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Human papillomavirus (HPV) infection at the cervix, anus and oropharynx has been rarely concurrently estimated among HIV-infected women. Using multiplex polymerase chain reaction testing, we prospectively evaluated HPV genotype distribution across three anatomic sites among 50 eligible HIV-infected women from Chennai, India, who provided biological specimens and answered a sexual behaviour questionnaire. We also assessed clinical and behavioural factors related to HPV prevalence. Oncogenic HPV prevalence was comparable between the anus and cervix at 52.2% and 52.0% and lower at the oropharynx at 13.2%; 78% of women with a cervical HPV infection had the same type in the anus. Newly acquired oncogenic HPV infections were lower at cervix (24%) than anus (35%) at three months. 'Any type' cervical HPV prevalence was higher among women with low education and less than five years since HIV diagnosis. CD4+ count and antiretroviral therapy status were not associated with HPV prevalence at the three anatomic sites; however, enrolment cervical HPV16 prevalence was elevated among women with nadir CD4+ <200 cells/µL and enrolment CD4+ <350 cells/µL. Regular cervical screening is essential in HIV-infected Indian women irrespective of CD4+ count and antiretroviral therapy status. Additional research clarifying the natural history of anal HPV infection is also needed in this population. [ABSTRACT FROM AUTHOR]

Background. Published data are equivocal about the relative rates of male-to-female and female-to-male human papillomavirus (HPV) transmission. Our objective was to estimate genital HPV incidence among heterosexual partners from a broad age range and to investigate the effects of monogamy and relationship duration on incidence.Methods. HPV genotyping was conducted for heterosexual partners, aged 18–70 years, from Tampa, Florida, who provided genital exfoliated cell specimens at semiannual visits during a 2-year study. The rate of incident HPV detection was assessed for 99 couples, and transmission incidence was estimated among a subset of 65 discordant couples. We also evaluated the effect of monogamy and relationship duration on transmission incidence.Results. Couples were followed up for a median of 25 months and had a mean age of 33 years for both sexes. The HPV type-specific transmission incidence rate was 12.3 (95% confidence interval, 7.1–19.6) per 1000 person-months for female-to-male transmission and 7.3 (95% confidence interval, 3.5–13.5) per 1000 person-months for male-to-female transmission. Regardless of monogamy status or relationship duration, there was a similar pattern of increased incident HPV detection among men compared with women.Conclusions. HPV may be transmitted more often from women to men than from men to women, suggesting a need for prevention interventions, such as vaccination, for men. [ABSTRACT FROM AUTHOR]

Background Reported associations of male circumcision (MC) with human papillomavirus (HPV) infection in men have been inconsistent. Methods 4,033 healthy men were examined every six months for a median of 17.5 months. In each study visit, exfoliated cell specimens from the coronal sulcus/glans penis, penile shaft, and scrotum were collected and combined into one sample per person for HPV DNA detection. Samples were tested for 37 HPV types. Cox proportional hazards models were used to evaluate the association between MC and the incidence and clearance of HPV infections and specific genotypes. Results The overall incidence of new HPV infections did not differ by MC status (for any HPV, adjusted hazard ratio (aHR) 1.08, 95% confidence interval (CI) 0.91-1.27). However, incidence was significantly lower among circumcised versus uncircumcised men for HPV types 58 (p = 0.01), 68 (p < 0.001), 42 (p = 0.01), 61 (p < 0.001), 71 (p < 0.001), 81 (p = 0.04), and IS39 (p = 0.01), and higher for HPV types 39 (p = 0.01) and 51 (p = 0.02). Despite the lack of an overall association in the risk of HPV clearance by MC (for any HPV, aHR 0.95, 95% CI 0.88-1.02), median times to clearance were significantly shorter among circumcised than uncircumcised men for HPV types 33 (p = 0.02) and 64 (p = 0.04), and longer for HPV types 6 (p < 0.001), 16 (p < 0.001), and 51 (p = 0.02). Conclusions MC is not associated with the incidence and clearance of genital HPV detection, except for certain HPV types. The use of a single combined sample from the penis and scrotum for HPV DNA detection likely limited our ability to identify a true effect of MC at the distal penis. [ABSTRACT FROM AUTHOR]

Background. Few studies have assessed genital human papillomavirus (HPV) concordance and factors associated with concordance among asymptomatic heterosexual couples.Methods. Genotyping for HPV was conducted with male and female sex partners aged 18–70 years from Tampa, Florida. Eligibility included no history of HPV-associated disease. Type-specific positive concordance (partners with ≥1 genotype in common) and negative concordance (neither partner had HPV) were assessed for 88 couples. Factors associated with concordance were assessed with Fisher exact tests and tests for trend.Results. Couples reported engaging in sexual intercourse for a median of 1.7 years (range, 0.1–49 years), and 75% reported being in the same monogamous relationship for the past 6 months. Almost 1 in 4 couples had type-specific positive concordance, and 35% had negative concordance for all types tested, for a total concordance of 59%. Concordance was not associated with monogamy. Type-specific positive concordance was associated with an increasing difference in partners’ lifetime number of sex partners and inversely associated with an increasing difference in age. Negative concordance was inversely associated with both the couple's sum of lifetime number of sex partners and the difference in the partners’ lifetime number of sex partners.Conclusions. Genital HPV concordance was common. Viral infectiousness and number of sex partners may help explain concordance among heterosexual partners. [ABSTRACT FROM AUTHOR]