Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Sex Transm Infect. 2018 May;94(3):222-225. doi: 10.1136/sextrans-2016-053031. Epub 2017 Sep 2.
Human papillomavirus (HPV) surveillance is important to monitor the effectiveness of national HPV vaccination programmes. Positivity of HPV in urine in men varies with different sampling methods. We aimed to determine the positivity for detection of HPV-6/11 in urine samples among men in relation to the position of genital warts and circumcision status.
We analysed stored chlamydia-positive urine specimens in young heterosexual men aged less than 25 years attending Melbourne Sexual Health Centre, Australia, between 2004 and 2015, for HPV genotypes. Positivity of HPV-6/11 and high-risk genotypes were stratified according to the position of genital warts and circumcision status. Positivity of HPV-6/11 was calculated using diagnosis of warts as the gold standard. Warts were classified as proximal penile warts from suprapubic area to midshaft of penis, and distal penile warts from distal shaft of penis to meatus.
Of the 934 specimens, 253 (27.1%) men were positive for any HPV and 82 men (8.8%) had genital warts. The ORs of HPV-6/11 detection in urine were 4.63 (95% CI: 1.68 to 12.78) and 40.20 (95% CI: 19.78 to 81.70) times higher among men who had proximal penile warts and distal penile warts, respectively, compared with men who did not have genital warts. Circumcised men were less likely to have high-risk HPV (OR 0.31; 95% CI: 0.14 to 0.65) than uncircumcised men. Uncircumcised men were more likely to have distal penile warts than circumcised men (OR 8.22; 95% CI: 1.34 to 337.46).
Positivity of HPV-6/11 in urine increases greatly in men with distal penile warts. Circumcised men are less likely to have distal penile warts, any HPV or high-risk HPV detected. Urine is likely to be an alternative sampling method for HPV-6/11 surveillance programme in men in countries with low circumcision rates.
人乳头瘤病毒（HPV）监测对于监测国家 HPV 疫苗接种计划的有效性非常重要。男性尿液中的 HPV 阳性率因采样方法不同而有所差异。本研究旨在确定男性尿液中 HPV-6/11 的检出率与生殖器疣的位置和包皮环切状态的关系。
我们分析了 2004 年至 2015 年间在澳大利亚墨尔本性健康中心就诊的年龄小于 25 岁的年轻异性恋男性的衣原体阳性尿液标本，以检测 HPV 基因型。根据生殖器疣的位置和包皮环切状态对 HPV-6/11 和高危型 HPV 阳性率进行分层。使用疣的诊断作为金标准计算 HPV-6/11 的阳性率。疣分为耻骨上区至阴茎中段的近端阴茎疣和阴茎远端至尿道口的远端阴茎疣。
在 934 例标本中，253 例（27.1%）男性 HPV 阳性，82 例（8.8%）男性有生殖器疣。与无生殖器疣的男性相比，有近端阴茎疣和远端阴茎疣的男性尿液中 HPV-6/11 的检出率分别高出 4.63 倍（95%CI：1.68 至 12.78）和 40.20 倍（95%CI：19.78 至 81.70）。与未行包皮环切的男性相比，行包皮环切的男性更不易感染高危 HPV（OR 0.31；95%CI：0.14 至 0.65）。未行包皮环切的男性更易发生远端阴茎疣，与行包皮环切的男性相比，其比值比（OR）为 8.22（95%CI：1.34 至 337.46）。
有远端阴茎疣的男性尿液中 HPV-6/11 的阳性率显著增加。行包皮环切的男性更不易发生远端阴茎疣、任何 HPV 或高危 HPV 感染。对于包皮环切率低的国家，尿液可能是 HPV-6/11 监测计划的一种替代采样方法。
