Male Circumcision Reduces Penile HPV Incidence and Persistence: A Randomized Controlled Trial in Kenya.
Adolescent
Alphapapillomavirus
/ genetics
Circumcision, Male
/ statistics & numerical data
DNA, Viral
/ isolation & purification
Humans
Incidence
Intention to Treat Analysis
Kenya
Male
Papillomavirus Infections
/ diagnosis
Penile Diseases
/ diagnosis
Penis
/ surgery
Persistent Infection
/ diagnosis
Treatment Outcome
Young Adult
Journal
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
ISSN: 1538-7755
Titre abrégé: Cancer Epidemiol Biomarkers Prev
Pays: United States
ID NLM: 9200608
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
received:
28
08
2020
revised:
24
01
2021
accepted:
22
03
2021
pubmed:
12
5
2021
medline:
27
1
2022
entrez:
11
5
2021
Statut:
ppublish
Résumé
Male circumcision reduces the risk of human immunodeficiency virus infection in men. We assessed the effect of male circumcision on the incidence and natural history of human papillomavirus (HPV) in a randomized clinical trial in Kisumu, Kenya. Sexually active, 18- to 24-year-old men provided penile exfoliated cells for HPV DNA testing every 6 months for 2 years. HPV DNA was detected via GP5+/6+ PCR in glans/coronal sulcus and in shaft samples. HPV incidence and persistence were assessed by intent-to-treat analyses. A total of 2,193 men participated (1,096 randomized to circumcision; 1,097 controls). HPV prevalence was 50% at baseline for both groups and dropped to 23.7% at 24 months in the circumcision group, and 41.0% in control group. Incident infection of any HPV type over 24 months was lower among men in the circumcision group than in the control group [HR = 0.61; 95% confidence interval (CI), 0.52-0.72]. Clearance rate of any HPV infection over 24 months was higher in the circumcision group than in the control group (HR = 1.87; 95% CI, 1.49-2.34). Lower HPV point-prevalence, lower HPV incidence, and higher HPV clearance in the circumcision group were observed in glans but not in shaft samples. Male circumcision reduced the risk of HPV acquisition and reinfection, and increased HPV clearance in the glans. Providing voluntary, safe, and affordable male circumcision should help reduce HPV infections in men, and consequently, HPV-associated disease in their partners.
Sections du résumé
BACKGROUND
Male circumcision reduces the risk of human immunodeficiency virus infection in men. We assessed the effect of male circumcision on the incidence and natural history of human papillomavirus (HPV) in a randomized clinical trial in Kisumu, Kenya.
METHODS
Sexually active, 18- to 24-year-old men provided penile exfoliated cells for HPV DNA testing every 6 months for 2 years. HPV DNA was detected via GP5+/6+ PCR in glans/coronal sulcus and in shaft samples. HPV incidence and persistence were assessed by intent-to-treat analyses.
RESULTS
A total of 2,193 men participated (1,096 randomized to circumcision; 1,097 controls). HPV prevalence was 50% at baseline for both groups and dropped to 23.7% at 24 months in the circumcision group, and 41.0% in control group. Incident infection of any HPV type over 24 months was lower among men in the circumcision group than in the control group [HR = 0.61; 95% confidence interval (CI), 0.52-0.72]. Clearance rate of any HPV infection over 24 months was higher in the circumcision group than in the control group (HR = 1.87; 95% CI, 1.49-2.34). Lower HPV point-prevalence, lower HPV incidence, and higher HPV clearance in the circumcision group were observed in glans but not in shaft samples.
CONCLUSION
Male circumcision reduced the risk of HPV acquisition and reinfection, and increased HPV clearance in the glans.
IMPACT
Providing voluntary, safe, and affordable male circumcision should help reduce HPV infections in men, and consequently, HPV-associated disease in their partners.
Identifiants
pubmed: 33972367
pii: 1055-9965.EPI-20-1272
doi: 10.1158/1055-9965.EPI-20-1272
pmc: PMC8172477
mid: NIHMS1689643
doi:
Substances chimiques
DNA, Viral
0
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1139-1148Subventions
Organisme : NIAID NIH HHS
ID : P30 AI050410
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI082151
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA114773
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI050440
Pays : United States
Organisme : CIHR
Pays : Canada
Commentaires et corrections
Type : CommentIn
Informations de copyright
©2021 American Association for Cancer Research.
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