Researchers from the Autonomous University of Barcelona, the Lluita Contra la SIDA (Fight Against AIDS) Foundation, and the IrsiCaixa Foundation in Spain report high rates of human papillomavirus (HPV) infection in the oral, anal, and penile cavities of HIV-infected men, particularly in the anal cavities of men who have sex with men (MSM).
For each year from 2005 to 2009, the researchers investigated the presence of HPV among 733 male HIV-infected patients at the Germans Trias i Pujol Hospital in Badalona, Spain, including 538 MSM. The researchers also studied the rate of new infections and clearance of the virus during the four years of study. In the sample studied, the prevalence rates were 73 percent of cases with anal HPV, 26 percent with penile, and 16 percent in oral sites; new cases during the four years were 36 percent with anal HPV, 17 percent penile, and 11 percent oral.
The results indicate high prevalence and incidence of HPV in the three sites and a low clearance rate. MSM presented higher prevalence (84 percent) and incidence in the anal canal, and lower clearance percentage than heterosexuals, but prevalence in heterosexuals was also high at 42 percent. The researchers commented that the prevalence in MSM was expected, but the prevalence in the heterosexual group was unexpected. In other sites, prevalence, incidence, and clearance were similar and coinfection in all three sites was similar at 7 percent in heterosexuals and 6 percent in MSM. The study found lower prevalence of HPV infection in anal sites of patients treated with antiretrovirals, but this was a weak effect.
The researchers recommended routine oral, penile, and anal examinations for all HIV-positive patients during annual clinic regardless of sexual behavior and practices.
The full report, "Natural History of Human Papillomavirus Infections Involving Anal, Penile, and Oral Sites Among HIV-Positive Men," was published online in the journal Sexually Transmitted Diseases (2013; doi: 10.1097/OLQ.0b013e31827e87bd).