Presence of human papillomavirus HPV in semen of healthy men is firmly associated with HPV infections of the penile epithelium

Capsule:
The association of human papillomavirus (HPV) in semen with HPV infections of the penile epithelium increases our understanding of the role of semen in the sexual transmission of HPV.

Authors:
Roosmarijn Luttmer, M.D., Maaike G. Dijkstra, M.D., Ph.D., Peter J.F. Snijders, Ph.D., Ekaterina S. Jordanova, Ph.D., Audrey J. King, Ph.D., Divera T.M. Pronk, Carlo Foresta, M.D., Ph.D., Andrea Garolla, M.D., Ph.D., Peter G.A. Hompes, M.D., Ph.D., Johannes Berkhof, Ph.D., Maaike C.G. Bleeker, M.D., Ph.D., John Doorbar, Ph.D., Daniëlle A.M. Heideman, Ph.D., Chris J.L.M. Meijer, M.D., Ph.D.

Volume 104, Issue 4, Pages 838-844

Abstract:

Objective:
To study the source of human papillomavirus (HPV) in semen.

Design:
Observational study (CCMO-NL3248800010).

Setting:
Academic hospital-based laboratory.

Patient(s):
Healthy male volunteers (n = 213).

Intervention(s):
One penile scrape and three semen samples per participant for HPV-DNA testing by both GP5+/6+ polymerase chain reaction (PCR) and SPF10 PCR to detect moderate/high and low viral loads, respectively; flat penile lesions (FPL) detected by penoscopy.

Main Outcome Measure(s):
HPV-DNA presence in semen and penile scrapes, and the presence of FPL.

Result(s):
HPV-DNA at moderate/high viral loads (i.e., GP5+/6+ PCR positive) was detected in ≥1 semen sample(s) in 27% of participants. Most men with moderate/high viral loads in the penile scrape also had moderate/high viral loads in semen (85%). Men with a HPV-negative penile scrape were very unlikely to have moderate/high viral loads in semen (3%). The presence of HPV in semen was associated with the presence of HPV in the penile scrape also on a genotype-specific level. Having FPL was a risk factor for HPV presence in semen.

Conclusion(s):
HPV-DNA presence in semen of healthy men is common and associated with HPV infections of the penile epithelium. HPV-DNA presence in semen may result from desquamation of HPV-infected penile cells.

  • Chris Meijer

    Thank you for your comment. Indeed, 20% of penile scrape specimens tested negative for both betaglobin and HPV PCR and were therefore considered invalid. As described previously (Bleeker et al.), penile scraping is a technique that yields a very limited amount of cells, in contrast to the collection of semen.

  • Jason M. Franasiak

    A very interesting study. It seems as though the penile scrapings yielded a high rate of invalid HPV results. Is this common with this method of collection? The semen samples did not have a similar rate of invalid results which is interesting.

  • Chris Meijer

    Thank you for your comment. We agree that HPV-vaccination of pre-sexually active adolescents is of great importance, not only in girls but also in boys (as was recently underscored by Bogaards and Berkhof in British Medical Journal). We hope to publish our additional research – on the relation of seminal HPV presence and semen parameters – very soon.

  • Very high HPV prevalence in sexually active men. Unsure how this virus impacts fertility or sperm function. Regardless, HPV infections, especially the more virulent strains, can result in penile or cervical cancer.
    I think this provides additional support for early immunization of pre-sexually active adolescents and teenagers.
    Interested to see the additional research from this group on impact on fertility or sperm function.

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