Format

Send to

Choose Destination
J Infect Dis. 2015 Mar 1;211(5):811-20. doi: 10.1093/infdis/jiu535. Epub 2014 Sep 26.

Acquisition and persistence of human papillomavirus 16 (HPV-16) and HPV-18 among men with high-HPV viral load infections in a circumcision trial in Kisumu, Kenya.

Author information

1
Department of Epidemiology.
2
Department of Epidemiology Department of Epidemiology, Brown Public Health, Brown University, Providence, Rhode Island.
3
Department of Biostatistics, Gillings School of Global Public Health.
4
Impact Research and Development Organization, Kisumu, Kenya.
5
Centre for Global Public Health, University of Manitoba, Winnipeg, Canada.
6
Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
7
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, New York.
8
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois, Chicago.
9
Department of Epidemiology Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.

Abstract

BACKGROUND:

Circumcision and lower human papillomavirus (HPV) viral loads in men are possibly associated with a reduced risk of HPV transmission to women. However, the association between male circumcision and HPV viral load remains unclear.

METHODS:

Swab specimens from the glans and shaft of the penis were collected from men enrolled in a circumcision trial in Kisumu, Kenya. GP5+/6+ polymerase chain reaction (PCR) was used to identify HPV DNA types. HPV-16 and HPV-18 loads were measured with a LightCycler real-time PCR and classified as high (>250 copies/scrape) or low (≤250 copies/scrape).

RESULTS:

A total of 1159 men were randomly assigned to undergo immediate circumcision, and 1140 men were randomly assigned to the control arm (these individuals were asked to remain uncircumcised until the study ended). The hazard of acquisition of high-viral load infections in the glans was lower in the circumcision arm, compared with the control arm, for HPV-16 (hazard ratio [HR], 0.32 [95% confidence interval {CI}, .20-.49]) and HPV-18 (HR, 0.34 [95% CI, .21-.54]). The 6-month risk of HPV persistence among men with high-viral load infections in the glans at baseline was lower in the circumcision arm, compared with the control arm, for HPV-16 (risk ratio [RR], 0.36 [95% CI, .18-.72]) and HPV-18 (RR 0.34 [95% CI, .13-.86]). Weaker and less precise results were obtained for shaft samples.

CONCLUSIONS:

Male circumcision could potentially reduce the risk of HPV transmission to women by reducing the hazard of acquisition, and the risk of persistence of high-HPV viral load infections in the glans in men.

KEYWORDS:

HPV-16; HPV-18; Kenya; human papillomavirus (HPV); male circumcision; men; persistence; randomized controlled trial (RCT), incidence; viral load

PMID:
25261492
PMCID:
PMC4402376
DOI:
10.1093/infdis/jiu535
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center