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Prevalence of HPV infection among men: A systematic review of the
literature.
JID 2006; 194:1044-1057.
Dunne EF, Nielson CM, Stone KM, Markowitz LE, Giuliano AR.
Abstract
BACKGROUND: Human papillomavirus (HPV) infection is estimated to be the most
common sexually transmitted infection; an estimated 6.2 million persons are
newly infected every year in the United States. There are limited data on
HPV infection in heterosexual men. METHODS. We conducted a systematic review
of the literature by searching MEDLINE using the terms "human papillomavirus," "HPV," "male," "seroprevalence," and "serology" to
retrieve articles published from 1 January 1990 to 1 February 2006. We included
studies that had data on population characteristics and that evaluated male
genital anatomic sites or specimens for HPV DNA or included assessments of
seropositivity to HPV type 6, 11, 16, or 18 in men. We excluded studies that
had been conducted only in children or immunocompromised persons (HIV infected,
transplant recipients, or elderly). RESULTS. We included a total of 40 publications
on HPV DNA detection and risk factors for HPV in men; 27 evaluated multiple
anatomic sites or specimens, 10 evaluated a single site or specimen, and
3 evaluated risk factors or optimal anatomic sites/specimens for HPV detection.
Twelve studies assessed site- or specimen-specific HPV DNA detection. HPV
prevalence in men was 1.3%-72.9% in studies in which multiple anatomic sites
or specimens were evaluated; 15 (56%) of these studies reported > or =20%
HPV prevalence. HPV prevalence varied on the basis of sampling, processing
methods, and the anatomic site(s) or specimen(s) sampled. We included 15
publications reporting HPV seroprevalence. Rates of seropositivity depended
on the population, HPV type, and methods used. In 9 studies that evaluated
both men and women, all but 1 demonstrated that HPV seroprevalence was lower
in men than in women. CONCLUSION. HPV infection is highly prevalent in sexually
active men and can be detected by use of a variety of specimens and methods.
There have been few natural-history studies and no transmission studies of
HPV in men. The information that we have reviewed may be useful for future
natural-history studies and for modeling the potential impact of a prophylactic
HPV vaccine.