High-risk Human Papillomavirus Infection of the Foreskin in Asymptomatic Men and Patients with Phimosis

There has been increasing interest in understanding the natural history of HPV and the diseases it causes in men. HPV infection is strongly associated with penile cancer, lack of neonatal circumcision, and phimosis.

We investigated the incidence of HPV infection in asymptomatic men and patients with phimosis.

We assessed 110 asymptomatic men and 30 patients who underwent circumcision due to presence of phimosis. DNA extraction was carried out from swab samples collected from asymptomatic men and from foreskin samples collected during circumcision. Polymerase chain reaction (PCR) with the use of consensus primers for the detection of HPV-MY09/11 was used to detect generic HPV DNA. HPV genotyping was done by PCR amplification with primers for the E6 gene DNA sequences of HPVs 6, 11, 16, 18, 31, 33, 35, 45, and 58.

HPV was present in 46. 66% of patients with phimosis, 50% of whom had high-risk HPV genotypes. In the asymptomatic cases, 16. 36% were HPV-positive, but only one sample presented a high-risk HPV. We detected a significantly high rate of HPV genital infection in patients presenting phimosis compared with asymptomatic subjects (p=0. 00167). The prevalence of high-risk HPV genotypes in patients with phimosis was also statistically significant (p=0. 0004).

We showed a robust association between phimosis and genital HPV prevalence in men and a significant frequency of high-risk HPV. Other studies are needed to investigate the occurrence of factors that can increase the incidence of penile carcinoma, as well as its impact on female genital infection in cervical cancer.

The Journal of urology. 2016 Jan 18 [Epub ahead of print]

Larissa A Afonso, Thaissa I Cordeiro, Fernanda N Carestiato, Antonio Augusto Ornellas, Gilda Alves, Sílvia M B Cavalcanti

Department of Microbiology and Parasitology, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brazil. , Department of Microbiology and Parasitology, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brazil. , Department of Microbiology and Parasitology, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brazil. , Departments of Urology, Brazilian National Institute of Cancer and Hospital Mário Kröeff, Rio de Janeiro, Brazil. , Research Coordination, Brazilian National Institute of Cancer and Circulating Biomarkers Laboratory, Department of Pathology, State University of Rio de Janeiro, Rio de Janeiro, Brazil. , Department of Microbiology and Parasitology, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brazil.

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