-16 subtype was significantly associated with patients from cases group (χ2 = 4.17; risk ratio (confidence interval) (0.39–0.59); p = 0.041). Oncogenic human papillomavirus-18 subtype was not found in any of the group. Conclusion: These observations indicate that infection with human papillomavirus (HPV-16 subtype) can be considered as a risk factor for the development of chronic prostatitis/chronic pelvic pain syndrome in Indian males under the age of 50 years.

Chronic Prostatitis: Impact of Lifestyle, Infection, and Inflammation on Semen Parameters

“…However, this infection is widespread in the general population and does not have a substantial effect on male fertility [2]. Although human papillomavirus infection has been reported as a risk factor for developing chronic prostatitis [58], this association was not detected in the present study. K. pneumoniae DNA was detected more frequently in the urine samples of the control group volunteers; this microorganism has been considered microbiota across different anatomic sites, such as the skin and the gastrointestinal tract.…”

Evidence for a causal role by human papillomaviruses in prostate cancer – a systematic review

“…HPV infections may have an indirect role by inhibiting the protective function of APOBEC3B enzymes against other virus infections [80,81]. (viii) There is evidence that high risk HPVs can be associated with inflammatory prostatitis which can lead to benign prostate hyperplasia and later prostate cancer [87][88][89][90][91]. (ix) There is ecological evidence which suggests that HPVs may have causal roles in both prostate and cervical cancer in the same populations.…”

“…There is evidence that high risk HPVs can be associated with inflammatory prostatitis which can lead to benign prostate hyperplasia and later prostate cancer [ 87 – 91 ].…”

“…Based on meta-analyses of 21 studies by Zhang et al, there is a correlation and enhanced risk between prostatitis leading to benign prostate hyperplasia and finally prostate cancer [ 87 ]. Multiple pathogenic organisms including high risk HPVs have been identified in prostatic secretions and semen of patients with prostatitis [ 88 – 91 ]. The biology underlying inflammation and cancer is complex particularly if infectious agents such as HPVs are involved.…”

Does the four-glass test still have a place in microbiological evaluation of chronic prostatitis? Findings from an Indian tertiary care centre

“…Similar findings were also noted by Heras-Canas et al 12 A few studies have investigated the role of atypical micro-organisms such as chlamydia, mycoplasma and human papillomavirus. 16,17 However, the exact role of these is unknown at present. Conducting many of these investigations also requires a polymerase chain reaction (PCR) test, which costly and not readily available everywhere.…”