01 March 2011

Half of men may have HPV infections

Half of men in the general population may be infected with human papillomavirus or HPV, strengthening the case for vaccinating boys against HPV, US researchers said.


Half of men in the general population may be infected with human papillomavirus or HPV, strengthening the case for vaccinating boys against HPV, US researchers said.

US vaccine advisers have been considering whether boys and young men should be vaccinated against the human papillomavirus, as they already recommend for girls and young women, but some worry that the vaccine is too costly to justify its use.

HPV infection is best known as the primary cause of cervical cancer, the second most common cancer in women worldwide. But various strains also cause anal, penile, head and neck cancers. Vaccinating men and boys would prevent some of these cancers.

Dr Anna Giuliano of the H Lee Moffitt Cancer Centre and Research Institute in Tampa, Florida, and colleagues studied infection rates among more than 1,100 men aged 18 to 70 in the United States, Brazil and Mexico to get a snapshot of the natural progression of HPV infection in men.

Men and women infection rates similar

"We found that there is a high proportion of men who have genital HPV infections. At enrolment, it was 50%," said Dr Giuliano, whose study appeared in The Lancet.

The team also found that the rate at which men acquire new HPV infections is very similar to women.

They also found that about 6% of men per year will get a new HPV 16 infection, the strain that is known for causing cervical cancer in women and other cancers in men.

Vaccines made by Merck & Co and GlaxoSmithKline both offer protection against this strain of HPV.

"The biology seems to be very similar (to women)," Dr Giuliano said.

"What is different is that men seem to have a high prevalence of genital HPV infections throughout their lifespans."

She said it appears that women are better able to clear an HPV infection, especially as they age, but men do not appear to have the same ability.

Vaccinating boys

Vaccine experts said the study builds momentum for widespread HPV vaccination among boys.

Currently, the US Centres for Disease Control and Prevention recommends Gardasil vaccinations for girls and women between the ages of 11 and 26. Gardasil had sales of more than $1 billion (about R7 billion) last year.

And while doctors are free to use the vaccine in boys and men ages 9 through 26, US health officials so far have declined to recommend routine vaccination for males.

"This study highlights the high incidence of HPV infection in men, which emphasises their role in transmission of HPV to women," Dr Anne Szarewski of the Wolfson Institute of Preventive Medicine in London said in a statement.

"It must surely strengthen the argument for vaccination of men, both for their own protection, and that of their partners."

In December, the US Food and Drug Administration approved Merck's Gardasil HPV vaccine for prevention of anal cancers in both men and women, based on studies showing Gardasil was effective in men who have sex with men, a group that has a higher incidence of anal cancer.

Anal cancer is one of the less common types of cancer, with an estimated 5,300 new US cases diagnosed each year, but the incidence is increasing.

(Reuters Health, Julie Steenhuysen, March 2011)

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