title: Multiple human papillomavirus infections and type competition in men.
abstract: BACKGROUND
  There is little information on multiple human papillomavirus (HPV) infections and the potential for type competition in men, yet competition may impact the type-specific efficacy of HPV vaccination.
  
  
  METHODS
  Among 2702 uncircumcised men in Kisumu, Kenya, who were seronegative for human immunodeficiency virus, the observed numbers of HPV types detected were compared with the expected number, which was simulated under the assumption of independent infections. To assess the potential for HPV type competition, adjusted odds ratios for pairwise combinations of prevalent HPV type infections were estimated using semi-Bayesian methods.
  
  
  RESULTS
  Half of all men were HPV positive, of whom 57% had multiple HPV types. We observed men without HPV infection and with ≥4 HPV types more often than expected if infections were independent. No negative associations between individual HPV types were observed. HPV types 31, 39, 56, 58, and 59 were positively associated with both carcinogenic vaccine types HPV-16 and HPV-18 (2-sided P value <.05).
  
  
  CONCLUSIONS
  Men who were HPV infected were likely to test positive for >1 HPV type. Cross-sectional associations between individual HPV types were positive and did not appear to be type-specific. Thus, we did not identify HPV types that are candidates for potential HPV type competition in men.
authors: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. arositch@jhsph.edu
authors: Anne F
authors: AF
authors: Rositch
authors: Charles
authors: C
authors: Poole
authors: Michael G
authors: MG
authors: Hudgens
authors: Kawango
authors: K
authors: Agot
authors: Edith
authors: E
authors: Nyagaya
authors: Stephen
authors: S
authors: Moses
authors: Peter J F
authors: PJ
authors: Snijders
authors: Chris J L M
authors: CJ
authors: Meijer
authors: Robert C
authors: RC
authors: Bailey
authors: Jennifer S
authors: JS
authors: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D052685:Alphapapillomavirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D001499:Bayes Theorem; D060085:Coinfection; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis*; D005838:Genotype; D006801:Humans; D007630:Kenya; D008297:Male; D056265:Microbial Interactions; D016017:Odds Ratio; D030361:Papillomavirus Infections / Q000821:virology*; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004279:DNA, Viral