Skip to main content
PMC home page
Genitourinary Medicine logoLink to Genitourinary Medicine
. 1994 Aug;70(4):240–246. doi: 10.1136/sti.70.4.240

Regional distribution and incidence of human papillomavirus infections among heterosexual men and women with multiple sexual partners: a prospective study.

G J Van Doornum 1, M Prins 1, L H Juffermans 1, C Hooykaas 1, J A van den Hoek 1, R A Coutinho 1, W G Quint 1
PMCID: PMC1195247  PMID: 7959707

Abstract

OBJECTIVE--To assess prevalence, incidence and potential risk factors of human papillomavirus (HPV) infection among heterosexual men and women with multiple partners and to identify niches of HPV-infection. DESIGN--A prospective study of heterosexual men and women with multiple partners attending an STD clinic as participants in a study on HIV from May 1988 until January 1991. Routine STD examination and physical examination using colposcopy were performed, interviews with standardised questionnaires were administered. Specimens for HPV DNA detection by polymerase chain reaction were collected from multiple sites of the genital, anorectal and oral regions. In women cervical cytology was performed. SETTING--The STD Clinic of the Municipal Health Service of Amsterdam. PARTICIPANTS--162 women and 85 men entered the study, 110 women and 48 men were followed up. RESULTS--At entry of the study 37 (23%) women and 24 (28%) men were found positive for HPV DNA at any site. Only in one woman was oral presence of HPV DNA found during follow-up. Abnormal cervical cytology was observed in four women. In multivariate analysis, diagnosis of condylomata [odds ratio (OR) 5.61, 95% confidence interval (CI) 1.86 to 16.90)], reporting genital dermatological abnormalities (OR 3.72, 95% CI 1.38 to 9.99) and age (OR per year 0.93, 95% CI 0.88 to 0.99) predicted independently the presence of HPV DNA in women at entry of the study. In women 59 of the 99 (60%) HPV infections were observed in the genital region and 40% in the anorectal region: in men these figures were 65% and 35%, respectively. The incidence of HPV infection was 47.1 and 50.5 per 100 person-years for women and men respectively. At least 20/99 (20%) infections in women were intermediate or long persistent and only 3/48 (6%) HPV infections in men (P = 0.03). No risk factor for persistency could be determined, either in women or in men. CONCLUSIONS--HPV infection was found to be a multicentric genital and/or anorectal event both in women and men. The oral presence of HPV DNA was detected only once in one of the participants. In women persistent HPV infection was more common than in men. Independent predictors for presence of HPV DNA in women were diagnosis of condylomata acuminata, reporting genital dermatologic abnormalities and age. Incidence of HPV infection in women turned out to be 47.1 infections per 100 person-years and for men 50.5 per 100 person-years.

Full text

PDF
240

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Campion M. J., McCance D. J., Cuzick J., Singer A. Progressive potential of mild cervical atypia: prospective cytological, colposcopic, and virological study. Lancet. 1986 Aug 2;2(8501):237–240. doi: 10.1016/s0140-6736(86)92067-2. [DOI] [PubMed] [Google Scholar]
  2. Claas E. C., Melchers W. J., van der Linden H. C., Lindeman J., Quint W. G. Human papillomavirus detection in paraffin-embedded cervical carcinomas and metastases of the carcinomas by the polymerase chain reaction. Am J Pathol. 1989 Oct;135(4):703–709. [PMC free article] [PubMed] [Google Scholar]
  3. Hippeläinen M. I., Syrjänen S., Hippeläinen M. J., Saarikoski S., Syrjänen K. Diagnosis of genital human papillomavirus (HPV) lesions in the male: correlation of peniscopy, histology and in situ hybridisation. Genitourin Med. 1993 Oct;69(5):346–351. doi: 10.1136/sti.69.5.346. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Hooykaas C., van der Pligt J., van Doornum G. J., van der Linden M. M., Coutinho R. A. Heterosexuals at risk for HIV: differences between private and commercial partners in sexual behaviour and condom use. AIDS. 1989 Aug;3(8):525–532. [PubMed] [Google Scholar]
  5. Jalal H., Sanders C. M., Prime S. S., Scully C., Maitland N. J. Detection of human papilloma virus type 16 DNA in oral squames from normal young adults. J Oral Pathol Med. 1992 Nov;21(10):465–470. doi: 10.1111/j.1600-0714.1992.tb00976.x. [DOI] [PubMed] [Google Scholar]
  6. Jenison S. A., Yu X. P., Valentine J. M., Koutsky L. A., Christiansen A. E., Beckmann A. M., Galloway D. A. Evidence of prevalent genital-type human papillomavirus infections in adults and children. J Infect Dis. 1990 Jul;162(1):60–69. doi: 10.1093/infdis/162.1.60. [DOI] [PubMed] [Google Scholar]
  7. Kashima H. K., Kutcher M., Kessis T., Levin L. S., de Villiers E. M., Shah K. Human papillomavirus in squamous cell carcinoma, leukoplakia, lichen planus, and clinically normal epithelium of the oral cavity. Ann Otol Rhinol Laryngol. 1990 Jan;99(1):55–61. doi: 10.1177/000348949009900110. [DOI] [PubMed] [Google Scholar]
  8. Kataoka A., Claesson U., Hansson B. G., Eriksson M., Lindh E. Human papillomavirus infection of the male diagnosed by Southern-blot hybridization and polymerase chain reaction: comparison between urethra samples and penile biopsy samples. J Med Virol. 1991 Mar;33(3):159–164. doi: 10.1002/jmv.1890330304. [DOI] [PubMed] [Google Scholar]
  9. Kellokoski J. K., Syrjänen S. M., Chang F., Yliskoski M., Syrjänen K. J. Southern blot hybridization and PCR in detection of oral human papillomavirus (HPV) infections in women with genital HPV infections. J Oral Pathol Med. 1992 Nov;21(10):459–464. doi: 10.1111/j.1600-0714.1992.tb00975.x. [DOI] [PubMed] [Google Scholar]
  10. Kiviat N. B., Koutsky L. A., Critchlow C. W., Lorincz A. T., Cullen A. P., Brockway J., Holmes K. K. Prevalence and cytologic manifestations of human papilloma virus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 among 500 consecutive women. Int J Gynecol Pathol. 1992 Jul;11(3):197–203. doi: 10.1097/00004347-199207000-00005. [DOI] [PubMed] [Google Scholar]
  11. Koutsky L. A., Holmes K. K., Critchlow C. W., Stevens C. E., Paavonen J., Beckmann A. M., DeRouen T. A., Galloway D. A., Vernon D., Kiviat N. B. A cohort study of the risk of cervical intraepithelial neoplasia grade 2 or 3 in relation to papillomavirus infection. N Engl J Med. 1992 Oct 29;327(18):1272–1278. doi: 10.1056/NEJM199210293271804. [DOI] [PubMed] [Google Scholar]
  12. Lorincz A. T., Reid R., Jenson A. B., Greenberg M. D., Lancaster W., Kurman R. J. Human papillomavirus infection of the cervix: relative risk associations of 15 common anogenital types. Obstet Gynecol. 1992 Mar;79(3):328–337. doi: 10.1097/00006250-199203000-00002. [DOI] [PubMed] [Google Scholar]
  13. Lorincz A. T., Schiffman M. H., Jaffurs W. J., Marlow J., Quinn A. P., Temple G. F. Temporal associations of human papillomavirus infection with cervical cytologic abnormalities. Am J Obstet Gynecol. 1990 Mar;162(3):645–651. doi: 10.1016/0002-9378(90)90974-c. [DOI] [PubMed] [Google Scholar]
  14. Melchers W., van den Brule A., Walboomers J., de Bruin M., Burger M., Herbrink P., Meijer C., Lindeman J., Quint W. Increased detection rate of human papillomavirus in cervical scrapes by the polymerase chain reaction as compared to modified FISH and southern-blot analysis. J Med Virol. 1989 Apr;27(4):329–335. doi: 10.1002/jmv.1890270413. [DOI] [PubMed] [Google Scholar]
  15. Reid R., Greenberg M., Jenson A. B., Husain M., Willett J., Daoud Y., Temple G., Stanhope C. R., Sherman A. I., Phibbs G. D. Sexually transmitted papillomaviral infections. I. The anatomic distribution and pathologic grade of neoplastic lesions associated with different viral types. Am J Obstet Gynecol. 1987 Jan;156(1):212–222. doi: 10.1016/0002-9378(87)90241-9. [DOI] [PubMed] [Google Scholar]
  16. Rymark P., Forslund O., Hansson B. G., Lindholm K. Genital HPV infection not a local but a regional infection: experience from a female teenage group. Genitourin Med. 1993 Feb;69(1):18–22. doi: 10.1136/sti.69.1.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Scholefield J. H., Hickson W. G., Smith J. H., Rogers K., Sharp F. Anal intraepithelial neoplasia: part of a multifocal disease process. Lancet. 1992 Nov 21;340(8830):1271–1273. doi: 10.1016/0140-6736(92)92961-e. [DOI] [PubMed] [Google Scholar]
  18. Scholefield J. H., Sonnex C., Talbot I. C., Palmer J. G., Whatrup C., Mindel A., Northover J. M. Anal and cervical intraepithelial neoplasia: possible parallel. Lancet. 1989 Sep 30;2(8666):765–769. doi: 10.1016/s0140-6736(89)90830-1. [DOI] [PubMed] [Google Scholar]
  19. Sonnex C., Scholefield J. H., Kocjan G., Kelly G., Whatrup C., Mindel A., Northover J. M. Anal human papillomavirus infection in heterosexuals with genital warts: prevalence and relation with sexual behaviour. BMJ. 1991 Nov 16;303(6812):1243–1243. doi: 10.1136/bmj.303.6812.1243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Vooijs G. P. De advisering bij afwijkende bevindingen van cytologisch onderzoek van de cervix uteri. Ned Tijdschr Geneeskd. 1987 Sep 19;131(38):1662–1663. [PubMed] [Google Scholar]
  21. de Vet H. C. Cytologische diagnostiek van baarmoederhalskanker; classificatiesystemen ter discussie. Ned Tijdschr Geneeskd. 1990 Jul 28;134(30):1435–1437. [PubMed] [Google Scholar]
  22. van Doornum G. J., Hooykaas C., Juffermans L. H., van der Lans S. M., van der Linden M. M., Coutinho R. A., Quint W. G. Prevalence of human papillomavirus infections among heterosexual men and women with multiple sexual partners. J Med Virol. 1992 May;37(1):13–21. doi: 10.1002/jmv.1890370104. [DOI] [PubMed] [Google Scholar]
  23. van den Brule A. J., Claas E. C., du Maine M., Melchers W. J., Helmerhorst T., Quint W. G., Lindeman J., Meijer C. J., Walboomers J. M. Use of anticontamination primers in the polymerase chain reaction for the detection of human papilloma virus genotypes in cervical scrapes and biopsies. J Med Virol. 1989 Sep;29(1):20–27. doi: 10.1002/jmv.1890290105. [DOI] [PubMed] [Google Scholar]
  24. van der Linden M. M., van der Velde F. W., Hooykaas C., van Doornum G. J., Coutinho R. A. HIV-prevalentie onder heteroseksuelen met veel wisselende partners in Amsterdam. Ned Tijdschr Geneeskd. 1990 Jul 14;134(28):1361–1364. [PubMed] [Google Scholar]

Articles from Genitourinary Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES