Patterns of human papillomavirus DNA and antibody positivity in young males and females, suggesting a site-specific natural course of infection

Abstract

Background: To monitor the impact of human papillomavirus types 16 and 18 vaccine on HPV infection dynamics in the Netherlands, we started an ongoing study in sexually transmitted infection (STI) clinics in 2009. Here, we analyze baseline type-specific HPV DNA and HPV-specific antibody positivity rates.

Methods: We enrolled 3569 men and women, 16-24 years of age, from 14 STI clinics, and estimated genital and anal HPV DNA and antibody positivity rates of 7 main carcinogenic HPV types. Generalized estimating equations regression analyses were applied to determine risk factors for, and associations between, type-specific HPV DNA and antibody positivity.

Results: Genital HPV DNA positivity rates were higher in women than in men; anal HPV DNA was especially high in men who have sex with men (MSM). HPV antibody seropositivity rates were also highest in women and MSM. High-risk sexual behavior was predictive of both HPV DNA and antibody positivity. Despite a strong correlation in serological profiles for multiple HPV types, seropositivity was independently associated with homologous HPV DNA detection.

Conclusions: HPV DNA and antibody positivity rates are higher in women and MSM than in heterosexual men, but their association is similar across gender. This suggests a site-specific natural course of infection.

Figure 1. Positivity rate for genital and anal DNA detection in women, MSW and MSM.

Black gives the positivity rate for persons with a HPV DNA detection only at the genitals, dark grey gives the positivity rate for persons with an HPV DNA infection genital as well as anal, and light grey are the positivity rates when persons are only detected with HPV DNA anally. The figures includes women (N = 118), MSW (N = 56) and MSM (N = 124) of whom a genital and an anal sample were available. MSW =  men who have sex with women only; MSM = men who have sex with men.

Figure 2. Genital (and anal) HPV DNA and HPV-specific antibody seropositivity in women, MSW, and MSM.

Figure 2a–c gives the genital HPV DNA (light grey), HPV-specific antibody seropositivity (dark grey), as well as the percentage of persons detected with genital HPV DNA as well as HPV antibodies (black) with 95% confidence intervals in women (N = 2233), MSW (N = 922), and MSM (N = 173) per HPV genotype. Figure 2d gives the anal HPV DNA (light grey), HPV-specific antibody seropositivity (dark grey) as well as the percentage of persons detected with anal HPV DNA as well as HPV antibodies (black) with 95% confidence intervals in MSM (N = 124). Ab = antibody; MSM = men who have sex with men; MSW = men who have sex with women only.