Racial Differences in the Incidence and Clearance of Human Papilloma Virus (HPV): The HPV in Men (HIM) Study

Abstract

Background This analysis assessed the acquisition (incidence) and persistence (clearance) of HPV infection by self-reported race among men in The HPV in Men (HIM) Study, a multinational prospective study of the natural history of genital HPV infections. Methods Self-reported race was categorized as White, Black, Asian/Pacific Islander (PI), or multiple and mixed race. Genital samples were combined for HPV DNA testing and categorized by any-, oncogenic-, and non-oncogenic HPV infections. Results Asian/PI race had significantly the lowest incidence of any-, oncogenic-, and non-oncogenic HPV infection (P < 0.001). In multivariable analyses Asian/PI race was associated with a lower probability of acquiring any- (HR=0.63; 95% CI 0.42–0.95) and non-oncogenic HPV infection (HR=0.61; 95% CI 0.40–0.93) when compared to Whites. No significant associations were evident for Asian/PI race for clearance. Multiple and mixed race was significantly associated with lower probability of acquiring non-oncogenic HPV infection (HR=0.83; 95% CI 0.69–0.99) and borderline significant associations were observed for any HPV (HR=0.91) and oncogenic infections (HR=0.92). Multiple and mixed race was associated with a lower probability of clearing any- (HR=0.92; 95% CI 0.84–1.00) and oncogenic HPV infections (HR=0.85; 95% CI 0.75–0.95). Conclusion Asian/PI race had the lowest incidence of HPV and exhibited a lower probability of acquiring new HPV infections. Multiple and mixed race had the second lowest incidence of infection and was associated with a lower probability of acquiring and clearing a HPV infection. Impact Race-specific differences in HPV infection could be due to behavior, innate genetic differences, or circulating intratypic HPV variants.

Monitoring for Human Papillomavirus Vaccine Impact Among Gay, Bisexual, and Other Men Who Have Sex With Men—United States, 2012–2014

“…Our study did not identify significant differences in HPV prevalence by race/ethnicity. One analysis of racial differences in HPV incidence and clearance found that Asian/Pacific Islander men had a lower incidence of HPV than white or black men [37]. Additional data are needed on racial disparities in anal HPV and anal cancer prevalence among MSM [38].…”

Pathophysiological basis of human papillomavirus in penile cancer: Key to prevention and delivery of more effective therapies

“…Infant as well as adult medical male circumcision provides partial protection against HPV (with protection varying by HPV genotype) . Consistent with the lower penile cancer incidence among men of Asian descent, a significantly lower burden of genital HPV infection has been observed in this population compared with that in other racial/ethnic groups …”

“…[69][70][71][72][73] Consistent with the lower penile cancer incidence among men of Asian descent, a significantly lower burden of genital HPV CA CANCER J CLIN 2016;66:481-495 VOLUME 66 _ NUMBER 6 _ NOVEMBER/DECEMBER 2016 infection has been observed in this population compared with that in other racial/ethnic groups. 74,75 The rate of progression from genital HPV infection to disease varies by HPV genotype. 76,77 In one study, 26% of men with a genital HPV6 infection progressed to an HPV6-positive condyloma, and 24% of men with a genital HPV11 infection progressed to an HPV11-positive condyloma, with rapid rates of progression to disease after initial genital infection (ie, a median of 7.7 months).…”

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

“…HPV infection prevalence and incidence in men varied by race, with Asian/Pacific Islanders having the lowest rates compared to Blacks and Whites [41, 44, 48]. HR-HPV infection prevalence and incidence were also higher among current smokers [46, 52], and individuals reporting high alcohol intake [55].…”