title: Human papillomavirus (HPV) infection in heterosexual South African men attending sexual health services: associations between HPV and HIV serostatus.
abstract: OBJECTIVE
  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.
authors.affiliation: Sexually Transmitted Infections Reference Centre, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg, South Africa. etiennem@nicd.ac.za
authors.forename: Etienne E
authors.initials: EE
authors.lastname: Müller
authors.forename: Tobias F
authors.initials: TF
authors.lastname: Chirwa
authors.forename: David A
authors.initials: DA
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000097:blood / Q000453:epidemiology / Q000821:virology*; D002944:Circumcision, Male / Q000706:statistics & numerical data; D003218:Condylomata Acuminata / Q000150:complications / Q000453:epidemiology / Q000821:virology*; D004279:DNA, Viral / Q000097:blood; D005838:Genotype; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000097:blood / Q000453:epidemiology / Q000821:virology; D020010:Heterosexuality / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics*; D015995:Prevalence; D013019:South Africa / Q000453:epidemiology; D014522:Urethral Diseases / Q000097:blood / Q000453:epidemiology / Q000821:virology*; D055815:Young Adult
chemical_list: D004279:DNA, Viral