title: Risk factors, prevalence, and site concordance of human papillomavirus in high-risk Greek men.
abstract: The aim of this study was to determine the risk factors, genotype-specific prevalence, and concordance of human papillomavirus (HPV) infections at three anatomical sites in a cohort of high-risk Greek men. Patients were recruited from sexually transmitted infection and HIV clinics in Athens. Samples were obtained from oral, penile, and anal sites of 294 study participants and HPV testing was performed on 882 samples using next-generation sequencing. Patients also completed a questionnaire assessing risk factors for infection. The mean age of the participants was 33.1, 30% identified as men who have sex with men (MSM), and 21% were HIV positive. The prevalence of HPV was 49%; it was the highest at anal sites (33%) compared with 23% at penile sites (P=0.008) and 4% at oral sites (P<0.001). The most common HPV types in order of frequency were 6, 44, 16, 53, and 89. The genotype concordance rate was the highest between the penile and anal sites (7%), followed by 2% for anal-oral concordance. Identifying as MSM [adjusted odds ratios (aOR)=6.75, P<0.001] and being HIV positive (aOR=2.89, P=0.026) were significant risk factors for anal HPV infection, whereas alcohol use (aOR=0.45, P=0.002) was associated negatively with infection. The only significant risk factor for oral infection was an older age of sexual debut (aOR=1.32, P=0.038). Nearly half of our study participants tested positive in at least one of three anatomical sites. Using next-generation sequencing, we could identify high-risk types that are not covered by the current vaccine and would be missed by traditional HPV testing kits.
authors.affiliation: Pritzker School of Medicine, University of Chicago.
authors.forename: Savas
authors.initials: S
authors.lastname: Tsikis
authors.affiliation: Pritzker School of Medicine, University of Chicago.
authors.forename: Lea
authors.initials: L
authors.lastname: Hoefer
authors.affiliation: Department of Dermatology and Venereology, 'Andreas Syggros' Hospital.
authors.forename: George
authors.initials: G
authors.lastname: Bethimoutis
authors.affiliation: Department of Dermatology and Venereology, 'Andreas Syggros' Hospital.
authors.forename: Electra
authors.initials: E
authors.lastname: Nicolaidou
authors.affiliation: Department of Dermatology and Venereology, 'Andreas Syggros' Hospital.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Paparizos
authors.affiliation: Department of Dermatology and Venereology, 'Andreas Syggros' Hospital.
authors.forename: Christina
authors.initials: C
authors.lastname: Antoniou
authors.affiliation: School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Leonidas
authors.initials: L
authors.lastname: Chardalias
authors.affiliation: School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Georgios-Emmanouil
authors.initials: GE
authors.lastname: Stavropoulos
authors.affiliation: Department of Pathology.
authors.forename: Shruti
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Pathology.
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Long
authors.affiliation: Department of Pathology.
authors.forename: Ibro
authors.initials: I
authors.lastname: Mujacic
authors.affiliation: Department of Pathology.
authors.forename: Sabah
authors.initials: S
authors.lastname: Kadri
authors.affiliation: Department of Pathology.
authors.forename: Jeremy P
authors.initials: JP
authors.lastname: Segal
authors.affiliation: Department of Pathology.
authors.forename: Larissa V
authors.initials: LV
authors.lastname: Furtado
authors.affiliation: Department of Medicine.|Department of Public Health Sciences, University of Chicago Medicine, Chicago, Illinois, USA.
authors.forename: John
authors.initials: J
authors.lastname: Schneider
authors.affiliation: Department of Pathology.
authors.forename: Angella
authors.initials: A
authors.lastname: Charnot-Katsikas
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000821:virology; D060085:Coinfection / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000302:isolation & purification; D005838:Genotype; D006115:Greece / Q000453:epidemiology; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D010413:Penis / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D000072339:Sexual and Gender Minorities / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D004279:DNA, Viral