title: Human papillomavirus virus (HPV) genotype- and age-specific analyses of external genital lesions among men in the HPV Infection in Men (HIM) Study.
abstract: BACKGROUND
  Human papillomavirus (HPV) causes external genital lesions (EGLs) in men, including condyloma and penile intraepithelial neoplasia (PeIN). We sought to determine the incidence of pathologically confirmed EGLs, by lesion type, among men in different age groups and to evaluate the HPV types that were associated with EGL development.
  
  
  METHODS
  HPV Infection in Men (HIM) study participants who contributed ≥2 visits from 2009-2013 were included in the biopsy cohort. Genotyping by an HPV line-probe assay was performed on all pathologically confirmed EGLs. Age-specific analyses were conducted for incident EGLs, with Kaplan-Meier estimation of cumulative incidence.
  
  
  RESULTS
  This biopsy cohort included 2754 men (median follow-up duration, 12.4 months [interquartile range, 6.9-19.2 months]). EGLs (n = 377) were pathologically confirmed in 228 men, 198 of whom had incident EGLs. The cumulative incidence of any EGL was highest among men <45 years old and, for condyloma, decreased significantly over time with age. The genotype-specific incidence of EGL varied by pathological diagnoses, with high- and low-risk genotypes found in 15.6% and 73.2% of EGLs, respectively. Condyloma primarily contained HPV 6 or 11. While PeIN lesions primarily contained HPV 16, 1 PeIN III lesion was positive for HPV 6 only.
  
  
  CONCLUSIONS
  Low- and high-risk HPV genotypes contribute to the EGL burden. Men remain susceptible to HPV-related EGLs throughout the life span, making it necessary to ensure the longevity of immune protection against the most common causative HPV genotypes.
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Ingles
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Pierce Campbell
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Messina
authors.affiliation: University of Virginia School of Medicine, Charlottesville.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Stoler
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Hui-Yi
authors.initials: HY
authors.lastname: Lin
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
authors.forename: William J
authors.initials: WJ
authors.lastname: Fulp
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Martha
authors.initials: M
authors.lastname: Abrahamsen
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Sirak
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Michael T
authors.initials: MT
authors.lastname: O'Keefe
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida University of Virginia School of Medicine, Charlottesville University of São Paulo School of Medicine, Brazil Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
authors.forename: Mary
authors.initials: M
authors.lastname: Papenfuss
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Christine
authors.initials: C
authors.lastname: Gage
authors.affiliation: University of São Paulo School of Medicine, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Carvalho da Silva
authors.affiliation: Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
authors.forename: Rossana
authors.initials: R
authors.lastname: Gonzalez Sosa
authors.affiliation: Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
authors.forename: Oscar
authors.initials: O
authors.lastname: Rojas Juarez
authors.affiliation: University of São Paulo School of Medicine, Brazil.
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa
authors.affiliation: Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano Ponce
authors.affiliation: Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003218:Condylomata Acuminata / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D005500:Follow-Up Studies; D005834:Genital Neoplasms, Male / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D005838:Genotype; D052140:Human papillomavirus 11 / Q000235:genetics / Q000302:isolation & purification; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification; D052163:Human papillomavirus 6 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D010413:Penis / Q000473:pathology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: HIM Study; age; condyloma; external genital lesions; genotype; human papillomavirus (HPV); penile intraepithelial neoplasia (PeIN)