Male circumcision and the incidence and clearance of genital human papillomavirus (HPV) infection in men: the HPV Infection in men (HIM) cohort study. BMC Infect Dis 2014 Feb 10;14:75
Date
02/13/2014Pubmed ID
24517172Pubmed Central ID
PMC3925013DOI
10.1186/1471-2334-14-75Scopus ID
2-s2.0-84893644201 (requires institutional sign-in at Scopus site) 33 CitationsAbstract
BACKGROUND: Reported associations of male circumcision (MC) with human papillomavirus (HPV) infection in men have been inconsistent.
METHODS: 4,033 healthy men were examined every six months for a median of 17.5 months. In each study visit, exfoliated cell specimens from the coronal sulcus/glans penis, penile shaft, and scrotum were collected and combined into one sample per person for HPV DNA detection. Samples were tested for 37 HPV types. Cox proportional hazards models were used to evaluate the association between MC and the incidence and clearance of HPV infections and specific genotypes.
RESULTS: The overall incidence of new HPV infections did not differ by MC status (for any HPV, adjusted hazard ratio (aHR) 1.08, 95% confidence interval (CI) 0.91-1.27). However, incidence was significantly lower among circumcised versus uncircumcised men for HPV types 58 (p = 0.01), 68 (p < 0.001), 42 (p = 0.01), 61 (p < 0.001), 71 (p < 0.001), 81 (p = 0.04), and IS39 (p = 0.01), and higher for HPV types 39 (p = 0.01) and 51 (p = 0.02). Despite the lack of an overall association in the risk of HPV clearance by MC (for any HPV, aHR 0.95, 95% CI 0.88-1.02), median times to clearance were significantly shorter among circumcised than uncircumcised men for HPV types 33 (p = 0.02) and 64 (p = 0.04), and longer for HPV types 6 (p < 0.001), 16 (p < 0.001), and 51 (p = 0.02).
CONCLUSIONS: MC is not associated with the incidence and clearance of genital HPV detection, except for certain HPV types. The use of a single combined sample from the penis and scrotum for HPV DNA detection likely limited our ability to identify a true effect of MC at the distal penis.
Author List
Albero G, Castellsagué X, Lin HY, Fulp W, Villa LL, Lazcano-Ponce E, Papenfuss M, Abrahamsen M, Salmerón J, Quiterio M, Nyitray AG, Lu B, Bosch FX, Giuliano ARAuthor
Alan Nyitray PhD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Circumcision, Male
Cohort Studies
DNA, Viral
Genotype
Humans
Incidence
Male
Middle Aged
Papillomaviridae
Papillomavirus Infections
Penis
Proportional Hazards Models
Scrotum
Sexually Transmitted Diseases
Young Adult
