DIAGNOSTICS

Human papillomavirus in men: comparison of different genital sites

L V Aguilar¹, E Lazcano-Ponce², S Vaccarella³, A Cruz², P Hernández², J S Smith⁴, N Muñoz⁵, J R Kornegay⁶, M Hernández-Avila² and S Franceschi³

¹ Escuela Militar de Graduados de Sanidad, Universidad del Ejército y Fuerza Aérea Mexicanos, (UDEFA), CP 11620 Lomas de San Isidro, Mexico DF, Mexico
² Instituto Nacional de Salud Publica, Av Universidad 655, Col Sta Maria Ahuacatitlan, CP 62508 Cuernavaca, Morelos, Mexico
³ International Agency for Research on Cancer, 150 Cours Albert Thomas, F-69372 Lyon cedex 08, France
⁴ University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7435, USA
⁵ Instituto Nacional de Cancerología, Calle 1a No 9-85, Apartado Aéreo 17158, Santa Fé de Bogotá, DE, Colombia
⁶ Roche Molecular Systems, Inc, 1145 Atlantic Avenue, Alameda, CA 94501, USA

Correspondence to:
Correspondence to:
Dr Eduardo Lazcano-Ponce
National Institute of Public Health, Avenida Universidad 655, Colonia Sta Ma Ahuacatitlán, Cuernavaca Morelos, Mexico; elazcano{at}correo.insp.mx

Objective: To elucidate which anatomical sites need to be sampled to detect human papillomavirus (HPV) infection in the lower male genital tract.

Method: In an HPV survey of Mexican soldiers (median age 24 years; range 16–50 years), a cell sample from 2 cm deep into the distal urethra (group 1; n = 168 men), or 0.5 cm deep into the meatus urethralis (group 2; n = 414 men) was collected, along with a sample from the external genitalia. The different samples were tested for 27 HPV types using a polymerase chain reaction based strip assay.

Results: HPV DNA was detected more frequently in external genitalia samples (46.4%) than in the urethra (20.8%) or meatus samples (12.1%). Lack of samples from the urethra or meatus would have led to 5.1% and 1.5% false HPV negative results, respectively. The most frequently detected high risk HPV types (HPV 59, 52, 51, and 16) were similar in different sites, whereas low risk types were found rarely in urethra samples.

Conclusions: The addition of cell samples from the meatus to those from external genitalia contributed negligibly to the evaluation of the prevalence of HPV in men. HPV detection was slightly improved by the addition of urethra samples, but the gain may not justify the discomfort of the procedure in large epidemiological studies.

Abbreviations: HPV, human papillomavirus; PBS, phosphate buffered saline; PCR, polymerase chain reaction

Keywords: human papillomavirus; penis; urethra; test sensitivity

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