J Korean Med Sci.  2016 Mar;31(3):371-375. 10.3346/jkms.2016.31.3.371.

Multiple Human Papillomavirus Infection Is Associated with High-Risk Infection in Male Genital Warts in Ulsan, Korea

• Kwon T
• Moon KH
• Yang SH
• Roh MC
• Lee SH
• Kim JW
• Kim IK
• Roh KH
• Park S

• KMID: 2363496
• DOI: http://doi.org/10.3346/jkms.2016.31.3.371

Abstract

Further understanding of male human papillomavirus (HPV) infection is necessary to prevent infection in men, as well as transmission to women. In our current study, we investigated patterns of HPV infection and genotype distributions in male genital warts using the Anyplex II HPV28 Detection kit. We reviewed the medical records of 80 male patients who presented to 5 neighborhood clinics in Ulsan, Korea, for the treatment of genital warts between April 2014 and January 2015. All patients underwent HPV genotyping. The prevalence and characteristics of HPV infection were analyzed, and the patterns of HPV infection according to age were assessed. Among the study patients, 13 (16.3%) were negative for HPV infection, 46 (57.3%) were infected with low-risk HPV, and 21 (26.3%) were infected with high-risk HPV. Patients with multiple HPV infection were more likely to have high-risk HPV infection (P = 0.001). The prevalence of HPV infection was much higher in samples obtained by tissue excision due to a definite lesion (P = 0.001). There were no differences in high-risk HPV infection (P = 0.459), multiple HPV infection (P = 0.185), and recurrence at diagnosis (P = 0.178) according to age. HPV-6 and HPV-11 were the most common type overall (39.7% and 13.8%, respectively). HPV-16 and HPV-18 were the most common high-risk infections (both 3.4%). HPV infection is not only commonly encountered in male genital warts, but is also accompanied by high-risk HPV and multiple infections.

Keyword

Human Papillomavirus; Oncogenic; Genotype; Human Papillomavirus-6; Human Papillomavirus-11; Condyloma Acuminata; Men, Ulsan

MeSH Terms

Adult
Condylomata Acuminata/epidemiology/*pathology/virology
DNA, Viral/genetics/metabolism
Genotype
Human papillomavirus 11/*genetics/isolation & purification
Human papillomavirus 16/genetics/isolation & purification
Human papillomavirus 18/genetics/isolation & purification
Human papillomavirus 6/*genetics/isolation & purification
Humans
Male
Middle Aged
Prevalence
Real-Time Polymerase Chain Reaction
Republic of Korea/epidemiology
Retrospective Studies
Risk Factors
DNA, Viral

Figure

• 

  Fig. 1 Distribution of HPV genotypes in the current study cohort.

Reference

1. Cogliano V, Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F; WHO International Agency for Research on Cancer. Carcinogenicity of human papillomaviruses. Lancet Oncol. 2005; 6:204.

2. de Sanjosé S, Diaz M, Castellsagué X, Clifford G, Bruni L, Muñoz N, Bosch FX. Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect Dis. 2007; 7:453–459.

3. de Villiers EM, Fauquet C, Broker TR, Bernard HU, zur Hausen H. Classification of papillomaviruses. Virology. 2004; 324:17–27.

4. zur Hausen H. Papillomavirus infections--a major cause of human cancers. Biochim Biophys Acta. 1996; 1288:F55–F78.

5. Sanclemente G, Gill DK. Human papillomavirus molecular biology and pathogenesis. J Eur Acad Dermatol Venereol. 2002; 16:231–240.

6. Trottier H, Mahmud S, Costa MC, Sobrinho JP, Duarte-Franco E, Rohan TE, Ferenczy A, Villa LL, Franco EL. Human papillomavirus infections with multiple types and risk of cervical neoplasia. Cancer Epidemiol Biomarkers Prev. 2006; 15:1274–1280.

7. Bachtiary B, Obermair A, Dreier B, Birner P, Breitenecker G, Knocke TH, Selzer E, Pötter R. Impact of multiple HPV infection on response to treatment and survival in patients receiving radical radiotherapy for cervical cancer. Int J Cancer. 2002; 102:237–243.

8. Paavonen J, Jenkins D, Bosch FX, Naud P, Salmerón J, Wheeler CM, Chow SN, Apter DL, Kitchener HC, Castellsague X, et al. Efficacy of a prophylactic adjuvanted bivalent L1 virus-like-particle vaccine against infection with human papillomavirus types 16 and 18 in young women: an interim analysis of a phase III double-blind, randomised controlled trial. Lancet. 2007; 369:2161–2170.

9. Arbyn M, Castellsagué X, de Sanjosé S, Bruni L, Saraiya M, Bray F, Ferlay J. Worldwide burden of cervical cancer in 2008. Ann Oncol. 2011; 22:2675–2686.

10. Chitale R. Merck hopes to extend gardasil vaccine to men. J Natl Cancer Inst. 2009; 101:222–223.

11. Bush M. HPV vaccine for MSM. Aust Nurs J. 2008; 16:33.

12. Kjaer SK, Munk C, Winther JF, Jørgensen HO, Meijer CJ, van den Brule AJ. Acquisition and persistence of human papillomavirus infection in younger men: a prospective follow-up study among Danish soldiers. Cancer Epidemiol Biomarkers Prev. 2005; 14:1528–1533.

13. Lee EH, Um TH, Chi HS, Hong YJ, Cha YJ. Prevalence and distribution of human papillomavirus infection in Korean women as determined by restriction fragment mass polymorphism assay. J Korean Med Sci. 2012; 27:1091–1097.

14. Dunne EF, Nielson CM, Stone KM, Markowitz LE, Giuliano AR. Prevalence of HPV infection among men: A systematic review of the literature. J Infect Dis. 2006; 194:1044–1057.

15. Shin HR, Franceschi S, Vaccarella S, Roh JW, Ju YH, Oh JK, Kong HJ, Rha SH, Jung SI, Kim JI, et al. Prevalence and determinants of genital infection with papillomavirus, in female and male university students in Busan, South Korea. J Infect Dis. 2004; 190:468–476.

16. Park SJ, Seo J, Ha SH, Jung GW. Prevalence and determinants of high-risk human papillomavirus infection in male genital warts. Korean J Urol. 2014; 55:207–212.

17. Bernard HU, Burk RD, Chen Z, van Doorslaer K, zur Hausen H, de Villiers EM. Classification of papillomaviruses (PVs) based on 189 PV types and proposal of taxonomic amendments. Virology. 2010; 401:70–79.

18. Garland SM, Steben M, Sings HL, James M, Lu S, Railkar R, Barr E, Haupt RM, Joura EA. Natural history of genital warts: analysis of the placebo arm of 2 randomized phase III trials of a quadrivalent human papillomavirus (types 6, 11, 16, and 18) vaccine. J Infect Dis. 2009; 199:805–814.

19. Smith JS, Gilbert PA, Melendy A, Rana RK, Pimenta JM. Age-specific prevalence of human papillomavirus infection in males: a global review. J Adolesc Health. 2011; 48:540–552.

20. Weaver BA, Feng Q, Holmes KK, Kiviat N, Lee SK, Meyer C, Stern M, Koutsky LA. Evaluation of genital sites and sampling techniques for detection of human papillomavirus DNA in men. J Infect Dis. 2004; 189:677–685.

21. Giuliano AR, Nielson CM, Flores R, Dunne EF, Abrahamsen M, Papenfuss MR, Markowitz LE, Smith D, Harris RB. The optimal anatomic sites for sampling heterosexual men for human papillomavirus (HPV) detection: the HPV detection in men study. J Infect Dis. 2007; 196:1146–1152.

22. Estrade C, Sahli R, McAdam AJ. Comparison of Seegene Anyplex II HPV28 with the PGMY-CHUV assay for human papillomavirus genotyping. J Clin Microbiol. 2014; 52:607–612.

23. Kwon MJ, Roh KH, Park H, Woo HY. Comparison of the Anyplex II HPV28 assay with the Hybrid Capture 2 assay for the detection of HPV infection. J Clin Virol. 2014; 59:246–249.

24. Koshiol J, Lindsay L, Pimenta JM, Poole C, Jenkins D, Smith JS. Persistent human papillomavirus infection and cervical neoplasia: a systematic review and meta-analysis. Am J Epidemiol. 2008; 168:123–137.