title: Condom use promotes regression of human papillomavirus-associated penile lesions in male sexual partners of women with cervical intraepithelial neoplasia.
abstract: Penile HPV-associated lesions are frequently seen in male sexual partners of women with CIN. The natural course and clinical significance of these lesions are unclear. Women with CIN and their male sexual partners were randomized for condom use (condom group n = 68, noncondom group n = 68). Males were screened for the presence of penile lesions, i.e., flat lesions, papular lesions and condylomata acuminata, and of HPV in their penile swabs by PCR testing. Median follow-up time was 13.1 months (range 2.9-57.4). The outcome of our study was clinical regression of penile lesions defined as disappearance of lesions at penoscopy. Potentially prognostic factors, i.e., HPV status, lesion type and age, were studied as well. Outcomes were assessed in 57 men of the condom group and in 43 men of the noncondom group. Condom use shortened the median time to regression of flat penile lesions (7.4 months condom group vs. 13.9 months noncondom group; HR = 2.1, 95% CI 1.2-3.7). This effect was not found for papular lesions (HR = 0.5, 95% CI 0.1-2.8). HPV-negative men showed a significantly shorter median time to regression of flat lesions (3.8 months) compared to men with either HPV-positive status (8.5 months; HR = 0.4, 95% CI 0.2-0.9) or inconsistent HPV status (13.1 months; HR = 0.2, 95% CI 0.1-0.6). Regression of flat penile lesions is HPV-dependent and accelerated by condom use. This effect is probably the result of blocking viral transmission between sexual partners.
authors.affiliation: Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Maaike C G
authors.initials: MC
authors.lastname: Bleeker
authors.forename: Cornelis J A
authors.initials: CJ
authors.lastname: Hogewoning
authors.forename: Feja J
authors.initials: FJ
authors.lastname: Voorhorst
authors.forename: Adriaan J C
authors.initials: AJ
authors.lastname: van den Brule
authors.forename: Peter J F
authors.initials: PJ
authors.lastname: Snijders
authors.forename: Theo M
authors.initials: TM
authors.lastname: Starink
authors.forename: Johannes
authors.initials: J
authors.lastname: Berkhof
authors.forename: Chris J L M
authors.initials: CJ
authors.lastname: Meijer
mesh_terms: D000328:Adult; D017280:Condoms; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000517:prevention & control*; D010409:Penile Diseases / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control*; D013997:Time Factors; D014412:Tumor Virus Infections / Q000517:prevention & control