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J Infect Dis. 2019 May 10. pii: jiz224. doi: 10.1093/infdis/jiz224. [Epub ahead of print]

Prevalence, concordance and transmission of human papillomavirus infection among heterosexual couples in Liuzhou, China: an observational perspective study.

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State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China.
Department of Obstetrics & Gynecology, Zhongshan Hospital, affiliated to Xiamen University, Xiamen, Fujian, China.
Liuzhou Centers for Disease Control and Prevention, Liuzhou, Guangxi, China.



Knowledge of human papillomavirus (HPV) transmission dynamics which has important public health implications for designing HPV vaccination strategies is scarce in undeveloped area.


From May to July 2014, 390 couples were enrolled from general population in Liuzhou, China. Exfoliated cells from male penis/glans penis/coronary sulcus (PGC) and perianal/anal canal (PA) sites and from female vaginal, vulvar, and PA sites were collected biannually for one year.


The HPV type-specific concordance rate between couples was 15.5% (95% confidence interval [CI]: 8.5, 25.0). For anogenital HPV transmission, male-to-female transmission rates (11.5 per 1000 person-month, 95% CI: 4.3, 30.7) were similar to female-to-male transmission rate (11.3, 95% CI: 5.9, 21.7). The concordance rates between male PGC site and female vaginal, vulvar and PA sites were 20.0%, 21.8% and 14.9%, respectively, which were significantly higher than expected by chance. Infections transmitted from male to female seemed mainly originated from male genital, while for female-to-male transmission, the vagina, vulva and PA sites might be all involved.


Among the heterosexual couples with relatively conserved sexual behavior, anogenital HPV transmission rate for female-to-male is similar to male-to-female. In addition to vagina and vulva, female PA site is also an important reservoir for HPV transmission.


Human papillomavirus; anatomic sites; concordance; couples; transmission


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