Acquisition and persistence of human papillomavirus 16 (HPV-16) and HPV-18 among men with high-HPV viral load infections in a circumcision trial in Kisumu, Kenya

Virginia Senkomago, Danielle M. Backes, Michael G. Hudgens, Charles Poole, Kawango Agot, Stephen Moses, Peter J F Snijders, Chris J L M Meijer, Albertus T. Hesselink, Nicolas F. Schlecht, Robert C. Bailey, Jennifer S. Smith

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Circumcision and lower human papillomavirus (HPV) viral loads in men are possibly associated with a reduced risk of HPV transmission to women. However, the association between male circumcision and HPV viral load remains unclear. Methods: Swab specimens from the glans and shaft of the penis were collected from men enrolled in a circumcision trial in Kisumu, Kenya. GP5+/6+ polymerase chain reaction (PCR) was used to identify HPV DNA types. HPV-16 and HPV-18 loads were measured with a LightCycler real-time PCR and classified as high (>250 copies/scrape) or low (≤250 copies/scrape). Results: A total of 1159 men were randomly assigned to undergo immediate circumcision, and 1140 men were randomly assigned to the control arm (these individuals were asked to remain uncircumcised until the study ended). The hazard of acquisition of high-viral load infections in the glans was lower in the circumcision arm, compared with the control arm, for HPV-16 (hazard ratio [HR], 0.32 [95% confidence interval {CI},.20-.49]) and HPV-18 (HR, 0.34 [95% CI,.21-.54]). The 6-month risk of HPV persistence among men with high-viral load infections in the glans at baseline was lower in the circumcision arm, compared with the control arm, for HPV-16 (risk ratio [RR], 0.36 [95% CI,.18-.72]) and HPV-18 (RR 0.34 [95% CI,.13-.86]). Weaker and less precise results were obtained for shaft samples. Conclusions: Male circumcision could potentially reduce the risk of HPV transmission to women by reducing the hazard of acquisition, and the risk of persistence of high-HPV viral load infections in the glans in men.

Original languageEnglish (US)
Pages (from-to)811-820
Number of pages10
JournalJournal of Infectious Diseases
Volume211
Issue number5
DOIs
StatePublished - 2015

Fingerprint

Human papillomavirus 18
Human papillomavirus 16
Kenya
Virus Diseases
Viral Load
Confidence Intervals
Male Circumcision
Odds Ratio
Penis
Real-Time Polymerase Chain Reaction
Polymerase Chain Reaction
DNA

Keywords

  • HPV-16
  • HPV-18
  • Human papillomavirus (HPV)
  • Kenya
  • Male circumcision
  • Men
  • Persistence
  • Randomized controlled trial (RCT), incidence
  • Viral load

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy

Cite this

Acquisition and persistence of human papillomavirus 16 (HPV-16) and HPV-18 among men with high-HPV viral load infections in a circumcision trial in Kisumu, Kenya. / Senkomago, Virginia; Backes, Danielle M.; Hudgens, Michael G.; Poole, Charles; Agot, Kawango; Moses, Stephen; Snijders, Peter J F; Meijer, Chris J L M; Hesselink, Albertus T.; Schlecht, Nicolas F.; Bailey, Robert C.; Smith, Jennifer S.

In: Journal of Infectious Diseases, Vol. 211, No. 5, 2015, p. 811-820.

Research output: Contribution to journalArticle

Senkomago, V, Backes, DM, Hudgens, MG, Poole, C, Agot, K, Moses, S, Snijders, PJF, Meijer, CJLM, Hesselink, AT, Schlecht, NF, Bailey, RC & Smith, JS 2015, 'Acquisition and persistence of human papillomavirus 16 (HPV-16) and HPV-18 among men with high-HPV viral load infections in a circumcision trial in Kisumu, Kenya', Journal of Infectious Diseases, vol. 211, no. 5, pp. 811-820. https://doi.org/10.1093/infdis/jiu535
Senkomago, Virginia ; Backes, Danielle M. ; Hudgens, Michael G. ; Poole, Charles ; Agot, Kawango ; Moses, Stephen ; Snijders, Peter J F ; Meijer, Chris J L M ; Hesselink, Albertus T. ; Schlecht, Nicolas F. ; Bailey, Robert C. ; Smith, Jennifer S. / Acquisition and persistence of human papillomavirus 16 (HPV-16) and HPV-18 among men with high-HPV viral load infections in a circumcision trial in Kisumu, Kenya. In: Journal of Infectious Diseases. 2015 ; Vol. 211, No. 5. pp. 811-820.
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title = "Acquisition and persistence of human papillomavirus 16 (HPV-16) and HPV-18 among men with high-HPV viral load infections in a circumcision trial in Kisumu, Kenya",
abstract = "Background: Circumcision and lower human papillomavirus (HPV) viral loads in men are possibly associated with a reduced risk of HPV transmission to women. However, the association between male circumcision and HPV viral load remains unclear. Methods: Swab specimens from the glans and shaft of the penis were collected from men enrolled in a circumcision trial in Kisumu, Kenya. GP5+/6+ polymerase chain reaction (PCR) was used to identify HPV DNA types. HPV-16 and HPV-18 loads were measured with a LightCycler real-time PCR and classified as high (>250 copies/scrape) or low (≤250 copies/scrape). Results: A total of 1159 men were randomly assigned to undergo immediate circumcision, and 1140 men were randomly assigned to the control arm (these individuals were asked to remain uncircumcised until the study ended). The hazard of acquisition of high-viral load infections in the glans was lower in the circumcision arm, compared with the control arm, for HPV-16 (hazard ratio [HR], 0.32 [95{\%} confidence interval {CI},.20-.49]) and HPV-18 (HR, 0.34 [95{\%} CI,.21-.54]). The 6-month risk of HPV persistence among men with high-viral load infections in the glans at baseline was lower in the circumcision arm, compared with the control arm, for HPV-16 (risk ratio [RR], 0.36 [95{\%} CI,.18-.72]) and HPV-18 (RR 0.34 [95{\%} CI,.13-.86]). Weaker and less precise results were obtained for shaft samples. Conclusions: Male circumcision could potentially reduce the risk of HPV transmission to women by reducing the hazard of acquisition, and the risk of persistence of high-HPV viral load infections in the glans in men.",
keywords = "HPV-16, HPV-18, Human papillomavirus (HPV), Kenya, Male circumcision, Men, Persistence, Randomized controlled trial (RCT), incidence, Viral load",
author = "Virginia Senkomago and Backes, {Danielle M.} and Hudgens, {Michael G.} and Charles Poole and Kawango Agot and Stephen Moses and Snijders, {Peter J F} and Meijer, {Chris J L M} and Hesselink, {Albertus T.} and Schlecht, {Nicolas F.} and Bailey, {Robert C.} and Smith, {Jennifer S.}",
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T1 - Acquisition and persistence of human papillomavirus 16 (HPV-16) and HPV-18 among men with high-HPV viral load infections in a circumcision trial in Kisumu, Kenya

AU - Senkomago, Virginia

AU - Backes, Danielle M.

AU - Hudgens, Michael G.

AU - Poole, Charles

AU - Agot, Kawango

AU - Moses, Stephen

AU - Snijders, Peter J F

AU - Meijer, Chris J L M

AU - Hesselink, Albertus T.

AU - Schlecht, Nicolas F.

AU - Bailey, Robert C.

AU - Smith, Jennifer S.

PY - 2015

Y1 - 2015

N2 - Background: Circumcision and lower human papillomavirus (HPV) viral loads in men are possibly associated with a reduced risk of HPV transmission to women. However, the association between male circumcision and HPV viral load remains unclear. Methods: Swab specimens from the glans and shaft of the penis were collected from men enrolled in a circumcision trial in Kisumu, Kenya. GP5+/6+ polymerase chain reaction (PCR) was used to identify HPV DNA types. HPV-16 and HPV-18 loads were measured with a LightCycler real-time PCR and classified as high (>250 copies/scrape) or low (≤250 copies/scrape). Results: A total of 1159 men were randomly assigned to undergo immediate circumcision, and 1140 men were randomly assigned to the control arm (these individuals were asked to remain uncircumcised until the study ended). The hazard of acquisition of high-viral load infections in the glans was lower in the circumcision arm, compared with the control arm, for HPV-16 (hazard ratio [HR], 0.32 [95% confidence interval {CI},.20-.49]) and HPV-18 (HR, 0.34 [95% CI,.21-.54]). The 6-month risk of HPV persistence among men with high-viral load infections in the glans at baseline was lower in the circumcision arm, compared with the control arm, for HPV-16 (risk ratio [RR], 0.36 [95% CI,.18-.72]) and HPV-18 (RR 0.34 [95% CI,.13-.86]). Weaker and less precise results were obtained for shaft samples. Conclusions: Male circumcision could potentially reduce the risk of HPV transmission to women by reducing the hazard of acquisition, and the risk of persistence of high-HPV viral load infections in the glans in men.

AB - Background: Circumcision and lower human papillomavirus (HPV) viral loads in men are possibly associated with a reduced risk of HPV transmission to women. However, the association between male circumcision and HPV viral load remains unclear. Methods: Swab specimens from the glans and shaft of the penis were collected from men enrolled in a circumcision trial in Kisumu, Kenya. GP5+/6+ polymerase chain reaction (PCR) was used to identify HPV DNA types. HPV-16 and HPV-18 loads were measured with a LightCycler real-time PCR and classified as high (>250 copies/scrape) or low (≤250 copies/scrape). Results: A total of 1159 men were randomly assigned to undergo immediate circumcision, and 1140 men were randomly assigned to the control arm (these individuals were asked to remain uncircumcised until the study ended). The hazard of acquisition of high-viral load infections in the glans was lower in the circumcision arm, compared with the control arm, for HPV-16 (hazard ratio [HR], 0.32 [95% confidence interval {CI},.20-.49]) and HPV-18 (HR, 0.34 [95% CI,.21-.54]). The 6-month risk of HPV persistence among men with high-viral load infections in the glans at baseline was lower in the circumcision arm, compared with the control arm, for HPV-16 (risk ratio [RR], 0.36 [95% CI,.18-.72]) and HPV-18 (RR 0.34 [95% CI,.13-.86]). Weaker and less precise results were obtained for shaft samples. Conclusions: Male circumcision could potentially reduce the risk of HPV transmission to women by reducing the hazard of acquisition, and the risk of persistence of high-HPV viral load infections in the glans in men.

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KW - HPV-18

KW - Human papillomavirus (HPV)

KW - Kenya

KW - Male circumcision

KW - Men

KW - Persistence

KW - Randomized controlled trial (RCT), incidence

KW - Viral load

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DO - 10.1093/infdis/jiu535

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