title: Partner Human Papillomavirus Viral Load and Incident Human Papillomavirus Detection in Heterosexual Couples.
abstract: BACKGROUND
  The association between partner human papillomavirus (HPV) viral load and incident HPV detection in heterosexual couples is unknown.
  
  
  METHODS
  HPV genotypes were detected in 632 human immunodeficiency virus (HIV)-negative couples followed for 2 years in a male circumcision trial in Rakai, Uganda, using the Roche HPV Linear Array. This assay detects 37 genotypes and provides a semiquantitative measure of viral load based on the intensity (graded 1-4) of the genotype-specific band; a band intensity of 1 indicates a low genotype-specific HPV load, whereas an intensity of 4 indicates a high load. Using Poisson regression with generalized estimating equations, we measured the association between partner's genotype-specific viral load and detection of that genotype in the HPV-discordant partner 1 year later.
  
  
  RESULTS
  Incident detection of HPV genotypes was 10.6% among men (54 of 508 genotype-specific visit intervals) and 9.0% among women (55 of 611 genotype-specific visit intervals). Use of male partners with a baseline genotype-specific band intensity of 1 as a reference yielded adjusted relative risks (aRRs) of 1.14 (95% confidence interval [CI], .58-2.27]) for incident detection of that genotype among women whose male partner had a baseline band intensity of 2, 1.75 (95% CI, .97-3.17) among those whose partner had an intensity of 3, and 2.52 (95% CI, 1.40-4.54) among those whose partner had an intensity of 4. Use of female partners with a baseline genotype-specific band intensity of 1 as a reference yielded an aRR of 2.83 (95% CI, 1.50-5.33) for incident detection of that genotype among men whose female partner had a baseline band intensity of 4. These associations were similar for high-risk and low-risk genotypes. Male circumcision also was associated with significant reductions in incident HPV detection in men (aRR, 0.53 [95% CI, .30-.95]) and women (aRR, 0.42 [95% CI, .23-.76]).
  
  
  CONCLUSIONS
  In heterosexual couples, the genotype-specific HPV load in one partner is associated with the risk of new detection of that genotype in the other partner. Interventions that reduce the HPV load may reduce the incidence of HPV transmission.
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Grabowski
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health.
authors.forename: Xiangrong
authors.initials: X
authors.lastname: Kong
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health Rakai Health Sciences Program, Entebbe.
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Gray
authors.affiliation: Rakai Health Sciences Program, Entebbe School of Public Health.
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.affiliation: Rakai Health Sciences Program, Entebbe.
authors.forename: Godfrey
authors.initials: G
authors.lastname: Kigozi
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health Department of Pathology, School of Medicine, University of New Mexico, Albuquerque.
authors.forename: Patti E
authors.initials: PE
authors.lastname: Gravitt
authors.affiliation: Department of Medicine.
authors.forename: Fred
authors.initials: F
authors.lastname: Nalugoda
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health Department of Medicine Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland Rakai Health Sciences Program, Entebbe.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Reynolds
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health Rakai Health Sciences Program, Entebbe.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Wawer
authors.affiliation: Department of Medicine Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Redd
authors.affiliation: Department of Urology, Makerere University, Kampala, Uganda.
authors.forename: Stephen
authors.initials: S
authors.lastname: Watya
authors.affiliation: Department of Medicine Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland Rakai Health Sciences Program, Entebbe.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.affiliation: Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore Rakai Health Sciences Program, Entebbe.
authors.forename: Aaron A R
authors.initials: AA
authors.lastname: Tobian
mesh_terms: D000328:Adult; D002944:Circumcision, Male; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000821:virology*; D012307:Risk Factors; D012747:Sexual Partners; D014454:Uganda / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
keywords: Africa; HIV; Uganda; cervical cancer; human papillomavirus; male circumcision; penile cancer; sexually transmitted infections; transmission; viral load