title: Genital Human Papillomavirus Infection Progression to External Genital Lesions: The HIM Study.
abstract: BACKGROUND
  Human papillomavirus (HPV) causes two types of external genital lesions (EGLs) in men: genital warts (condyloma) and penile intraepithelial neoplasia (PeIN).
  
  
  OBJECTIVE
  The purpose of this study was to describe genital HPV progression to a histopathologically confirmed HPV-related EGL.
  
  
  METHODS
  A prospective analysis nested within the HPV Infection in Men (HIM) study was conducted among 3033 men. At each visit, visually distinct EGLs were biopsied; the biopsy specimens were subjected to pathologic evaluation and categorized by pathologic diagnoses. Genital swabs and biopsies were used to identify HPV types using the Linear Array genotyping method for swabs and INNO-LiPA for biopsy specimens.
  
  
  METHODS
  EGL incidence was determined among 1788 HPV-positive men, and cumulative incidence rates at 6, 12, and 24 mo were estimated. The proportion of HPV infections that progressed to EGL was also calculated, along with median time to EGL development.
  
  
  CONCLUSIONS
  Among 1788 HPV-positive men, 92 developed an incident EGL during follow-up (9 PeIN and 86 condyloma). During the first 12 mo of follow-up, 16% of men with a genital HPV 6 infection developed an HPV 6-positive condyloma, and 22% of genital HPV 11 infections progressed to an HPV 11-positive condyloma. During the first 12 mo of follow-up, 0.5% of men with a genital HPV 16 infection developed an HPV 16-positive PeIN. Although we expected PeIN to be a rare event, the sample size for PeIN (n=10) limited the types of analyses that could be performed.
  
  
  CONCLUSIONS
  Most EGLs develop following infection with HPV 6, 11, or 16, all of which could be prevented with the 4-valent HPV vaccine.
  
  
  RESULTS
  In this study, we looked at genital human papillomavirus (HPV) infections that can cause lesions in men. The HPV that we detected within the lesions could be prevented by a vaccine.
authors.affiliation: Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
authors.forename: Staci L
authors.initials: SL
authors.lastname: Sudenga
authors.affiliation: Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Ingles
authors.affiliation: Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Pierce Campbell
authors.affiliation: Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
authors.forename: Hui-Yi
authors.initials: HY
authors.lastname: Lin
authors.affiliation: Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Fulp
authors.affiliation: Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Messina
authors.affiliation: University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Stoler
authors.affiliation: Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Abrahamsen
authors.affiliation: School of Medicine, University of São Paulo and Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa
authors.affiliation: Instituto Nacional de Salud Pública, Cuernavaca, México.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.affiliation: Moffitt Cancer Center & Research Institute, Tampa, FL, USA. Electronic address: Anna.Giuliano@Moffitt.org.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D003218:Condylomata Acuminata / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D018450:Disease Progression; D005500:Follow-Up Studies; 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; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010412:Penile Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D015995:Prevalence; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Condyloma; External genital lesion; HIM study; HPV; Human papillomavirus; PeIN