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Prevalence of high risk penile human papillomavirus in men who have sex with men (MSM) and transgender women (TGW)
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AIDS 2024 Munich July 20-26
HIV+ had higher rates of detectable penile HPV. Lifetime sex work also associated with higher rates. Although not statistically significant there was a trend for association between anal & penile HPV "so perhaps with larger number of patients in study we would see connection"
"penile HPV may create reservoir for transmission to other anatomic locations which have higher burden of disease"
abstract
BACKGROUND: High-risk HPV in anogenital locations, can lead to preneoplastic and neoplastic lesions. HPV transmission occurs through genital-genital or oral-genital contact and penile HPV represents a potential reservoir. This study aims to evaluate the prevalence of penile HPV among MSM and TGW populations.
METHODS: A study on penile HPV was conducted at a Buenos Aires research center, involving MSM and TGW, some participating in an ongoing anal and oral HPV study. Epidemiological and clinical data were collected and penile samples were obtained using a 600-grit emery paper and a saline water-imbibed Dacron swab. DNA was purified using the Biocomma Universal Genomic DNA Purification kit, and HPV was detected with ATILA (Genotyping High-Risk HPV Real Time Fluorescent Detection).
RESULTS: Between June 2022-August 2023, 200 participants were enrolled. Median age: 33(IQR 28-40); 98.5%(197) hispanic-latino ethnicity; 13.5%(27) circumcised; 85%(171) had at least one previous sexually transmitted infection (STI): syphilis(63%), gonorrhea(27.5%), chlamydiasis(21.5%), 36.5%(73) had HIV, median CD4 count: 417 cel/mL (IQR 315-664); 44%(88) had a history of anal or penile warts and 59%(69/113) anal intraepithelial lesions; 14.5%(29) had complete HPV vaccination. Baseline characteristics by group are shown in the table.
Penile HPV was detected in 69 participants (34.5%), with no differences between groups (MSM/TGW 33.5/38.9%). HPV genotypes distribution were: HPV-33(26%), HPV-59(17%), HPV-35,HPV-43,HPV-45(16%), HPV-16(15%), HPV-56(14%), HPV-18,HPV-31,HPV-39(10%), HPV-52,HPV-68(9%), HPV-58(7%), HPV-51(4%), HPV-66(3%). 19 penile samples(10%) showed 3 or more concomitant genotypes. Among those with anal (n=99) and oral (n=103) samples, the HPV prevalence was 79% and 22% respectively. HPV-33 was the most frequent genotype in penile and anal samples. Participants with penile HPV had a higher frequency of anal infection (p=0.02). No other statistically significant association was found.
CONCLUSIONS: One third of participants presented high-risk HPV penile infection. An association between penile and anal HPV was found. These facts reinforce the potential role of the penis as a reservoir. Prevention strategies such as gender-neutral vaccination and circumcision should be considered.
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