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Epidemiology
Original research
HPV16 and HPV18 seropositivity and DNA detection among men who have sex with men: a cross-sectional study conducted in a sexual health clinic in London
  1. Eleanor M King1,
  2. David Mesher2,
  3. Pam Sonnenberg1,
  4. Ezra Linley3,
  5. Kavita Panwar4,
  6. Simon Beddows4,
  7. Kate Soldan2,
  8. Ray Borrow3,
  9. Mark Jit5,6,
  10. Richard Gilson1,7
  1. 1 Institute for Global Health, University College London, London, UK
  2. 2 Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service, Public Health England, London, UK
  3. 3 Vaccine Evaluation Unit, Public Health England, Manchester, UK
  4. 4 Virus Reference Department, Public Health England, London, UK
  5. 5 Modelling and Economics Unit, Public Health England, London, UK
  6. 6 Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
  7. 7 The Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
  1. Correspondence to Dr Richard Gilson, University College London Institute for Global Health, London WC1E 6JB, London, UK; r.gilson{at}ucl.ac.uk

Abstract

Objectives Men who have sex with men (MSM) have an increased risk of human papillomavirus (HPV) infection and related diseases compared with men who have sex exclusively with women. From April 2018, there has been a phased roll-out of HPV vaccination offered to MSM aged up to 45 years old who are attending sexual health clinics and HIV clinics in England. The vaccine is most effective if delivered prior to HPV infection. We estimated the proportion of MSM with no current vaccine-type infection and no serological evidence of prior infection, in a study undertaken prior to vaccine introduction.

Methods We conducted a cross-sectional study among 484 MSM aged 18–40 years old who attended a sexual health clinic in London between 2010 and 2012. We estimated the prevalence of current and past infection by testing for HPV DNA in anogenital samples and for serum antibodies to HPV16 and HPV18.

Results The median age was 30 years (IQR 25–35). The prevalence of HPV16 and HPV18 DNA was 13.2% and 6.2%, respectively. Seropositivity for HPV16 and HPV18 was 28.5% and 17.1%, respectively, with 11.4% seropositive for both types. Seropositivity for the same HPV type was strongly associated with anogenital DNA detection. 279 MSM (57.6%) tested negative for both HPV16 and HPV18 serology and were DNA negative for these two types; only 5 MSM (1.0%) were seropositive and DNA positive for both HPV types.

Conclusions This is the first study to determine both the prevalence of HPV DNA in anogenital samples and HPV seroprevalence among MSM attending a sexual health clinic in the UK. Over half of MSM in this study had no evidence of a previous or current infection with either of the high-risk HPV types included in the quadrivalent vaccine, which supports the rationale for opportunistic HPV vaccination of MSM attending sexual health clinics.

  • HPV
  • serology
  • vaccination
  • men
  • sexual health

Data availability statement

Data are available upon reasonable request.

https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/sextrans-2020-054726

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • EMK and DM are joint first authors.

    • Handling editor Joseph D Tucker

    • Contributors EMK, RG, PS, MJ and KS informed the initial design of the study. EMK coordinated the recruitment and data collection. SB and KP tested the anogenital swabs for HPV DNA infection. RB and EL tested the serology specimens for HPV antibodies. EMK and DM designed and performed the data analysis and interpreted the results. EMK, DM, PS and RG wrote the first version of the manuscript. All authors have reviewed and approved the manuscript. GlaxoSmithKline Biologicals SA was provided the opportunity to review a preliminary version of this manuscript for factual accuracy, but the authors are solely responsible for final content and interpretation.

    • Funding GlaxoSmithKline SA supplied all assay critical reagents and virus-like particles (VLPs). EMK was funded on a Medical Research Council studentship. The study was supported in part by funds from the National Institute for Health Research (NIHR). MJ was supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Immunisation at LSHTM in partnership with PHE.

    • Competing interests RB and EL declare they perform contract research on behalf of Public Health England for the GSK group of companies, Pfizer and Sanofi Pasteur. The Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service at Public Health England (DM and KS) has provided GSK with postmarketing surveillance reports on HPV infections. A cost recovery charge is made for these reports. RG reports grant (PhD studentship) from the Medical Research Council, non-financial support (laboratory reagents) from GSK and funding (staff support for recruitment) from the National Institute for Health Research.

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