RESUMEN
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was firstly identified in China and has been declared a global pandemic. Several serious extrapulmonary manifestations due to SARS-CoV-2 infection have also been reported and associated with hypercoagulability thrombotic vasculopathy. In addition, cases of Mycobacterium-leprae infection have also been known associated with blood coagulation abnormality. Methods: Here, we report a 56-year-old male with coronavirus disease-19 (COVID-19) with concomitant leprosy infection with manifestation of glans penile necrosis, presented to the emergency department with acute penile pain. This case is unique because no occlusion blood flow to the penile was observed in the radiographic imaging. We described the potential pathophysiology in this case through a literature review. Results: The patient received treatment according to the COVID-19 protocol and was given low molecular weight heparin (LMWH) therapy for 4 days. During the follow up, the clinical and functional condition of the penis showed significant improvement. Conclusions: Microthrombus involvement, platelet abnormalities and impaired hemostasis due to SARS-CoV-2 and leprosy co-infection are the hypothesis in this case report.
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COVID-19 , Lepra , Necrosis , Pene , SARS-CoV-2 , Humanos , Masculino , COVID-19/complicaciones , Persona de Mediana Edad , Pene/patología , Pene/irrigación sanguínea , Lepra/complicaciones , Lepra/patología , Lepra/tratamiento farmacológico , Coinfección , Enfermedades del Pene/patología , Enfermedades del Pene/tratamiento farmacológico , Enfermedades del Pene/virología , Enfermedades del Pene/complicaciones , Heparina de Bajo-Peso-Molecular/uso terapéuticoRESUMEN
BACKGROUND: Male circumcision reduces the risk of human immunodeficiency virus infection in men. We assessed the effect of male circumcision on the incidence and natural history of human papillomavirus (HPV) in a randomized clinical trial in Kisumu, Kenya. METHODS: Sexually active, 18- to 24-year-old men provided penile exfoliated cells for HPV DNA testing every 6 months for 2 years. HPV DNA was detected via GP5+/6+ PCR in glans/coronal sulcus and in shaft samples. HPV incidence and persistence were assessed by intent-to-treat analyses. RESULTS: A total of 2,193 men participated (1,096 randomized to circumcision; 1,097 controls). HPV prevalence was 50% at baseline for both groups and dropped to 23.7% at 24 months in the circumcision group, and 41.0% in control group. Incident infection of any HPV type over 24 months was lower among men in the circumcision group than in the control group [HR = 0.61; 95% confidence interval (CI), 0.52-0.72]. Clearance rate of any HPV infection over 24 months was higher in the circumcision group than in the control group (HR = 1.87; 95% CI, 1.49-2.34). Lower HPV point-prevalence, lower HPV incidence, and higher HPV clearance in the circumcision group were observed in glans but not in shaft samples. CONCLUSION: Male circumcision reduced the risk of HPV acquisition and reinfection, and increased HPV clearance in the glans. IMPACT: Providing voluntary, safe, and affordable male circumcision should help reduce HPV infections in men, and consequently, HPV-associated disease in their partners.
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Circuncisión Masculina/estadística & datos numéricos , Infecciones por Papillomavirus/epidemiología , Enfermedades del Pene/epidemiología , Pene/virología , Infección Persistente/epidemiología , Adolescente , Alphapapillomavirus/genética , Alphapapillomavirus/aislamiento & purificación , ADN Viral/aislamiento & purificación , Humanos , Incidencia , Análisis de Intención de Tratar , Kenia , Masculino , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/virología , Enfermedades del Pene/diagnóstico , Enfermedades del Pene/prevención & control , Enfermedades del Pene/virología , Pene/cirugía , Infección Persistente/diagnóstico , Infección Persistente/prevención & control , Infección Persistente/virología , Resultado del Tratamiento , Adulto JovenAsunto(s)
Carcinoma Verrugoso/patología , Carcinoma Verrugoso/virología , Condiloma Acuminado/complicaciones , Quistes/patología , Quistes/virología , Papillomavirus Humano 6 , Enfermedades del Pene/patología , Enfermedades del Pene/virología , Adulto , Condiloma Acuminado/virología , Papillomavirus Humano 6/aislamiento & purificación , Papillomavirus Humano 6/patogenicidad , Humanos , MasculinoRESUMEN
BACKGROUND: Human papillomavirus (HPV) is a common sexually transmitted pathogen and the cause of several cancers and of anogenital warts. With this study, we estimated the trend of hospitalizations for anogenital warts (AGWs) in the Veneto region (Italy) from 2007 to 2018. METHODS: The analysis included all the hospital discharge records of public and accredited private hospitals occurred in Veneto residents in the timespan 2007-2018. The ICD9-CM code 078.11 considered were those associated with condyloma acuminatum and those associated with surgical interventions for vulval/vaginal warts, penile warts anal warts. Annual total and sex- and age-specific hospitalization rates and trends were calculated and correlated with the different HPV vaccine coverage over the study period. RESULTS: We observed an overall reduction of hospitalization rates for AGWs: from 15.0 hospitalizations every 100,000 Veneto residents in years 2007-08 to 10.9 hospitalizations every 100,000 Veneto residents in year 2017-18 (- 37.4%; p < 0.05). Reduction has been caused by a drop in hospitalizations in females - from a rate of 20.4/100,000 in 2007-2008 to a rate of 10.8/100,000 in 2017-18 (AAPC: -7.1; 95%CI: - 10.6;-3.4); while in males, we observed a slight - but not statistically significant - increase in hospitalization rates. CONCLUSION: The marked decline in hospitalization rates for AGWs in Veneto Region is probably attributable to the high coverage rates of HPV vaccination programs implemented since 2008.
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Enfermedades del Ano/prevención & control , Condiloma Acuminado/prevención & control , Hospitalización/tendencias , Papillomaviridae/inmunología , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/inmunología , Enfermedades del Pene/prevención & control , Enfermedades Virales de Transmisión Sexual/prevención & control , Vacunación , Enfermedades Vaginales/prevención & control , Enfermedades de la Vulva/prevención & control , Adolescente , Adulto , Enfermedades del Ano/virología , Niño , Preescolar , Estudios de Cohortes , Condiloma Acuminado/epidemiología , Condiloma Acuminado/virología , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Italia/epidemiología , Masculino , Persona de Mediana Edad , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Enfermedades del Pene/virología , Enfermedades Virales de Transmisión Sexual/epidemiología , Enfermedades Vaginales/virología , Enfermedades de la Vulva/virología , Adulto JovenRESUMEN
BACKGROUND: Men who have sex with men (MSM) have a high prevalence of anal and penile human papillomavirus (HPV) infections with MSM living with HIV (MSMLH) bearing the highest rates. Data on anogenital high-risk HPV (hrHPV) among MSM in Rwanda and the associated risk factors are scant. METHODS: We recruited 350 self-identified MSM aged 18 years living in Kigali, Rwanda, with 300 recruited from the community and 50 from partner clinics. Anal and penile specimens from all participants were analyzed for hrHPV using the AmpFire platform. Logistic regression was used to calculate crude odds ratios (ORs) and adjusted ORs (aORs) with 95% confidence intervals (95% CIs) as a measure of association between various factors and anal and penile hrHPV infection prevalence. RESULTS: Anal hrHPV prevalence was 20.1%, was positively associated with having receptive anal sex with more partners (aOR: 9.21, 95% CI: 3.66 to 23.14), and was negatively associated with having insertive anal sex with more partners (aOR: 0.28, 95% CI: 0.12 to 0.66). Penile hrHPV prevalence was 35.0%, was negatively associated with having receptive anal sex with more partners (aOR: 0.29, 95% CI: 0.13 to 0.66), and differed significantly by HIV status, with 55.2% and 29.7% for MSMLH and HIV-negative MSM, respectively (P < 0.01). CONCLUSION: Penile hrHPV prevalence was higher than that of anal hrHPV and it was significantly higher in Rwandan MSMLH than in HIV-negative MSM. The prevalence of anal and penile HPV infections is likely variable at different locations in Africa, according to a number of factors including HIV status and sexual practices.
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Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Papillomaviridae , Infecciones por Papillomavirus/epidemiología , Adolescente , Adulto , Enfermedades del Ano/virología , Coinfección , Humanos , Masculino , Enfermedades del Pene/virología , Pene/virología , Prevalencia , Rwanda/epidemiología , Población Urbana , Adulto JovenRESUMEN
BACKGROUND: Flat penile lesions (FPL) in heterosexual men are thought to play a role in the transmission of HPV. We investigated the association between FPL and penile HPV, and explored determinants of FPL in men who have sex with men (MSM). METHODS: In 2015-2016, MSM were recruited based on HIV and penile HPV status in a previous cohort. MSM self-completed a questionnaire. Peniscopy was performed after application of acetic acid to visualize FPL. Penile physician-collected samples were tested for HPV-DNA using the highly sensitive SPF10-PCR DEIA/LiPA25 system. HPV viral load (VL) was determined using a quantitative type-specific (q)PCR targeting the L1-region. Presence of HPV and HIV, HPV VL and circumcision status were compared between MSM with and without FPL. RESULTS: We included 116 MSM, of whom 59/116 (51%) MSM were HIV-positive and 54/116 (47%) had FPL. A penile HPV infection was present in 31/54 (57%) MSM with FPL and 34/62 (55%) MSM without FPL (pâ¯=â¯0.8). There was no difference between MSM with and without FPL regarding presence of penile HPV infection, HPV VL, HIV status or circumcision status (pâ¯>â¯0.05 for all). CONCLUSION: Among MSM in Amsterdam, we found no association between FPL and penile HPV, HPV VL, HIV status or circumcision status.
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Homosexualidad Masculina , Papillomaviridae , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/patología , Enfermedades del Pene/epidemiología , Enfermedades del Pene/patología , Pene/patología , Pene/virología , Adulto , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Papillomaviridae/clasificación , Papillomaviridae/genética , Infecciones por Papillomavirus/diagnóstico , Enfermedades del Pene/diagnóstico , Enfermedades del Pene/virología , Vigilancia en Salud Pública , Carga ViralRESUMEN
OBJECTIVES: We examined the association between anogenital human papillomavirus (HPV) infection and sexual networks in men who have sex with men (MSM). METHODS: A total of 253 MSM, 20 years of age and older, were recruited from the community in Southern Taiwan in 2015-2016. At baseline and at each follow-up visit, MSM were screened for HPV to identify 37 HPV genotypes. At the six-month follow-up, MSM were asked to fill out an egocentric network assessment and to report the last five persons with whom they had sex regarding the characteristics of sexual behavior with each network member. RESULTS: A total of 182 participants (71.9%) returned for the follow-up and one third had at least one HPV type detected. A higher level of bridging network position calculated by the level of constraints in the network was significantly less likely to have HPV detection at the anal site. A high level of concurrency was associated with penile HPV detection (AOR = 3.16, 95% CI = 1.01-9.86). CONCLUSIONS: Identifying network-related characteristics can advance our understanding of high-risk populations and for prioritizing HPV vaccine recommendations.
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Enfermedades del Ano , Genotipo , Homosexualidad Masculina , Papillomaviridae/genética , Infecciones por Papillomavirus/genética , Enfermedades del Pene , Enfermedades de Transmisión Sexual/genética , Adulto , Enfermedades del Ano/genética , Enfermedades del Ano/virología , Estudios de Seguimiento , Humanos , Masculino , Infecciones por Papillomavirus/virología , Enfermedades del Pene/genética , Enfermedades del Pene/virología , Enfermedades de Transmisión Sexual/virología , TaiwánRESUMEN
Six novel human papillomaviruses from penile swabs were characterised. Multiple full genome clones for each novel type were generated, and complete genome sizes were: HPV211 (7253bp), HPV212 (7208bp), HPV213 (7096bp), HPV214 (7357), HPV215 (7186bp) and HPV216 (7233bp). Phylogenetically the novel papillomaviruses all clustered with Gammapapillomaviruses: HPV211 is most closely related to HPV168 (72% identity in the L1 nucleotide sequence) of the Gamma-8 species, HPV212 is most closely related to HPV144 (82.9%) of the Gamma-17 species, HPV213 is most closely related to HPV153 (71.8%) of the Gamma-13 species, HPV214 is most closely related to HPV103 (75.3%) of the Gamma-6 species, HPV215 and HPV216 are most closely related to HPV129 (76.8% and 79.2% respectively) of the Gamma-9 species. The novel HPV types demonstrated the classical genomic organisation of Gammapapillomavirusess, with seven open reading frames (ORFs) encoding five early (E1, E2, E4, E6 and E7) and two late (L1 and L2) proteins. Typical of Gammapapillomavirusess the novel types all lacked the E5 ORF and HPV214 also lacked the E6 ORF. HPV212 had nine unique variants, HPV213 had five and HPV215 had four variants. Conserved domains observed among the novel types are the Zinc finger Binding Domain and PDZ domains. A retinoblastoma binding domain (pRB) binding domain in E7 protein was additionally identified in HPV214. This study expands the knowledge of the rapidly growing Gammapapillomavirus genus.
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Gammapapillomavirus/clasificación , Gammapapillomavirus/aislamiento & purificación , Genotipo , Infecciones por Papillomavirus/virología , Enfermedades del Pene/virología , Adulto , Análisis por Conglomerados , Femenino , Gammapapillomavirus/genética , Variación Genética , Genoma Viral , Humanos , Masculino , Persona de Mediana Edad , Filogenia , Análisis de Secuencia de ADN , SudáfricaRESUMEN
Human papillomavirus (HPV) infection is highly prevalent in the sexually active population. This study estimates the prevalence of HPV DNA in anal and oral samples from a cohort of men and women with incident anogenital warts. Anal and/or oral samples from 541 patients with anogenital warts were tested for 35 HPV genotypes using a PCR assay. The overall prevalence of anal HPV and oral HPV DNA was 59.9% (n = 305/509; 95% confidence interval (CI) 55.6-64.1%) and 14.5% (n = 78/538; 95% CI 11.8-17.7%), respectively. Among patients with perianal warts, the anal HPV DNA prevalence was 92.3% (95% CI 87.0-95.5%). Anal HPV DNA prevalence in patients with genital warts but no perianal warts was 55.7% (95% CI 50.6-60.7%). Both anal and oral HPV infections were more common in men who have sex with men than in heterosexual men (90.4% versus 38.5% and 20.8% versus 11.8%, respectively). Anal high risk-HPV infection was more common in women (58.8%) and in men who have sex with men (67.7%). We found that anogenital warts represent a clinical marker for both anal and oral HPV infections, including anal high risk-HPV infections, particularly among women and men who have sex with men.
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Enfermedades del Ano/epidemiología , Condiloma Acuminado/epidemiología , ADN Viral/análisis , Enfermedades de la Boca/epidemiología , Papillomaviridae , Adulto , Canal Anal/virología , Enfermedades del Ano/virología , Condiloma Acuminado/virología , Femenino , Genotipo , Heterosexualidad , Homosexualidad Masculina , Humanos , Masculino , Enfermedades de la Boca/virología , Mucosa Bucal/virología , Papillomaviridae/genética , Enfermedades del Pene/virología , Portugal/epidemiología , Prevalencia , Enfermedades de la Vulva/virologíaAsunto(s)
Infecciones por Virus de Epstein-Barr/patología , Trastornos Linfoproliferativos/patología , Enfermedades del Pene/patología , Úlcera Cutánea/patología , Anciano , Infecciones por Virus de Epstein-Barr/diagnóstico , Herpesvirus Humano 4 , Humanos , Trastornos Linfoproliferativos/diagnóstico , Masculino , Enfermedades del Pene/diagnóstico , Enfermedades del Pene/virología , Úlcera Cutánea/diagnóstico , Úlcera Cutánea/virologíaRESUMEN
Bovine herpesvirus-1 (BHV-1) causes infectious bovine rhinotracheitis (IBR), and infectious pustular vulvovaginitis (IPV) in cows and infectious pustular balanopostitis (IPB) in bulls worldwide. Infection of seronegative cattle with BHV-1 leads to abortion, retention of fetal membranes, increased service per conception, metritis and oophoritis. As part of an ongoing study on infectious causes of reproductive disorders in Ethiopia, this investigation aims at assessing the role of BHV-1 in the disorders and the risk factors affecting its seroprevalence. A cross-sectional study was conducted on a total of 1379 randomly selected dairy cattle from 149 herds. These dairy cattle were sampled from milks sheds of central (nâ¯=â¯555), western (nâ¯=â¯195) and southern (nâ¯=â¯629) Ethiopia. Blocking enzyme-linked immunosorbent assay (B-ELISA) was applied to detect antibodies specific to BHV-1. Additionally, a semi-structured questionnaire was administered and farm records were assessed to capture potential risk factors associated with BHV-1 seropositivity. Univariable and multivariable random-effects logistic regression analyses were used to assess potential risk factors associated with BHV-1 serostatus. Model fitness and reliability were assessed using the Hosmer and Lemeshow method and the receiver operating curve (ROC) respectively. An overall herd level BHV-1 seroprevalence of 81.8% (95% confidence interval (CI): 74.7-87.7%) and individual animal level seroprevalence of 41.0% (95% CI: 38.4-43.7%) were found. In a random-effects multivariable logistic regression model, the seroprevalence of BHV-1 exposure was higher in dairy cattle from breeding (Odds ratio [OR]â¯=â¯1.3; pâ¯=â¯0.036) than in commercial (ORâ¯=â¯0.9; pâ¯=â¯0.137) and small-holder farms. Geographically, the prevalence was higher in western (ORâ¯=â¯1.4; pâ¯<â¯0.001) and southern Ethiopia (ORâ¯=â¯1.2; pâ¯<â¯0.001) than in central regions. BHV-1 seropositive cows had higher (pâ¯<â¯0.05) odds of clinical reproductive disorders including abortion, retained fetal membranes, stillbirth, birth of weak calf and metritis compared to seronegative cows. Thus, it is suggested that BHV-1 should be considered as differential diagnosis among improved dairy cattle herds with reproductive disorders in Ethiopia.
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Herpesvirus Bovino 1/aislamiento & purificación , Rinotraqueítis Infecciosa Bovina/epidemiología , Enfermedades del Pene/veterinaria , Vulvovaginitis/veterinaria , Animales , Bovinos , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática , Etiopía/epidemiología , Femenino , Rinotraqueítis Infecciosa Bovina/virología , Masculino , Enfermedades del Pene/epidemiología , Enfermedades del Pene/virología , Prevalencia , Factores de Riesgo , Estudios Seroepidemiológicos , Vulvovaginitis/epidemiología , Vulvovaginitis/virologíaAsunto(s)
Herpesvirus Humano 3/aislamiento & purificación , Enfermedades del Pene/virología , Pene/virología , Enfermedades Cutáneas Virales/virología , Piel/virología , Infección por el Virus de la Varicela-Zóster/virología , Anciano , Antivirales/uso terapéutico , Biopsia , Diagnóstico Diferencial , Herpesvirus Humano 3/efectos de los fármacos , Humanos , Masculino , Enfermedades del Pene/tratamiento farmacológico , Enfermedades del Pene/patología , Pene/efectos de los fármacos , Pene/patología , Valor Predictivo de las Pruebas , Piel/efectos de los fármacos , Piel/patología , Enfermedades Cutáneas Virales/tratamiento farmacológico , Enfermedades Cutáneas Virales/patología , Resultado del Tratamiento , Infección por el Virus de la Varicela-Zóster/tratamiento farmacológico , Infección por el Virus de la Varicela-Zóster/patologíaAsunto(s)
Infecciones por VIH/diagnóstico , VIH-1 , Enfermedades del Pene/virología , Úlcera Cutánea/virología , Aciclovir/análogos & derivados , Aciclovir/uso terapéutico , Fármacos Anti-VIH/uso terapéutico , Antivirales/uso terapéutico , Enfermedad Crónica , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Enfermedades del Pene/tratamiento farmacológico , Valaciclovir , Valina/análogos & derivados , Valina/uso terapéutico , Adulto JovenRESUMEN
Abstract The aims of this study were to determine the incidence of external genital lesions (EGLs), specifically histologically confirmed condyloma (genital warts) and Penile Intraepithelial Neoplasia (PeIN), and genital HPV infection progression to EGLs among healthy men aged 18-73 residing in Brazil. Subjects included 1118 men enrolled in the HPV Infection in Men (HIM) study between July 2005 and June 2009. At each visit, EGLs were biopsied and subjected to pathological evaluation. HPV status in genital swabs and biopsies was determined by Linear Array and INNO-LiPA, respectively. Age-specific EGLs incidence and the proportion and median time to EGL development were estimated. Kaplan-Meier cumulative incidence rates at 6, 12, and 24 months were determined. During follow-up, 73 men developed an incident EGL. Men could develop multiple EGLs and there were 36 men with condyloma, 27 men with lesions suggestive of condyloma, six men with PeIN, and 20 men with non-HPV lesions. HPV-positive men who developed EGLs were younger (p = 0.002) than men that did not develop lesions. Among the 815 men with HPV infection, 4% progressed to EGL with the same HPV detected in the swab. During follow up, 15.7% of genital HPV-6 and HPV-11 infections progressed to condyloma (median progression time of nine months for HPV-6 versus 6.8 months for HPV-11). Approximately 1% of HPV-16 infections progressed to PeIN with a median progression time of 25 months. HPV types covered by the 4-valent HPV vaccine were detected in 82.3% and 83.3% of condyloma and PeIN, respectively. The high burden of HPV and high frequency of progression to disease underscores the need to offer HPV prophylactic vaccination to men to reduce the overall burden of infection and diseases caused by HPV.
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Humanos , Masculino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Papillomaviridae/genética , Enfermedades del Pene/epidemiología , Condiloma Acuminado/epidemiología , Papillomaviridae/clasificación , Enfermedades del Pene/diagnóstico , Enfermedades del Pene/virología , Brasil/epidemiología , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/virología , Incidencia , Progresión de la Enfermedad , GenotipoRESUMEN
BACKGROUND: The clinical morphology of anogenital warts may vary from flat, filiform, papular, or verrucous to giant condyloma acuminatum. Clinically atypical-looking genital warts may alarm the clinician because of their suspected malignant potential, which may cause anxiety, often leading to aggressive interventions. OBJECTIVE: To study if clinically atypical-looking anogenital warts are more likely to be premalignant or malignant as compared to typical warts. METHOD: Data of 41 (37 males, 4 females) patients with anogenital warts was retrospectively analyzed. After a detailed literature review and in-house discussions, criteria for anogenital warts with typical and atypical clinical morphology were defined. Clinical photographs were independently reviewed by three dermatologists, and human papillomavirus (HPV) genotyping results, histological evaluation, and immunohistochemical analysis for p53 expression were evaluated. RESULTS: Fifteen (36.6%) anogenital warts were classified as atypical by at least two of three blinded dermatologists. The histological examination showed mitotic figures in 31/41 (75.6%) specimens, dysplasia in 14/41 (44.1%) specimens, and p53 positivity in 34/41 (82.9%) specimens. There was no significant difference in the high-risk HPV genotyping (P = 0.67), frequency of dysplastic changes on histology (P = 0.19), and immunohistochemistry with p53 (P = 0.08) between clinically typical and atypical-appearing anogenital warts. Similarly, no significant difference was found in the frequency of dysplastic changes (P = 0.67) or p53 expressions (P =0.41) based on the HPV genotypes. CONCLUSIONS: The atypical clinical morphology of anogenital warts may not be a marker of increased malignant potential. High-risk HPV genotypes do not have a statistically significant association with dysplasia or positive immunohistochemistry with p53.
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Condiloma Acuminado/patología , Papillomaviridae/genética , Lesiones Precancerosas/patología , Proteína p53 Supresora de Tumor/metabolismo , Adolescente , Adulto , Anciano , Enfermedades del Ano/metabolismo , Enfermedades del Ano/patología , Enfermedades del Ano/virología , Biomarcadores , Coinfección/virología , Condiloma Acuminado/metabolismo , Condiloma Acuminado/virología , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Enfermedades del Pene/patología , Enfermedades del Pene/virología , Perineo , Fotograbar , Lesiones Precancerosas/metabolismo , Lesiones Precancerosas/virología , Estudios Retrospectivos , Método Simple Ciego , Enfermedades de la Vulva/metabolismo , Enfermedades de la Vulva/patología , Enfermedades de la Vulva/virología , Adulto JovenRESUMEN
BACKGROUND: Studies that compare penoscopic evaluation with the results of molecular human papillomavirus (HPV) testing are scarce. This study assessed and compared both type and distribution of various penile lesions using penoscopy (peniscopy) technique in Croatian men with different, laboratory-confirmed HPV status. METHODS: From a large cohort of men attending an outpatient STD clinic for HPV testing, a total of 120 patients were randomly selected and grouped into those positive for low-risk HPV, high-risk HPV, both low-risk and highrisk HPV, and those with negative results. Samples for HPV-DNA detection were taken by penile brushing and tested with the hc2 HPV DNA Test using Hybrid Capture 2 technology. Lesions were observed by photocolposcope after the application of aqueous 5% acetic acid, and classified as flat (macular), papular, papillary, classical condyloma, PIN-suspicious and non-specific lesions. RESULTS: The results have shown that flat and non-specific acetowhite lesions were the most common overall. All groups differed significantly with respect to papular and papillary lesions. A combination of heterogeneous lesions (i.e., a mixed penoscopic pattern) was commonly observed in all HPV-positive groups, but was significantly lower in the HPV-negative group. A majority of lesions were located in the coronal sulcus, and the four groups differed with respect to the location only considering the lesions of the penile shaft. Distribution of lesions in different sites did not appear to be significantly different with respect to the group, although differences within the high-risk HPV group and the group with both low-risk and high-risk HPV were detected. CONCLUSIONS: Penoscopy is relevant, but not a conclusive diagnostic tool for differentiating HPV from non-HPV findings in men - thus combining it with an HPV DNA test represents a more reliable approach.
Asunto(s)
Infecciones por Papillomavirus/diagnóstico , Enfermedades del Pene/virología , Ácido Acético , Humanos , Masculino , Papillomaviridae , PeneRESUMEN
BACKGROUND: Human papillomavirus (HPV) is one of the most common sexually transmitted pathogens. This observational study was conducted to estimate the trend of hospitalization for genital warts (GWs) in the Veneto region (Italy) from 2004 to 2015. METHODS: All patients with GWs were identified in the hospital discharge records of all public and accredited private hospitals that related to Veneto residents and contained the ICD9-CM code 078.11 associated with a genital surgical procedure (vulval/vaginal warts, penile warts and anal warts). Annual total and sex- and age-specific hospitalization rates and trends were calculated and correlated with the different HPV vaccine coverage over the study period. RESULTS: An annual rate of 11.8 per 100,000 population (8.6 per 100,000 males, and 14.8 per 100,000 females) was found, corresponding to 6076 hospitalizations for condyloma (53.3% vulval/vaginal, 35.8% anal, 8.3% penile, and 2.6% both penile or vulval/vaginal and anal). Among females, the rate of overall GWs remained stable to 2007 (19.1 per 100,000), then dropped significantly, reaching a rate of 11.3 per 100,000 in 2015 (average annual percent changes [AAPC]: -6.1%; 95% CI: -8.4; -3.7). For males, the overall rate increased over the study period (from 6.4 per 100,000 in 2004 to 10.8 per 100,000 in 2015; AAPC: 3.8%; 95% CI: 1.2; 6.4). Among the potentially vaccinated females (12- to 20-year-olds) there was a 62.1% decrease in the number of vulval/vaginal warts from the years 2010-2012 to the years 2013-2015 due to an increase in the HPV coverage rate. A similar reduction among males was observed in the same period and the same age group for penile warts (-68.2%). CONCLUSION: GWs have an important impact on the health services and data suggest that GW-related hospitalization rates rapidly decline in a population with a high HPV vaccination coverage (about 75%). Further efforts should be made to better clarify the epidemiological picture regarding HPV-related diseases, with particular regard to sexual behavior.
Asunto(s)
Condiloma Acuminado/prevención & control , Hospitalización/estadística & datos numéricos , Vacunas contra Papillomavirus/administración & dosificación , Adulto , Condiloma Acuminado/epidemiología , Femenino , Humanos , Italia , Masculino , Papillomaviridae/inmunología , Vacunas contra Papillomavirus/inmunología , Enfermedades del Pene/prevención & control , Enfermedades del Pene/virología , Conducta Sexual , Enfermedades de la Vulva/prevención & control , Enfermedades de la Vulva/virología , Adulto JovenRESUMEN
The aims of this study were to determine the incidence of external genital lesions (EGLs), specifically histologically confirmed condyloma (genital warts) and Penile Intraepithelial Neoplasia (PeIN), and genital HPV infection progression to EGLs among healthy men aged 18-73 residing in Brazil. Subjects included 1118 men enrolled in the HPV Infection in Men (HIM) study between July 2005 and June 2009. At each visit, EGLs were biopsied and subjected to pathological evaluation. HPV status in genital swabs and biopsies was determined by Linear Array and INNO-LiPA, respectively. Age-specific EGLs incidence and the proportion and median time to EGL development were estimated. Kaplan-Meier cumulative incidence rates at 6, 12, and 24 months were determined. During follow-up, 73 men developed an incident EGL. Men could develop multiple EGLs and there were 36 men with condyloma, 27 men with lesions suggestive of condyloma, six men with PeIN, and 20 men with non-HPV lesions. HPV-positive men who developed EGLs were younger (p=0.002) than men that did not develop lesions. Among the 815 men with HPV infection, 4% progressed to EGL with the same HPV detected in the swab. During follow up, 15.7% of genital HPV-6 and HPV-11 infections progressed to condyloma (median progression time of nine months for HPV-6 versus 6.8 months for HPV-11). Approximately 1% of HPV-16 infections progressed to PeIN with a median progression time of 25 months. HPV types covered by the 4-valent HPV vaccine were detected in 82.3% and 83.3% of condyloma and PeIN, respectively. The high burden of HPV and high frequency of progression to disease underscores the need to offer HPV prophylactic vaccination to men to reduce the overall burden of infection and diseases caused by HPV.
Asunto(s)
Condiloma Acuminado/epidemiología , Papillomaviridae/genética , Enfermedades del Pene/epidemiología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/virología , Progresión de la Enfermedad , Genotipo , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Papillomaviridae/clasificación , Enfermedades del Pene/diagnóstico , Enfermedades del Pene/virología , Adulto JovenRESUMEN
BACKGROUND: The epidemiology of penile human papillomavirus (HPV) infection is not well understood. Our objective was to determine the prevalence of penile HPV infection in the United States. METHODS: We analyzed a nationally representative sample of civilian noninstitutionalized US men from the National Health and Nutritional Examination Survey (NHANES) 2013-2014. Penile swab samples were collected from men aged 18-59 years. For detection of HPV types, a Roche Linear Array test was performed. We used NHANES sampling weights to estimate the population prevalence of penile HPV infection. RESULTS: The overall prevalence of any HPV infection was 45.2% (95% confidence interval [CI], 41.3%-49.3%). The prevalence of any high-risk HPV types and low-risk HPV types (mutually exclusive of high-risk HPV) was 30.5% (95% CI, 28.0%-33.0%) and 14.8% (95% CI, 12.7%-17.2%), respectively. Overall HPV prevalence increased with increasing age: the prevalence was lowest among 18- to 24-year-old men (33.8%) and highest among 55- to 59-year-old men (53.4%). HPV types 16 and 18 were detected in 4.3% (95% CI, 3.2%-5.7%) and 1.7% (95% CI, 1.1%-2.6%) of men, respectively. The prevalence of any HPV infection was almost 80% among men who reported having ≥16 lifetime sexual partners and using condoms intermittently. CONCLUSIONS: Our findings indicate that penile HPV is common among men in the United States. Almost one-third of all men are infected with high-risk HPV. Prevalence of penile HPV infection increases with increasing age.