Concurrent and Concordant Anal and Oral Human PapillomaVirus Infections Are Not Associated with Sexual Behavior in At-Risk Males
Abstract
:1. Introduction
2. Results
2.1. Study Population
2.2. Prevalence of Anal and Oral HPV Infection in HIV-Infected and HIV-Uninfected MSM
2.3. Concurrent and Concordant Anal–Oral HPV Infections
2.4. Determinants of Concurrent and Concordant Anal–Oral HPV Infections
3. Discussion
4. Materials and Methods
4.1. Study Population
4.2. Clinical Sample Collection
4.3. HPV-DNA Detection and Genotyping
4.4. Data Analysis
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- De Martel, C.; Georges, D.; Bray, F.; Ferlay, J.; Clifford, G.M. Global burden of cancer attributable to infections in 2018: A worldwide incidence analysis. Lancet Glob. Health 2020, 8, e180–e190. [Google Scholar] [CrossRef] [Green Version]
- King, E.M.; Gilson, R.; Beddows, S.; Soldan, K.; Panwar, K.; Young, C.; Jit, M.; Edmunds, W.J.; Sonnenberg, P. Oral human papillomavirus (HPV) infection in men who have sex with men: Prevalence and lack of anogenital concordance. Sex. Transm. Infect. 2015, 91, 284–286. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wei, F.; Gaisa, M.M.; D’Souza, G.; Xia, N.; Giuliano, A.R.; E Hawes, S.; Gao, L.; Cheng, S.-H.; Donà, M.G.; E Goldstone, S.; et al. Epidemiology of anal human papillomavirus infection and high-grade squamous intraepithelial lesions in 29900 men according to HIV status, sexuality, and age: A collaborative pooled analysis of 64 studies. Lancet HIV 2021, 8, e531–e543. [Google Scholar] [CrossRef]
- A Machalek, D.; Poynten, M.; Jin, F.; Fairley, C.K.; Farnsworth, A.; Garland, S.M.; Hillman, R.J.; Petoumenos, K.; Roberts, J.; Tabrizi, S.N.; et al. Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: A systematic review and meta-analysis. Lancet Oncol. 2012, 13, 487–500. [Google Scholar] [CrossRef]
- Farahmand, M.; Monavari, S.H.; Tavakoli, A. Prevalence and genotype distribution of human papillomavirus infection in different anatomical sites among men who have sex with men: A systematic review and meta-analysis. Rev. Med. Virol. 2021. [Google Scholar] [CrossRef]
- Menezes, L.J.; Poongulali, S.; Tommasino, M.; Lin, H.-Y.; Kumarasamy, N.; Fisher, K.J.; Saravanan, S.; Gheit, T.; Ezhilarasi, C.; Jeeva, A.; et al. Prevalence and concordance of human papillomavirus infection at multiple anatomic sites among HIV-infected women from chennai, india. Int. J. STD AIDS 2016, 27, 543–553. [Google Scholar] [CrossRef]
- Pamnani, S.J.; Nyitray, A.G.; Abrahamsen, M.; Rollison, D.E.; Villa, L.L.; Lazcano-Ponce, E.; Huang, Y.; Borenstein, A.; Giuliano, A.R. Sequential acquisition of anal human papillomavirus (HPV) infection following genital infection among men who have sex with women: The HPV infection in men (HIM) study. J. Infect. Dis. 2016, 214, 1180–1187. [Google Scholar] [CrossRef]
- Thorsteinsson, K.; Storgaard, M.; Katzenstein, T.L.; Ladelund, S.; Rönsholt, F.F.; Johansen, I.S.; Pedersen, G.; Gaardsting, A.; Nielsen, L.N.; Bonde, J.; et al. Prevalence of cervical, oral, and anal human papillomavirus infection in women living with HIV in denmark—The SHADE cohort study. J. Clin. Virol. 2018, 105, 64–71. [Google Scholar] [CrossRef] [Green Version]
- Custer, J.; Patel, R.; Delclos, G.L.; DeSantis, S.M. Concurrent and concordant oral and genital high-risk human papillomavirus in the united states: Results from the national health and nutrition examination survey. J. Infect. Dis. 2021, 223, 1400–1409. [Google Scholar] [CrossRef]
- Dickey, B.L.; Fan, W.; Bettampadi, D.; Reich, R.R.; Sirak, B.; Abrahamsen, M.; Baggio, M.L.; Galan, L.; Silva, R.C.; Salmerón, J.; et al. Sequential acquisition of human papillomavirus infection between genital and oral anatomic sites in males. Int. J. Cancer 2021, 149, 1483–1494. [Google Scholar] [CrossRef]
- Wei, F.; Su, Y.; Cui, X.; Yu, X.; Li, Y.; Song, Q.; Yin, K.; Huang, S.; Li, M.; Zhang, J.; et al. Sequential acquisition of human papillomavirus infection at genital and anal sites, liuzhou, china. Emerg. Infect. Dis. 2020, 26, 2387–2393. [Google Scholar] [CrossRef]
- Nasioutziki, M.; Chatzistamatiou, K.; Loufopoulos, P.-D.; Vavoulidis, E.; Tsampazis, N.; Pratilas, G.-C.; Liberis, A.; Karpa, V.; Parcharidis, E.; Daniilidis, A.; et al. Cervical, anal and oral HPV detection and HPV type concordance among women referred for colposcopy. Infect. Agent. Cancer 2020, 15, 22. [Google Scholar] [CrossRef] [PubMed]
- Goodman, M.T.; Shvetsov, Y.B.; McDuffie, K.; Wilkens, L.R.; Zhu, X.; Thompson, P.J.; Ning, L.; Killeen, J.; Kamemoto, L.; Hernandez, B.Y. Sequential acquisition of human papillomavirus (HPV) infection of the anus and cervix: The hawaii HPV cohort study. J. Infect. Dis. 2010, 201, 1331–1339. [Google Scholar] [CrossRef] [PubMed]
- Donà, M.G.; Gheit, T.; Latini, A.; Benevolo, M.; Torres, M.; Smelov, V.; McKay-Chopin, S.; Giglio, A.; Cristaudo, A.; Zaccarelli, M.; et al. Alpha, beta and gamma human papillomaviruses in the anal canal of HIV-infected and uninfected men who have sex with men. J. Infect. 2015, 71, 74–84. [Google Scholar] [CrossRef] [PubMed]
- Gheit, T.; Rollo, F.; Brancaccio, R.N.; Robitaille, A.; Galati, L.; Giuliani, M.; Latini, A.; Pichi, B.; Benevolo, M.; Cuenin, C.; et al. Oral infection by mucosal and cutaneous human papillomaviruses in the men who have sex with men from the OHMAR study. Viruses 2020, 12, 899. [Google Scholar] [CrossRef] [PubMed]
- Videla, S.; Darwich, L.; Cañadas, M.-P.; Coll, J.; Piñol, M.; García-Cuyás, F.; Molina-Lopez, R.A.; Cobarsi, P.; Clotet, B.; Sirera, G. Natural history of human papillomavirus infections involving anal, penile, and oral sites among HIV-positive men. Sex. Transm. Dis. 2013, 40, 3–10. [Google Scholar] [CrossRef] [PubMed]
- Van Rijn, V.M.; Mooij, S.H.; Mollers, M.; Snijders, P.J.F.; Speksnijder, A.G.C.L.; King, A.J.; De Vries, H.J.C.; Van Eeden, A.; Van Der Klis, F.R.M.; De Melker, H.E.; et al. Anal, penile, and oral high-risk HPV infections and HPV seropositivity in HIV-positive and HIV-negative men who have sex with men. PLoS ONE 2014, 9, e92208. [Google Scholar] [CrossRef] [Green Version]
- Blas, M.M.; Brown, B.; Menacho, L.; Alva, I.E.; Silva-Santisteban, A.; Cárcamo, C. HPV prevalence in multiple anatomical sites among men who have sex with men in peru. PLoS ONE 2015, 10, e0139524. [Google Scholar] [CrossRef]
- Steinau, M.; Gorbach, P.; Gratzer, B.; Braxton, J.; Meites, E.; Kerndt, P.R.; Crosby, R.A.; Unger, E.R.; Markowitz, L.E. Concordance between anal and oral human papillomavirus infections among young men who have sex with men. J. Infect. Dis. 2017, 215, 1832–1835. [Google Scholar] [CrossRef]
- Bouassa, R.-S.M.; Bélec, L.; Gubavu, C.; Péré, H.; Matta, M.; Maka, A.; Puech, J.; Wolyec, S.T.; Veyer, D.; Gravier, A.; et al. High prevalence of anal and oral high-risk human papillomavirus in human immunodeficiency virus-uninfected french men who have sex with men and use preexposure prophylaxis. Open Forum Infect. Dis. 2019, 6, ofz291. [Google Scholar] [CrossRef] [Green Version]
- Taylor, S.; Bunge, E.; Bakker, M.; Castellsagué, X. The incidence, clearance and persistence of non-cervical human papillomavirus infections: A systematic review of the literature. BMC Infect. Dis. 2016, 16, 293–299. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Donà, M.; Vescio, M.F.; Latini, A.; Giglio, A.; Moretto, D.; Frasca, M.; Benevolo, M.; Rollo, F.; Colafigli, M.; Cristaudo, A.; et al. Anal human papillomavirus in HIV-uninfected men who have sex with men: Incidence and clearance rates, duration of infection, and risk factors. Clin. Microbiol. Infect. 2016, 22, 1004.e1–1004.e7. [Google Scholar] [CrossRef] [PubMed]
- Giuliani, M.; Rollo, F.; Vescio, M.F.; Pichi, B.; Latini, A.; Benevolo, M.; Pellini, R.; Cristaudo, A.; Dona, M.G. Oral human papillomavirus infection in HIV-infected and HIV-uninfected MSM: The OHMAR prospective cohort study. Sex. Transm. Infect. 2020, 96, 528–536. [Google Scholar] [CrossRef] [PubMed]
- Beachler, D.C.; D’Souza, G.; Sugar, E.A.; Xiao, W.; Gillison, M.L. Natural history of anal vs. oral HPV infection in HIV-infected men and women. J. Infect. Dis. 2013, 208, 330–339. [Google Scholar] [CrossRef] [Green Version]
- Kahn, J.A.; Belzer, M.; Chi, X.; Lee, J.; Gaur, A.H.; Mayer, K.; Martinez, J.; Futterman, D.C.; Stier, E.A.; Paul, M.E.; et al. Pre-vaccination prevalence of anogenital and oral human papillomavirus in young HIV-infected men who have sex with men. Papillomavirus Res. 2019, 7, 52–61. [Google Scholar] [CrossRef]
- Donà, M.G.; Latini, A.; Benevolo, M.; Moretto, D.; Cristaudo, A.; Giuliani, M. Anal human papillomavirus infection prevalence in men who have sex with men is age-independent: A role for recent sexual behavior? Future Microbiol. 2014, 9, 837–844. [Google Scholar] [CrossRef]
- Poynten, I.M.; Machalek, D.; Templeton, D.; Jin, F.; Hillman, R.; Zablotzska, I.; Prestage, G.; Holt, M.; Grulich, A. Comparison of age-specific patterns of sexual behaviour and anal HPV prevalence in homosexual men with patterns in women. Sex. Transm. Infect. 2016, 92, 228–231. [Google Scholar] [CrossRef]
- Donà, M.G.; Benevolo, M.; Vocaturo, A.; Palamara, G.; Latini, A.; Giglio, A.; Moretto, D.; Rollo, F.; Impara, G.; Ensoli, F.; et al. Anal cytological abnormalities and epidemiological correlates among men who have sex with men at risk for HIV-1 infection. BMC Cancer 2012, 12, 476. [Google Scholar] [CrossRef] [Green Version]
- Rollo, F.; Latini, A.; Pichi, B.; Colafigli, M.; Benevolo, M.; Sinopoli, I.; Sperduti, I.; Laquintana, V.; Fabbri, G.; Frasca, M.; et al. Prevalence and determinants of oral infection by human papillomavirus in HIV-infected and uninfected men who have sex with men. PLoS ONE 2017, 12. [Google Scholar] [CrossRef] [Green Version]
- Donà, M.G.; Rollo, F.; Latini, A.; Benevolo, M.; Pichi, B.; Pellini, R.; Giuliani, E.; Giglio, A.; Cristaudo, A.; Giuliani, M. Anal and oral human papillomavirus infection in men who have sex with men: Implications for risk-targeted vaccination. Future Microbiol. 2020, 15, 1713–1722. [Google Scholar] [CrossRef] [PubMed]
HIV-Infected MSM | HIV-Uninfected MSM | ||||
---|---|---|---|---|---|
n = 85 | n = 76 | ||||
median (IQR) | pvalue | ||||
Age, years | 44 (34–49) | 37 (32–45) | 0.007 | ||
Age at first sex, years | 18 (17–20) | 20 (17–24) | 0.16 | ||
N. lifetime partners for any sex | 100 (34–300) | 70 (33–120) | 0.40 | ||
N. lifetime partners for receptive oral sex | 60 (15–150) | 40 (15–86) | 0.20 | ||
N. recent partners for any sex1 | 2 (1–8) | 6 (3–13) | 0.0002 | ||
N. recent partners for receptive oral sex1 | 2 (1–6) | 4 (1–10) | 0.01 | ||
n | % | n | % | pvalue | |
Caucasian ethnicity | 82 | 96.5 | 74 | 97.4 | 0.52 |
Graduate education | 31 | 36.5 | 40 | 52.6 | 0.039 |
Annual income | 0.17 | ||||
>12,000 euros | 14 | 16.5 | 7 | 9.2 | |
Up to 12,000 euros | 71 | 83.5 | 69 | 90.8 | |
Alcohol consumption | 0.13 | ||||
Light/non drinker | 61 | 71.8 | 46 | 60.5 | |
Moderate and heavy | 24 | 28.2 | 30 | 39.5 | |
Smoking status | 0.33 | ||||
Current | 40 | 47.1 | 27 | 35.5 | |
Former | 8 | 9.4 | 8 | 10.5 | |
Never | 37 | 43.5 | 41 | 53.9 | |
Receptive oral sex (ever) | 83 | 97.6 | 76 | 100.0 | 0.18 |
Recent receptive oral sex | 70 | 82.4 | 73 | 96.1 | 0.006 |
Condomless recent oral sex2 | 67 | 95.7 | 71 | 97.3 | 0.62 |
Recent receptive anal sex | 67 | 78.8 | 65 | 85.5 | 0.27 |
Condomless receptive anal sex3 | 29 | 43.3 | 27 | 41.5 | 0.83 |
History of STI | 0.01 | ||||
No | 15 | 17.6 | 29 | 38.2 | |
Ano-genital warts | 32 | 37.6 | 20 | 26.3 | |
Other than ano-genital warts | 38 | 44.7 | 27 | 35.5 |
Anal–Oral HPV Infection | ||||
---|---|---|---|---|
MSM | Concurrent 1 n/N (%) | p Value 2 | Concordant 3 n/N (%) | p Value 2 |
HIV-infected | 22/85 (25.9) | 0.18 | 10/85 (11.8) | 0.26 |
HIV-uninfected | 13/76 (17.1) | 5/76 (6.6) | ||
Total | 35/161 (21.7) | 15/161 (9.3) |
Concurrent Anal–Oral HPV Infection | ||||||
---|---|---|---|---|---|---|
Variable | COR | 95% CI | p Value | AOR | 95% CI | p Value |
Age, >39 vs. ≤39 years | 3.33 | 1.48–7.52 | 0.004 | 3.10 | 1.34–7.19 | 0.008 |
Alcohol consumption, moderate/heavy vs. light/no | 1.22 | 0.56–2.67 | 0.61 | |||
Smoking, current vs. never/former | 1.44 | 0.68–3.05 | 0.35 | |||
Age at first sex, ≤19 vs. >19 years | 1.51 | 0.71–3.19 | 0.28 | |||
N. lifetime partners, any sex (>75 vs. ≤75) | 2.32 | 1.06–4.07 | 0.03 | 0.90 | 0.26–3.13 | 0.87 |
N. recent partners, any sex (>4 vs. ≤4) | 1.09 | 0.52–2.31 | 0.82 | |||
N. lifetime partners, receptive oral sex (>50 vs. ≤50) | 2.91 | 1.33–6.38 | 0.008 | 2.87 | 0.84–9.77 | 0.09 |
N. recent partners, receptive oral sex (>3 vs. ≤3) | 1.09 | 0.51–2.31 | 0.83 | |||
Receptive anal sex, yes vs. no | 1.41 | 0.50–4.02 | 0.52 | |||
Condomless receptive anal sex, yes vs. no | 1.85 | 0.81–4.20 | 0.14 | |||
Receptive oral sex (ever), yes vs. no | 1.43 | 0.07–30.38 | 0.82 | |||
Receptive oral sex (recent), yes vs. no | 0.97 | 0.30–3.15 | 0.96 | |||
Condomless receptive oral sex, yes vs. no | 0.40 | 0.06–2.50 | 0.33 | |||
Ano-genital wart history, yes vs. no | 1.32 | 0.60–2.88 | 0.49 | |||
HIV status, positive vs. negative | 0.59 | 0.27–1.28 | 0.18 | |||
Age, >39 vs. ≤39 years | 2.23 | 0.73–6.85 | 0.16 | |||
Alcohol consumption, moderate/heavy vs. light/no | 1.00 | 0.32–3.06 | 0.98 | |||
Smoking, current vs. never/former | 2.28 | 0.77–6-74 | 0.13 | |||
Age at first sex, ≤19 vs. >19 years | 0.44 | 0.13–1.45 | 0.18 | |||
N. lifetime partners, any sex (>75 vs. ≤75) | 4.59 | 1.24–16.94 | 0.022 | 3.05 | 0.54–17.16 | 0.21 |
N. recent partners, any sex (>4 vs. ≤4) | 1.17 | 0.41–3.41 | 0.77 | |||
N. lifetime partners, receptive oral sex (>50 vs. ≤50) | 3.73 | 1.13–12.25 | 0.03 | 1.77 | 0.36–8.60 | 0.48 |
N. recent partners, receptive oral sex (>3 vs. ≤3) | 0.83 | 0.28–2.45 | 0.74 | |||
Receptive anal sex, yes vs. no | 3.32 | 0.42–26.33 | 0.25 | |||
Condomless receptive anal sex, yes vs. no | 2.81 | 0.89–8.93 | 0.08 | |||
Receptive oral sex (ever), yes vs. no | 0.54 | 0.02–11.68 | 0.69 | |||
Receptive oral sex (recent), yes vs. no | 0.80 | 0.16–3.87 | 0.78 | |||
Condomless receptive oral sex, yes vs. no | 1.18 | 0.06–22.59 | 0.91 | |||
Ano-genital wart history, yes vs. no | 1.45 | 0.49–4.31 | 0.50 | |||
HIV status, positive vs. negative | 0.53 | 0.17–1.62 | 0.26 |
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Rollo, F.; Latini, A.; Benevolo, M.; Giglio, A.; Giuliani, E.; Pichi, B.; Pellini, R.; Giuliani, M.; Donà, M.G. Concurrent and Concordant Anal and Oral Human PapillomaVirus Infections Are Not Associated with Sexual Behavior in At-Risk Males. Pathogens 2021, 10, 1254. https://doi.org/10.3390/pathogens10101254
Rollo F, Latini A, Benevolo M, Giglio A, Giuliani E, Pichi B, Pellini R, Giuliani M, Donà MG. Concurrent and Concordant Anal and Oral Human PapillomaVirus Infections Are Not Associated with Sexual Behavior in At-Risk Males. Pathogens. 2021; 10(10):1254. https://doi.org/10.3390/pathogens10101254
Chicago/Turabian StyleRollo, Francesca, Alessandra Latini, Maria Benevolo, Amalia Giglio, Eugenia Giuliani, Barbara Pichi, Raul Pellini, Massimo Giuliani, and Maria Gabriella Donà. 2021. "Concurrent and Concordant Anal and Oral Human PapillomaVirus Infections Are Not Associated with Sexual Behavior in At-Risk Males" Pathogens 10, no. 10: 1254. https://doi.org/10.3390/pathogens10101254