Anal Human Papillomavirus Infection among HIV-Infected Men in Korea

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Abstract

Background

Little is known about the epidemiology on human papillomavirus (HPV) infection among HIV-infected men in Korea. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among HIV-infected men in Korea.

Methods

A single-center cross-sectional study was conducted with HIV-infected men in Korea. Participants completed a detailed sexual behavior risk factor questionnaire. Anal samples were collected for cytology and HPV genotyping. Factors associated with anal HPV infection were assessed using multivariable logistic regression, stratifying by sexual behaviour.

Results

A total of 201 HIV-infected men were included in the study: 133 were from men who have sex with men (MSM) and 68 from men who have sex with women (MSW). Any anal HPV infection was detected in 82.7% of HIV-infected MSM and in 51.5% of HIV- infected MSW ( P < 0.001). High-risk HPV (HR-HPV) prevalence was higher among MSM (47.4%) than MSW (25.0%; P = 0.002). The HR-HPV types identified most frequently were HPV 16 (11%), HPV 18 (9.9%), and HPV 58 (5%) in MSM, and HPV 58(11%) and HPV 16 (8.9%) in MSW. Prevalence of any HPV types in 9-valent vaccine types was higher among MSM than MSW (47.4% vs 22.1%. P = 0.001). Abnormal anal cytology was more commonly detected in MSM than MSW (42.9% vs.19.1%, P < 0.001). In HIV-infected MSM, higher number of lifetime male sex partners was significantly associated with any anal HPV infection, but age was a significant risk factor associated with anal HR-HPV infection.

Conclusion

Anal HPV infection was highly prevalent in HIV-infected MSM in Korea, and also commonly found in HIV-infected MSW. In HIV-infected MSM, the significant risk factor for being infected with any HPV infection was lifetime number of male sexual partners, and with anal oncogenic HPV infection was age.

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Most cited references 35

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Prevalence of HPV infection among men: A systematic review of the literature.

Eileen Dunne, Carrie M Nielson, Katherine M Stone … (2006)

Human papillomavirus (HPV) infection is estimated to be the most common sexually transmitted infection; an estimated 6.2 million persons are newly infected every year in the United States. There are limited data on HPV infection in heterosexual men. We conducted a systematic review of the literature by searching MEDLINE using the terms "human papillomavirus," "HPV," "male," "seroprevalence," and "serology" to retrieve articles published from 1 January 1990 to 1 February 2006. We included studies that had data on population characteristics and that evaluated male genital anatomic sites or specimens for HPV DNA or included assessments of seropositivity to HPV type 6, 11, 16, or 18 in men. We excluded studies that had been conducted only in children or immunocompromised persons (HIV infected, transplant recipients, or elderly). We included a total of 40 publications on HPV DNA detection and risk factors for HPV in men; 27 evaluated multiple anatomic sites or specimens, 10 evaluated a single site or specimen, and 3 evaluated risk factors or optimal anatomic sites/specimens for HPV detection. Twelve studies assessed site- or specimen-specific HPV DNA detection. HPV prevalence in men was 1.3%-72.9% in studies in which multiple anatomic sites or specimens were evaluated; 15 (56%) of these studies reported > or =20% HPV prevalence. HPV prevalence varied on the basis of sampling, processing methods, and the anatomic site(s) or specimen(s) sampled. We included 15 publications reporting HPV seroprevalence. Rates of seropositivity depended on the population, HPV type, and methods used. In 9 studies that evaluated both men and women, all but 1 demonstrated that HPV seroprevalence was lower in men than in women. HPV infection is highly prevalent in sexually active men and can be detected by use of a variety of specimens and methods. There have been few natural-history studies and no transmission studies of HPV in men. The information that we have reviewed may be useful for future natural-history studies and for modeling the potential impact of a prophylactic HPV vaccine.

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Is Open Access

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2011

Kyu-Won Jung, Young-Joo Won, Hyun-Joo Kong … (2014)

Purpose This study aimed to report nationwide cancer statistics in Korea, including incidence, mortality, survival, and prevalence, and their trends. Materials and Methods Incidence data from 1993 to 2011 were obtained from the Korea National Cancer Incidence Database, and vital status was followed through December 31, 2012. Mortality data from 1983 to 2011 were obtained from Statistics Korea. Crude and age-standardized rates for incidence, mortality, and prevalence, and relative survival were calculated. Results A total of 218,017 cancer cases and 71,579 cancer deaths were reported to have occurred in 2011, and there were 1,097,253 prevalent cases identified in Korea as of January 1, 2012. Over the past 13 years (1999-2011), overall incidence rates have increased by 3.4% per year. The incidence rates of liver and cervical cancers have decreased, while those of thyroid, breast, prostate, and colorectal cancers have increased. Notably, thyroid cancer increased by 23.3% per year in both sexes, and became the most common cancer since 2009. The mortality for all cancers combined decreased by 2.7% per year from 2002 to 2011. Five-year relative survival rates of patients diagnosed in the last 5 years (2007-2011) have improved by 25.1% compared with those from 1993 to 1995. Conclusion Overall cancer mortality rates have declined since 2002 in Korea, while incidence has increased rapidly and survival has improved.

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Prevalence, clearance, and incidence of anal human papillomavirus infection in HIV-infected men: the HIPVIRG cohort study.

Pierre Côté, Alexandra Sánchez de Lozada, G Ghattas … (2009)

Human immunodeficiency virus (HIV)-seropositive men who have sex with men (MSM) are at higher risk of human papillomavirus (HPV) infection. This study was conducted to better understand the natural history of type-specific HPV infection in the anus. A cohort study was conducted among HIV-seropositive MSM in Montreal to investigate acquisition and loss of anal HPV infection. Participants were followed up every 6 months for 3 years for risk behaviors, HIV-related parameters, and HPV testing. HPV DNA was detected in 97.9% of the 247 participants at baseline (median, 5 HPV types). The most common types were HPV-16 (38.2%) and HPV-6 (35.3%). Prevalent HPV-16 infections had the lowest clearance rate (12.2 cleared episodes per 1000 person-months [95% confidence interval {CI}, 8.5-17.7]) and a mean retention time of 36 months (95% CI, 32.7-38.8). The highest incidence rates were found for HPV-16 (10.8 new cases per 1000 person-months [95% CI, 8.0-14.7]), HPV-52 (10.8 new cases per 1000 person-months [95% CI, 8.2-14.1]), and HPV-53 (9.8 new cases per 1000 person-months [95% CI, 7.4-13.0]), with cumulative incidences at 36 months of approximately 30%. Multiple HPV types were common in the anal canals of HIV-seropositive MSM. Incidence and clearance rates were not similar among HPV types. Ongoing surveillance of this cohort will help our understanding of the determinants of HPV persistence and progression to lesions.

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Author and article information

Contributors

Maria Lina Tornesello: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 22 August 2016

Publication date Collection: 2016

Volume: 11

Issue: 8

Electronic Location Identifier: e0161460

Affiliations

[1 ]Department of Pathology, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea

[2 ]Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea

[3 ]Department of Internal Medicine, Pusan National University School of Medicine, Yangsan Pusan National University Hospital, Geongsangnam-do, Korea

[4 ]Department of Obstetrics & Gynecology, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea

[5 ]Department of Psychiatry, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea

[6 ]Department of Surgery, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea

Fondazione IRCCS Istituto Nazionale dei Tumori, ITALY

Author notes

Competing Interests: The authors have declared that no competing interests exist.

Conceptualization: CHL SHL.
Data curation: SHL SL HC.
Formal analysis: CHL SHL SL.
Funding acquisition: CHL SHL.
Investigation: CHL SHL SL HC HJC EM KHK.
Methodology: CHL SHL.
Project administration: CHL SHL.
Software: SHL.
Supervision: CHL SHL SL.
Validation: KK JEL EJJ SJL EJK.
Writing – original draft: SHL.
Writing – review & editing: CHL SHL SL.

* E-mail: zzanmery@ 123456gmail.com

Article

Publisher ID: PONE-D-16-21282

DOI: 10.1371/journal.pone.0161460

PMC ID: 4993367

PubMed ID: 27548632

SO-VID: f3b51ccb-68cf-402b-bd96-aa95444f3d8b

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 26 May 2016

Date accepted : 5 August 2016

Page count

Figures: 1, Tables: 4, Pages: 15

Funding

Funded by: Biomedical Research Institute Grant (2013-19), Pusan National University Hospital.

Award Recipient : Sun Hee Lee

This study was supported by Biomedical Research Institute Grant (2013-19), Pusan National University Hospital.

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Data Availability All relevant data are within the paper and its Supporting Information files.

Anal Human Papillomavirus Infection among HIV-Infected Men in Korea

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Abstract

Background

Methods

Results

Conclusion

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PLOS Climate

Most cited references 35

Prevalence of HPV infection among men: A systematic review of the literature.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2011

Prevalence, clearance, and incidence of anal human papillomavirus infection in HIV-infected men: the HIPVIRG cohort study.

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