Prevalence of acetowhite areas in male partners of women affected by HPV and squamous intra-epithelial lesions (SIL) and their prognostic significance. A multicenter study.
BACKGROUND
Estimates for the prevalence of cervical HPV infection vary and are only available for a few populations with regard to male partners. Attention has been drawn to the male role in cancer progression from cervical intra-epithelial neoplasia, but most of the male lesions are subclinical and only visible after acetowhite staining. The prognostic significance of acetowhite areas, of male partners of women affected by HPV and preneoplastic lesions, was evaluated.


METHODS
A cohort of 3210 male partners of women affected by HPV infection and/or preneoplastic lesion of the lower genital tract was observed from 1987 to 2001. Acetowhite changes were assessed 5 min after the application of 5% solution of acetic acid and biopsies were tested for HPV-DNA by PCR. Patients with HPV lesions underwent CO2 laser surgery and follow-up.


RESULTS
Of the 3210 male partners, 39.12% exhibited clinical HPV lesions and 3.64% subclinical lesions identified as acetowhite areas. In the group of 117 male partners with acetowhite areas, the HPV-DNA test was positive (HPV 6-11) in 36.75% and negative in 63.24% (p<0.001). No statistical differences were observed between HPV+/- groups regarding their sexual habits. The HPV-positive infection group compared to the HPV-negative group showed a statistically significant difference for CO2 laser surgery (p<0.001).


CONCLUSIONS
The acetic acid test can give false-positives and is not a specific indicator of HPV infection, and thus the limited efficacy of tests for acetowhite areas was confirmed. The treatment of clinical lesions is necessary. Follow-up represents the major route to the diagnosis of preneoplastic lesions in men and for the prevention of cervical carcinoma in their female partners.
Frega
Antonio
A
Department of Gynecology, Perinatology and Child Health, University of Rome La Sapienza, Policlinic Umberto I, Viale Regina Elena 324, Rome, Italy. a.frega@tin.it
French
Deborah
D
Pace
Sebastiano
S
Maranghi
Luca
L
Palazzo
Antonella
A
Iacovelli
Roberto
R
Biamonti
Alberto
A
Moscarini
Massimo
M
Vecchione
Aldo
A
D019342:Acetic Acid; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000635:transmission*; D010409:Penile Diseases / Q000473:pathology / Q000821:virology*; D012747:Sexual Partners; D015229:Sexually Transmitted Diseases, Viral / Q000473:pathology / Q000635:transmission* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000821:virology*
D004279:DNA, Viral; D019342:Acetic Acid