Urethral Swab use in Diagnossis of Human Papilloma Virus Infection among Men Seeking Routine Evaluation

Abstract

More than 100 human papilloma virus (HPV) types have been identified so far. These oncoviruses can infect either mucosal or cutaneous sites. Mucosal HPV types predominantly infect the genital tract and are sexually transmitted. Several epidemiologic studies of genital HPV infection in women have been conducted lately but data on HPV prevalence and type distribution among men are lacking. It has been shown that in men HPV can be detected in urethral secretions. We aimed to verify that by the use of urethral swab we are able to diagnose HPV infection in men. The investigation started with 113 patients (37 men, seeking routine investigation) who were referred to the Institute of Virology “Stefan S. Nicolau” laboratory on a 12 month period (2007-2008), prior the National Vaccination Campaign against HPV. For HPV diagnosis, samples were collected from lesions presumed HPV infected. In all men we collected urethral swab by scraping the urinary canal. We found a high presence of the HPV infection in the initial studied population, 59.3% patients were HPV positive. The following HPV genotypes were founded: 6; 11; 16; 18; 31; 33; 40; 42; 45; 51; 53; 54; 58; 59; 61; 66; 68; 70. The men tested from the urethral swab turned out to be HPV positive in a percent of 40.5%, and from them 40% were infected with oncogenic HPV genotypes. In this study the urethral swab was used to detect HPV DNA even in asymptomatic HPV carriers and by collecting urethral swab we were able to diagnose HPV infection. Taking into account the overall presence of HPV, the high diversity of HPV types and the high proportion of oncogenic types, the epidemiologic characteristics of HPV infection in men seem different to that observed in women.