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Human papillomavirus (HPV) infection in heterosexual South African men attending sexual health services: associations between HPV and HIV serostatus
  1. Etienne E Müller1,
  2. Tobias F Chirwa2,
  3. David A Lewis1,3,4
  1. 1Sexually Transmitted Infections Reference Centre, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
  2. 2Epidemiology and Biostatistics Division, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  3. 3Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  4. 4Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
  1. Correspondence to Dr Etienne E Müller, Sexually Transmitted Infections Reference Centre, National Institute for Communicable Diseases of the National Health Laboratory Service, Private Bag X4, Sandringham, Johannesburg 2131, South Africa; etiennem{at}nicd.ac.za

Abstract

Objectives To investigate the distribution of human papillomavirus (HPV) genotypes and determine the associations between HPV infection and HIV coinfection in sexually active heterosexual men with anogenital warts (GW), male urethral discharge or asymptomatic men.

Methods Valid specimens for HPV genotyping were obtained from three patient groups consisting of 108 men with GW, 56 men with urethral discharge syndrome and 50 asymptomatic men attending for HIV voluntary counselling and testing. The Linear Array HPV Genotyping Test was used to determine the HPV genotype distribution among study participants. Sera were tested for HIV antibodies using two commercial rapid tests.

Results The prevalence of anogenital HPV among study participants was 78% (166). HPV DNA was detected in 100% (108) of GW, 48% (27) of men with urethral discharge syndrome and 62% (31) of voluntary counselling and testing participants. HPV types 6, 11, 16 and 18 were prevalent as either single or combined infections in 81% (134) of all HPV-positive study participants. HPV types 6 and/or 11 were significantly higher among GW patients (p<0.001). After adjusting for patient groups, HIV seropositivity was significantly associated with multiple HPV infections (OR=3.98, 95% CI 1.58 to 10.03) but not with the presence of a foreskin (OR=0.67, 95% CI 0.32 to 1.40).

Conclusions Infections with HPV were prevalent among sexually active heterosexual men attending the men's sexual health clinic. Associations were observed between HIV coinfection and multiple HPV infections. Further population-based studies on the prevalence of HPV genotypes are required to determine if men should be included in any future national HPV vaccination programme in South Africa.

  • HPV
  • HIV
  • anogenital warts
  • men
  • genital warts
  • heterosexuals

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Footnotes

  • Funding This research was internally funded at the National Institute for Communicable Diseases, National Health Laboratory Service, South Africa.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Human Research Ethics Committee (Medical) of the University of the Witwatersrand (Protocol nos M060434 and M070912).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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