title: Genital prevalence of HPV types and co-infection in men.
abstract: BACKGROUND
  HPV infection is a highly prevalent sexually transmitted disease and there is evidence of the relationship of HPV infection and the development of genital warts, penile intraepitelial neoplasia, invasive penile carcinoma and cervical cancer. However, there is sparse data regarding the prevalence of HPV types and co-infection of different HPV types among men.
  
  
  OBJECTIVE
  To assess the prevalence of HPV subtypes infections and rates of co-infection among men.
  
  
  METHODS
  366 men were evaluated from March to October 2010. Men were referred to our institution for HPV diagnostic evaluation based on the following criteria: 1. presence of a genital wart; 2. presence of an atypical genital lesion; 3. absence of symptoms and a partner with a HPV diagnosis; 4. absence of symptoms and a desire to undergo a full STD diagnostic evaluation. Genital samples were collected from the urethra, penile shaft, scrotum and anus with Digene® collection and preservation kit and submitted to HPV genotype microarray detection (Papillocheck®). All men were tested for the low-risk HPV types 6-11-40-42-43-44 and for the high-risk HPV types 16-18-31-33-35-39-45-51-52-53-56-58-59-66-68-70-73-82.
  
  
  RESULTS
  Of the 366 men, 11 were tested inconclusive and were excluded from the analysis. 256 men (72.1% of the men from the cohort referred to our institution) tested positive with genotype micro-array detection and 99 tested negative. The most preva¬lent HPV-subtypes in the studied population were 6, 42, 51 and 16. Co-infection was found in 153 men. Of those, 70 (19.7%) had a co-infection by 2 types, 37 (10.4%) by 3 types; 33 men (9.2%) by 4 types; 8 men (2.2%) by 5 types; 1 man (0.3%) by 6 types; 1 man (0.3%) by 7 types; 2 men (0.6%) by 8 types and 1 man (0.3%) by 9 types.
  
  
  CONCLUSIONS
  The most frequent HPV types were 6, 16, 42 and 51. Co-infection was found in 59% of our patients. This information is vital to drive future public health policies including massive public vaccination campaign.
authors.affiliation: Division of Urology, Fleury Group; Anhembi Morumbi Medical School and Federal University of Sao Paulo, SP, Brazil.
authors.forename: Marcos P
authors.initials: MP
authors.lastname: Freire
authors.affiliation: Anhembi Morumbi Medical School, Sao Paulo, SP, Brazil.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pires
authors.affiliation: Anhembi Morumbi Medical School, Sao Paulo, SP, Brazil.
authors.forename: Raphael
authors.initials: R
authors.lastname: Forjaz
authors.affiliation: Anhembi Morumbi Medical School, Sao Paulo, SP, Brazil.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Sato
authors.affiliation: Division of Urology, Fleury Group and Federal University of Sao Paulo, Sao Paulo, SP, Brazil.
authors.forename: Ismael
authors.initials: I
authors.lastname: Cotrim
authors.affiliation: Division of Urology, Fleury Group, Sao Paulo, SP, Brazil.
authors.forename: Mônica
authors.initials: M
authors.lastname: Stiepcich
authors.affiliation: Division of Urology, Fleury Group, Sao Paulo, SP, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Scarpellini
authors.affiliation: Division of Urology, Fleury Group, Sao Paulo and Federal University of Sao Paulo, Sao Paulo, SP, Brazil.
authors.forename: José C
authors.initials: JC
authors.lastname: Truzzi
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D060085:Coinfection; D004279:DNA, Viral; D005832:Genital Diseases, Male / Q000453:epidemiology* / Q000235:genetics / Q000821:virology; D005838:Genotype; D006801:Humans; D008297:Male; D046228:Microarray Analysis; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000235:genetics; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004279:DNA, Viral