Incidence of external genital lesions related to human papillomavirus among Mexican men. A cohort study

Salud Publica Mex. 2018 Nov-Dec;60(6):633-644. doi: 10.21149/8461.

Abstract

Objective: To determine external genital lesion (EGL) incidence -condyloma and penile intraepithelial neoplasia (PeIN)- and genital HPV-genotype progression to these EGLs.

Materials and methods: Participants (healthy males 18- 74y from Cuernavaca, Mexico, recruited 2005-2009, n=954) underwent a questionnaire, anogenital examination, and sample collection every six months;including excision biopsy on suspicious EGL with histological confirmation.Linear array assay PCR characterized 37 high/low-risk HPV-DNA types. EGL incidence and cumulative incidence were calculated, the latter with Kaplan-Meier.

Results: EGL incidence was 1.84 (95%CI=1.42-2.39) per 100-person-years (py); 2.9% (95%CI=1.9-4.2) 12-month cumulative EGL.Highest EGL inci- dence was found in men 18-30 years:1.99 (95%CI=1.22-3.25) per 100py. Seven subjects had PeIN I-III (four with HPV16). HPV11 most commonly progresses to condyloma (6-month cumulative incidence=44.4%, 95%CI=14.3-137.8). Subject with high-risk sexual behavior had higher EGL incidence.

Conclusions: In Mexico, anogenital HPV infection in men is high and can cause condyloma. Estimation of EGL magnitude and associated healthcare costs is necessary to assess the need for male anti-HPV vaccination.

Objetivo: Determinar incidencia de lesiones genitales externas (LGE) –condiloma y neoplasia intraepitelial del pene (NIP)– y progresión de genotipos deVPH a LGE.

Material y métodos: Se aplicaron cuestionarios,examen anogenital y recolección de muestras cada seis meses a hombres sanos (18-74 años, de Cuernavaca, México, reclutados 2005-2009, n=954) con biopsia y confirmación histológica. Se caracteri- zaron 37 tipos de ADN-VPH; se calculó incidencia de LGE (cumulativa con Kaplan-Meier).

Resultados: Incidencia de LGE=1.84 (IC95%=1.42-2.39) por 100-persona-años (pa); 2.9% (IC95%=1.9-4.2) LGE acumulativa a 12 meses. Mayor incidencia de LGE entre hombres 18-30 años; 1.99 (IC95%=1.22-3.25) por 100pa.Siete sujetos tuvieron NIP I-III. VPH-11 más comúnmente progresa a condiloma (incidencia acumulativa a seis meses=44.4%, IC95%=14.3-137.8). Los sujetos con comportamiento sexual de alto riesgo tuvieron mayor incidencia de LGE.

Conclusiones: En México la infección anogenital conVPH es alta y puede causar condiloma. La estimación de magnitud de LGE y los costos sanitarios asociados se necesita para evaluar la necesidad de vacunación contra VPH en hombres.

Keywords: condylomata acuminata; genital warts; penile neoplasm.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Alcohol Drinking / epidemiology
  • Biopsy
  • Carcinoma in Situ / epidemiology
  • Carcinoma in Situ / virology
  • Circumcision, Male / statistics & numerical data
  • Condylomata Acuminata / epidemiology
  • Disease Progression
  • Follow-Up Studies
  • Genital Diseases, Male / epidemiology*
  • Genital Diseases, Male / virology
  • Human papillomavirus 11 / isolation & purification
  • Human papillomavirus 16 / isolation & purification
  • Humans
  • Incidence
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Papillomavirus Infections / epidemiology*
  • Penile Neoplasms / epidemiology
  • Penile Neoplasms / virology
  • Prospective Studies
  • Smoking / epidemiology
  • Surveys and Questionnaires
  • Unsafe Sex
  • Young Adult