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Review – Andrology

Human Papillomavirus Infection and Vaccination in Males

By: Eugenio Ventimigliaa b , Simon Horenblasc, Asif Muneerd and Andrea Saloniaa b

EU Focus, Volume 2 Issue 4, October 2016, Pages 355-362

Published online: 01 October 2016

Keywords: Human papillomavirus, Infection, Penile cancer, Genital warts, Vaccine

Abstract Full Text Full Text PDF (618 KB)

Abstract

Context

Human papillomavirus (HPV) is the commonest sexually transmitted pathogen in humans and is linked to the aetiopathogenesis for both benign and malignant disease in men.

Objective

To evaluate and summarise the evidence for HPV infection and vaccination in men.

Evidence acquisition

A search of Medline, PubMed, and Scopus was performed to identify articles published in English within the last 10 yr addressing HPV epidemiology, the natural history of HPV infection and its long-term consequences, and vaccination in men. Relevant studies were then screened, and the data were extracted, analysed, and summarised. The Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria were applied.

Evidence synthesis

HPV has an overall prevalence of >20% among men, although a minority of individuals develop external genital lesions (EGLs). The risk of acquiring a new HPV infection is robustly linked to sexual behaviour, with the most commonly infected sites being the prepuce, shaft, glans, corona, and scrotum. Of all cancer cases among men, 2% are attributable to HPV, and up to 50% of penile cancers are estimated to be either directly or indirectly driven by it, with HPV-16 the subtype most frequently isolated. Currently there are two different vaccines approved for men, with a good immunogenic profile and efficacy of up to 80% against EGLs; however, efficacy data regarding malignant lesions are still limited.

Conclusions

HPV, owing to its high prevalence and harmful consequences for men's health, has recently attracted considerable attention. Novel insights into the natural history of HPV infection, together with the successful development of several efficacious vaccines, have provided valuable tools in the prevention of HPV infections and their related consequences. HPV vaccination appears to be the only reliable method to provide protection against new HPV infections in men.

Patient summary

Human papillomavirus (HPV) infection is very common among sexually active men and can lead to more serious consequences, including cancer. Male vaccination is both a safe and efficacious option preventing both HPV infection and its long-term consequences.

Take Home Message

Human papillomavirus (HPV) infection is highly prevalent among sexually active men, and up to 50% of penile cancer cases are related to HPV infection. Male vaccination appears to be an effective option to prevent HPV infection and reduce the risk of HPV-driven cancers.

Keywords: Human papillomavirus, Infection, Penile cancer, Genital warts, Vaccine.

Footnotes

a Università Vita-Salute San Raffaele, Milan, Italy

b Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy

c Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands

d Department of Urology and NIHR Biomedical Research Centre, University College London Hospital, London, UK

Corresponding author. Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132 Milan, Italy. Tel. +39 02 26435506; Fax: +39 02 26437298.

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