Resumen de Incidence of external genital lesions related to human papillomavirus among Mexican men. A cohort study

Eduardo Lazcano-Ponce, Staci L. Sudenga, B Nelson Torres, Mark Stoler, Leith León Maldonado, Betania Allen-Leigh, Héctor Posso, Manuel Quiterio, Pilar Hernández Nevarez, Jorge Salmerón, Anna Giuliano

• español

  Objetivo. Determinar incidencia de lesiones genitales externas (LGE) –condiloma y neoplasia intraepitelial del pene (NIP)– y progresión de genotipos deVPH a LGE. Material y métodos. Se aplicaron cuestionarios,examen anogenital y recolección de muestras cada seis meses a hombres sanos (18-74 años, de Cuernavaca, México, reclutados 2005-2009, n=954) con biopsia y confirmación histológica. Se caracteri- zaron 37 tipos de ADN-VPH; se calculó incidencia de LGE (cumulativa con Kaplan-Meier). Resultados. Incidencia de LGE=1.84 (IC95%=1.42-2.39) por 100-persona-años (pa); 2.9% (IC95%=1.9-4.2) LGE acumulativa a 12 meses.

  Mayor incidencia de LGE entre hombres 18-30 años; 1.99 (IC95%=1.22-3.25) por 100pa.Siete sujetos tuvieron NIP I-III.

  VPH-11 más comúnmente progresa a condiloma (incidencia acumulativa a seis meses=44.4%, IC95%=14.3-137.8). Los sujetos con comportamiento sexual de alto riesgo tuvieron mayor incidencia de LGE. Conclusiones. En México la infección anogenital conVPH es alta y puede causar condiloma.

  La estimación de magnitud de LGE y los costos sanitarios asociados se necesita para evaluar la necesidad de vacunación contra VPH en hombres

• English

  Objective. To determine external genital lesion (EGL) incidence –condyloma and penile intraepithelial neoplasia (PeIN)– and genital HPV-genotype progression to these EGLs.

  Materials and methods. Participants (healthy males 18- 74y from Cuernavaca, Mexico, recruited 2005-2009, n=954) underwent a questionnaire, anogenital examination, and sample collection every six months;including excision biopsy on suspicious EGL with histological confirmation.Linear array assay PCR characterized 37 high/low-risk HPV-DNA types.

  EGL incidence and cumulative incidence were calculated, the latter with Kaplan-Meier. Results. EGL incidence was 1.84 (95%CI=1.42-2.39) per 100-person-years (py); 2.9% (95%CI=1.9-4.2) 12-month cumulative EGL.Highest EGL inci- dence was found in men 18-30 years:1.99 (95%CI=1.22-3.25) per 100py. Seven subjects had PeIN I-III (four with HPV16).

  HPV11 most commonly progresses to condyloma (6-month cumulative incidence=44.4%, 95%CI=14.3-137.8). Subjects with high-risk sexual behavior had higher EGL incidence.

  Conclusion. In Mexico, anogenital HPV infection in men is high and can cause condyloma. Estimation of EGL magnitude and associated healthcare costs is necessary to assess the need for male anti-HPV vaccination.