HPV vaccine acceptability in high-risk Greek men.

HPV is associated with malignancy in men, yet there is a lack of data on HPV knowledge, vaccine acceptability, and factors affecting vaccine acceptability in Greek men. This study aims to identify determinants of knowledge and willingness to vaccinate against HPV among high-risk Greek men. Men (n = 298) between the ages of 18 and 55 were enrolled from the STI and HIV clinics at "Andreas Syggros" Hospital in Athens, Greece from July-October 2015. Participants completed a survey on demographics, economic factors, sexual history, HPV knowledge, and vaccine acceptability. The majority of participants were younger than 40 (76.6%) and unmarried (84.6%). Our sample was 31.2% MSM (men who have sex with men), and 20.1% were HIV-positive. Most participants (>90%) were aware that HPV is highly prevalent in both men and women; however, fewer identified that HPV causes cancers in both sexes (68%) and that vaccination protects men and women (67%). Amongst participants, 76.7% were willing to vaccinate themselves against HPV, 71.4% an adolescent son, and 69.3% an adolescent daughter. HIV-positive men were more likely to be willing to vaccinate themselves (OR 2.83, p = .015), a son (OR 3.3, p = .015) or a daughter (3.01, p = .020). Higher income levels were associated with increased willingness to vaccinate oneself (OR 1.32, p = .027), a son (1.33, p = .032) or daughter (1.34, p = .027). Although there is a HPV knowledge gap, HPV vaccine acceptability is high despite lack of vaccine promotion to Greek men. Future studies should include lower-risk men to adequately inform public health efforts.

Risk factors, prevalence, and site concordance of human papillomavirus in high-risk Greek men.

The aim of this study was to determine the risk factors, genotype-specific prevalence, and concordance of human papillomavirus (HPV) infections at three anatomical sites in a cohort of high-risk Greek men. Patients were recruited from sexually transmitted infection and HIV clinics in Athens. Samples were obtained from oral, penile, and anal sites of 294 study participants and HPV testing was performed on 882 samples using next-generation sequencing. Patients also completed a questionnaire assessing risk factors for infection. The mean age of the participants was 33.1, 30% identified as men who have sex with men (MSM), and 21% were HIV positive. The prevalence of HPV was 49%; it was the highest at anal sites (33%) compared with 23% at penile sites (P=0.008) and 4% at oral sites (P<0.001). The most common HPV types in order of frequency were 6, 44, 16, 53, and 89. The genotype concordance rate was the highest between the penile and anal sites (7%), followed by 2% for anal-oral concordance. Identifying as MSM [adjusted odds ratios (aOR)=6.75, P<0.001] and being HIV positive (aOR=2.89, P=0.026) were significant risk factors for anal HPV infection, whereas alcohol use (aOR=0.45, P=0.002) was associated negatively with infection. The only significant risk factor for oral infection was an older age of sexual debut (aOR=1.32, P=0.038). Nearly half of our study participants tested positive in at least one of three anatomical sites. Using next-generation sequencing, we could identify high-risk types that are not covered by the current vaccine and would be missed by traditional HPV testing kits.

Condylomata acuminata in children.

We describe a study on 38 children from 1 to 11 years of age, with anogenital warts, 25 were girls. The disease was primarily perianal. Sexual abuse was confirmed in one 9-year-old boy. Most responded to monotherapy with podophyllotoxin, imiquimod 5%, or cryotherapy in a 3-month follow-up period.

The role of cytology and HPV typing as a screening tool in patients with intraanal warts.

BACKGROUND AND AIM: Given that anorectal human papillomavirus (HPV) infection has been related to anal intraepithelial neoplasia (AIN) and rectal cancer, we conducted this study to evaluate the role of cytology of anal smears in the diagnosis of intraanal disease and related AIN and to correlate it to HPV genotypes. METHOD: A total of 72 patients (58 males and 14 females) with perianal warts underwent anoscopy with biopsies and anal cytologic examination. Cytology was carried out for the identification of any dysplasia according to the Bethesda system. All specimens were examined with polymerase chain reaction (PCR) for HPV DNA identification. Exclusion criteria included immunosuppression and high-grade squamous intraepitheliel lesion (HGSIL) or SCC in anal specimens. RESULTS: Seven patients were excluded from the study. Intraanal warts were detected with anoscopy in 57 out of 65 patients, whereas histology showed HPV infection in 56 out of 65 patients and cytology was positive in 52 out of 65 low-grade squamous intraepitheliel lesion (LGSIL) patients. In 43 out of 52 positive patients, simple HPV infection was detected whereas in 9 out of 52 positive patients AIN I. HPV DNA was detected in 51 out of 65 patients, whereas 3 specimens were characterized as invalids. In the majority, HPV 6 could be identified (39/48, 81%), whereas HPV 16 was detected in 4 patients (4/48, 8.3%). One fourth of the positive patients had been infected with more than 1 HPV types (13/48, 27%). Cytology presented a sensitivity 87.5% and specificity 67% in comparison with the histology. CONCLUSIONS: Cytology is highly sensitive in the diagnosis of intraanal warts comparable with histopathology. The combination of the 3 examinations (anoscopy, cytology, and PCR HPV typing) improves diagnostic accuracy and offers a global picture of the anorectal HPV disease.

Comparison of cryotherapy to imiquimod 5% in the treatment of anogenital warts.

The aim of this study was to compare the efficacy of crotherapy versus imiquimod 5% in the treatment of anogenital warts. Eighty HIV-negative males were included in the analysis; 35 of them were treated with imiquimod 5% three times a week for 6-10 hours and 45 of them with cryotherapy once in three weeks. Follow-up appointments were arranged every month for the first three months and then at six and 12 months, or in between whenever the patients noticed any signs of recurrence. Treatment for both groups was continued for a total of 12 weeks or until the warts cleared. At the end of three months, irrespective of the type of treatment, 78.8% of the patients demonstrated 100% improvement. Cryotherapy was more effective, as 86.7% of patients showed 100% improvement compared with 68.6% of patients in the imiquimod group. On the contrary, 17.1% of the imiquimod group did not show any signs of improvement, compared with 2.2% of the cryotherapy group (P = 0.017). However, patients treated with imiquimod tended to improve earlier than patients on cryotherapy (P = 0.012). No statistically significant difference was observed regarding the recurrence rate between the two groups (P = 0.138). Treatment with imiquimod was less painful than cryotherapy (P = 0.034). Cryotherapy was more effective than imiquimod 5% for the treatment of anogenital warts in males but was more inconvenient.

Human papillomavirus assay in genital warts--correlation with symptoms.

Our purpose was to investigate the human papillomavirus (HPV) type distribution using the Hybrid Capture 2 (HC2) Microplate assay in males. We tested a urethral swab from 550 HIV-negative males with genital warts and 64 HIV-negative males clinically free of genital warts, partners of HPV-infected females, using the HC2 Microplate assay. A perianal swab was also obtained from patients with perianal warts. In the first group, HPV DNA of any type was detected in 280 (50.9%) patients. Relatively few patients with urethral or perianal warts demonstrated a negative test (both P < 0.0001). Low-risk types were commoner, accounting for 60.0% of the HPV cases, high/intermediate-risk types accounted for 23.6%, while 46 men (16.4%) were infected with both types. Of 13 subjects (20.3%) of the second group who tested positive for HPV DNA, 61.5% were infected by low-risk types, 23.1% by high/intermediate-risk types and 15.4% had a dual infection. In conclusion, male partners of infected females and males with genital warts are predominantly infected by low-risk HPV types, but a substantial proportion is also or only affected by high-risk types.