Risk factors for the acquisition of genital warts: are condoms protective?

Wen, Lizhang; Estcourt, Claudia; Simpson, Judy M.; Mindel, Adrian

doi:10.1136/sti.75.5.312

Cited by 92 publications

(67 citation statements)

References 18 publications

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“…Only a few studies were performed in men and reported that consistent condom use reduced the risk for genital warts or subclinical HPV infection (Hippelainen M et al, 1993a;Wen et al, 1999). Of interest is the work of Hippelainen MI et al (1994) who found that condom use had a positive effect on the cure rate of genital HPV lesions in male partners of HPV-infected women.…”

Section: Discussionmentioning

confidence: 99%

HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions

et al. 2005

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We earlier demonstrated, in a randomised clinical trial, that the regression time of flat penile lsions in male sexual partners of women with cervical intraepithelial neoplasia (CIN) was shorter in men who used condoms compared to those who did not. To further evaluate this finding, we examined whether the effect of condom use on the regression of flat penile lesions depends on the presence of human papillomavirus (HPV) type concordance in sexual couples, as determined in cervical and penile scrapes by GP5 þ /6 þ PCR testing. A Cox model with time-dependent covariates showed a beneficial effect of condoms on regression of flat penile lesions in concordant couples (hazard ratio 2.63, 95% CI 1.07 -6.48) but not in those who were nonconcordant. When both partners harboured different HPV types, no effect of condoms was found (hazard ratio 0.90, 95% CI 0.27 -2.96). Delayed regression of flat penile lesions was associated with either stable lesions or with new penile lesions developing at sites surrounding pre-existing lesions suggesting reinfection of the penile epithelium. We conclude that condom use blocks sexual HPV transmission by preventing reinfection and development of new penile lesions in men who are susceptible to the same type as present in the female partner. Infection with high-risk types of human papillomavirus (HPV) is the major cause of cervical cancer and its precursor lesions (Schiffman et al, 1993;Walboomers et al, 1999;Bosch et al, 2002;Munoz et al, 2003). Human papillomavirus has also been linked to cancers of the vulva, vagina, anus, and penis (IARC 1995;Melbye and Frisch, 1998). Genital HPV types are transmitted sexually and the risk of infection has been associated with numerous parameters involving sexual behaviour (Franco et al, 1995;Bosch et al, 1996;Kjaer et al, 2001).Partner studies have shown that penile lesions are found in more than half of the male partners of women with cervical intraepithelial neoplasia (CIN) (Barrasso et al, 1987;Campion et al, 1988;Hippelainen M et al, 1991;Bleeker et al, 2002). Flat lesions are reported as the most prevalent lesion type and their relationship with HPV has been established (Barrasso et al, 1987;Campion et al, 1988;Hippelainen M et al, 1991;Hippelainen MI et al, 1993b;Bleeker et al, 2002). Since flat penile lesions are only well visible after acetowhitening, their presence remains often unnoticed. This explains why the natural history of penile lesions and HPV infection in men has not been studied extensively and is largely unknown.We have recently shown that the presence of penile HPV is associated with delayed regression whereas condom use revealed accelerated regression . The beneficial effect of condom intervention on regression of penile lesions suggests that a sexual transmittable factor, that is, most likely cervical HPV, influences the clinical course of these lesions. To evaluate this hypothesis, the effect of condom use on regression of flat penile lesions was studied in relation to the presence of HPV type concordance between sexual part...

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Section: Discussionmentioning

confidence: 99%

HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions

et al. 2005

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“…This presumably implies different transmission modes and dynamics for HPV-6, HPV-11 and HPV-16 infections. HPV-16 is predominantly transmitted by mucosal contacts, while HPV-6 and HPV-11 are also transmitted via the skin (Wen et al, 1999). Finally, possible competitive advantages favouring the spread of HPV-16 over HPV-6 and HPV-11 or chance cannot be ruled out as explanations for the observed differences between the oncogenic and non-oncogenic HPV types.…”

mentioning

confidence: 99%

Time trends in incidence and prevalence of human papillomavirus type 6, 11 and 16 infections in Finland

Laukkanen

Koskela

Pukkala

et al. 2003

Journal of General Virology

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Human papillomavirus (HPV) type 16 is the major cause of cervical carcinoma, the incidence of which is decreasing in western countries. In Finland the incidence is, however, increasing in women aged <40 years, but possible underlying changes in HPV-16 epidemiology are unknown. To assess incidence trends of HPV infections, paired sera from a random sample of 8000 women with two pregnancies/sera within 5 years, taken from the serum bank of the Finnish Maternity Cohort (1983-98), were analysed for HPV-6, -11 and -16 antibodies. For 23-31-year-old women, HPV-16 incidence increased over the period 1983-97. HPV-16 seroprevalence increased from 17 % in 1983-85 to 24 % in 1995-97, but HPV-6 and HPV-11 prevalence was stable at 9-12 % throughout the study period. Epidemic spread of the oncogenic HPV-16, but not the nononcogenic HPV-types, throughout the 1980s and 1990s preceded an increase in the incidence of cervical carcinoma in fertile-aged Finnish women.

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“…89 Overall, condoms appear to offer minimal protection against incident infection with HPV but greater protection against progression to disease (warts or intraepithelial lesions). [89][90][91] Two studies have shown more rapid resolution of clinically defined HPV lesions in both males and females with consistent condom use, 92,93 and Shew et al 94 found reduced duration of infection with condom use in women. Thus, if condoms reduce the time taken for resolution of HPVassociated lesions, they may also indirectly reduce onward transmission.…”

Section: Are Circumcision and Condoms Protective Against Infection?mentioning

confidence: 99%

Unresolved questions concerning human papillomavirus infection and transmission: a modelling perspective

2010

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Abstract. Mathematical transmission models are widely used to forecast the potential impact of interventions such as vaccination and to inform the development of health policy. Effective vaccines are now available for the prevention of cervical cancer and other diseases attributable to human papillomavirus (HPV). Considerable uncertainties remain regarding the characterisation of HPV infection and its sequelae, infectivity, and both vaccine-conferred and naturallyacquired immunity. In this review, we discuss the key knowledge gaps that impact on our ability to develop accurate models of HPV transmission and vaccination.

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Risk factors for the acquisition of genital warts: are condoms protective?

Cited by 92 publications

References 18 publications

HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions

HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions

Time trends in incidence and prevalence of human papillomavirus type 6, 11 and 16 infections in Finland

Unresolved questions concerning human papillomavirus infection and transmission: a modelling perspective

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