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Oral Session 2: Clinical Sciences—genital human papillomaviruses & trichomoniasis
O3-S2.03 The spectrum of genital HPV infection among men attending a Swedish STI Clinic: HPV typing and clinical presentation
  1. A Wikström1,
  2. M A Hedblad1,
  3. S Syrjänen2
  1. 1Karolinska University Hospital, Stockholm, Sweden
  2. 2University of Turku, Turku, Finland

Abstract

Background Some Swedish studies on HPV typing in men exist. Most earlier studies have used less sensitive HPV typing techniques. The purpose of this study is to see if the HPV types in genital HPV associated lesions have changed since the 80ies, and to describe the lesions in detail.

Methods Between 2004 and 2007, male patients attending the STI clinic of Karolinska Hospital with genital HPV induced lesions planned for surgery, were asked to participate in the study. All men exhibited multiple lesions—men with solitary lesions were excluded. Two clinically identical lesions on the same genital site, were collected by punch biopsy or by scissor excision. One sample was put in formalin for histopathological routine preparation, and the other sample was frozen in −70°C for PCR analysis using a highly sensitive nested PCR technique, detecting 24 different HPV types. The macroscopic morphology of the lesions was classified in acuminate, papular, macular and seborrhoeic keratosis like. The colour of the lesions and the location were recorded. Data on previous therapy and how long time the patients had been afflicted with genital symptoms/and or warts was also noted.

Results Totally 303 men were included in the study. Of these, 47 men (16%) exhibited lesions of PIN and have been described previously. The remaining 256 men had benign lesions and are described here. Acuminate lesions dominated, occurring in 106 (41%) of the men, followed by papular lesions found in 88 (34%) men. The penile shaft, the pubic area and the foreskin were the most common locations for the HPV induced lesions, afflicted in 36%, 29% and 25% of the men, respectively. Pink and brown were the dominating colours of the leions. HPV was detected in 233 (91%) lesions. Low risk HPV types only, were found in 75% of the lesions. On the other hand, 7% of the lesions contained only high risk HPV types, and 9% had a mix of low- and high risk HPV types. Multiple HPV types were found in 13%. HPV 6 was the most common HPV type (70% of the lesions were positive for HPV 6 only). Duration of genital symptoms and/or warts was mean 24 months and 211 of the men had previously been treated.

Conclusion Using a highly sensitive PCR technique, a high HPV detection rate of 91% was found. As in earlier studies, HPV 6 was most common, but also other HPV types including high-risk types were detected. As expected, most of the benign lesions were acuminate, but the morphology as well as the genital location varied.

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