Elsevier

Urology

Volume 65, Issue 2, February 2005, Pages 251-255
Urology

Adult urology
Human papillomavirus DNA detection in male sexual partners of women with genital human papillomavirus infection

https://doi.org/10.1016/j.urology.2004.09.031Get rights and content

Abstract

Objectives

To determine the prevalence of human papillomavirus (HPV) DNA in the male partners of HPV-infected women, assess the concordance of the viral group in the infected pair, define the most affected sites in the male genitalia, and compare diagnostic methods in men.

Methods

Fifty male, stable sexual partners of women positive for HPV DNA by the Hybrid Capture 2 (hc2) test had material brushed from six different anogenital areas for hc2 testing. One week later, patients underwent classic peniscopy, and the lesions were biopsied for histologic analysis and hc2 testing.

Results

The brushings were HPV DNA positive in 35 (70%) of the 50 men: 32% in the high-risk HPV group, 14% in the low-risk HPV group, and 24% in both groups. HPV detection per anatomic site was 24% in the glans, 44% in the prepuce internal surface, 30% in the distal urethra, 24% in the prepuce external surface, 12% in the scrotum, and 8% in the anus. Acetowhite lesions were seen in 44 (88%) of the 50 patients. Overall, HPV DNA was detected in 27 (26%) of the 104 biopsy specimens, but histologic examination showed evidence of HPV infection in only 14 (13.5%) of 104 biopsy specimens. In 3 (6%) of 50 patients, hc2 was positive only in the histologic examination. Overall, the prevalence of detectable high-risk HPV DNA among male partners was 60% (30 of 50).

Conclusions

Of the 50 male partners studied, 76% were HPV DNA positive. Histologic examination was an inaccurate method to diagnose HPV DNA infection in men; however, brushings detected HPV in 92.1% of the infected men.

Section snippets

Material and methods

The present cross-sectional study evaluated 50 heterosexual male, stable sexual partners of confirmed HPV-infected women seen at the outpatient unit of pathology of the lower genital tract at the university hospital using the Hybrid Capture 2 (hc2; Digene). The study was conducted between September 1997 and May 2000. All patients provided written informed consent, and the institutional review board approved the study. A stable relationship was defined as a duration of longer than 6 months,

Results

The mean age of the 50 men was 31 years (range 19 to 53 years). On average, the current sexual relationship lasted for 71 months (range 6 to 360 months). The mean age at first sexual intercourse was 14.9 years (range 12 to 19 years). On average, couples reported sexual intercourse three times per week (range one to seven). A previous episode of a sexually transmitted disease was reported by 11 (22.4%) of 49 men and regular condom use by 9 (18.4%) of 49. Of the 50 men, 20 (40%) reported sexual

Comment

The results of this study have demonstrated that the best strategy to diagnose HPV infection in men is HPV DNA testing. In that regard, HPV DNA positivity in brushed material was greater than in biopsy fragments of the same affected area. Although the prepuce internal surface was the penile area where HPV DNA was most frequently detected, collecting from the urethra contributed significantly to HPV detection. The HPV group (high-risk or low-risk) of the female partner did not predict the male

Conclusions

Although examination of the male partners of women with identified HPV infections is of unclear value, our data underscored the role of HPV DNA tests. Brushed material collected from the distal urethra, in addition to the external surface of the penis, seems to be the optimal approach for diagnosing HPV infection in men.

Acknowledgment

To Cristiane Gallo and Eliane Taromaru who worked at Digene of Brazil at the time of the study and processed all the Hybrid Capture tests.

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    This study was partially supported by the Digene Corporation-USA.

    G. B. das Dores and A. Lorincz hold stock in the sponsor.

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