DISTRIBUTION OF GENITAL HUMAN PAPILLOMAVIRUS IN SICILIAN MEN WITH AND WITHOUT CLINICAL MANIFESTATIONS

Abstract

Introduction: Infection Human Papillomavirus (HPV) is the cause of several disease in men and in women: genital warts, penile and cervical intraepithelial neoplasia, invasive penile carcinoma and cervical cancer. However, less is known about HPV infection and prevalence of HPV types in men. Materials and Methods: 820 genital samples of men (age 19-77; mean age: 36.7 ys) who had come to the Virology laboratory of the Department of Sciences for Health Promotion and Mother and Child Care (Policlinico, University of Palermo, Italy) were examined for HPV infection. The study included men with genital warts, men with atypical genital lesion, partners of HPV-positive women and asymptomatic men for Sexually Transmitted Diseases (STD) diagnostic evaluation. HPV-DNA genotyping was performed by the INNOLiPA HPV Genotyping Extra II Test (Fujirebio) and nested PCR/sequencing method. Results: 461/820 (56.2%) genital samples were HPV positive. The highest HPV detection rate was found in the 25-34 year age group (41.4%), followed by the 35-44 group (31.7%). Oncogenic types were found in 360 (78.1%) samples, alone 228 (63.3%) or with non-oncogenic types 132 (36.7%). Multiple HPV type infections were shown in 225 (48.8%) samples of whom 109 (23.6%) had two genotypes, 58 (12.6%) three genotypes, 38 (8.2%) four genotypes, 15 (3.2%) five genotypes, 3 (0.6%) six genotypes and then only 2 (0.4%) eight genotypes. Thirty-eight different HPV types were identified: the mostly frequent were HPV-16 (19.9% of HPV positive patients), -51 and -6 (18.2%), -31 (13.9%), -66 (13.7%), -53 (11%), -18 (7.6%), -44 (7.1%), -56 (7%), -11 (5.8%), -39 and –52 (5.6%), -54 (5.2%), -58 (5%), -62 (4.5%); other viral types occurred at a frequency of less than 4.0%. Men who have made the HPV test: 138 (16.8%) were diagnosed with genital warts, 3 (0.4%) carcinomas, 413 (50.3%) were HPV-positive women partners, 30 (3.6%) presence of an atypical genital lesion, 236 (28.7%) men who wanted a full assessment of sexual transmitted diseases. HPV infection was evident in 100% men with carcinomas, in 103 (74.6%) men with genital warts, in 254 men (61.5%) partners of HPV-positive women, in 11 (36.6%) men with presence of an atypical genital lesion and in 90 (38.1%) in asymptomatic men. HPV-16 was prevalent in 2 (66.7%) men with carcinoma, in 55 (21.6%) men HPV-positive women partners and in 3 (27.3) men with atypical genital lesion; HPV-6 in 36 (35%) men with genital warts and in 19 (21.1%) asymptomatic men. Discussion and conclusions: this study showed a high prevalence of genital HPV infection in Sicilian men. This information will contribute to elucidating the epidemiology of HPV infection in man, and it will also be helpful in the implementation of future prevention strategies.