Male Circumcision Reduces Penile HPV Incidence and Persistence: A Randomized Controlled Trial in Kenya.

Smith, Jennifer S; Backes, Danielle M; Hudgens, Michael G; Mei, Wenwen; Chakraborty, Hrishikesh; Rohner, Eliane; Moses, Stephen; Agot, Kawango; Meijer, Chris J L M; Bailey, Robert C (2021). Male Circumcision Reduces Penile HPV Incidence and Persistence: A Randomized Controlled Trial in Kenya. Cancer epidemiology, biomarkers & prevention, 30(6), pp. 1139-1148. American Association for Cancer Research AACR 10.1158/1055-9965.EPI-20-1272

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BACKGROUND

Male circumcision reduces the risk of human immunodeficiency virus infection in men. We assessed the effect of male circumcision on the incidence and natural history of human papillomavirus (HPV) in a randomized clinical trial in Kisumu, Kenya.

METHODS

Sexually active, 18- to 24-year-old men provided penile exfoliated cells for HPV DNA testing every 6 months for 2 years. HPV DNA was detected via GP5+/6+ PCR in glans/coronal sulcus and in shaft samples. HPV incidence and persistence were assessed by intent-to-treat analyses.

RESULTS

A total of 2,193 men participated (1,096 randomized to circumcision; 1,097 controls). HPV prevalence was 50% at baseline for both groups and dropped to 23.7% at 24 months in the circumcision group, and 41.0% in control group. Incident infection of any HPV type over 24 months was lower among men in the circumcision group than in the control group [HR = 0.61; 95% confidence interval (CI), 0.52-0.72]. Clearance rate of any HPV infection over 24 months was higher in the circumcision group than in the control group (HR = 1.87; 95% CI, 1.49-2.34). Lower HPV point-prevalence, lower HPV incidence, and higher HPV clearance in the circumcision group were observed in glans but not in shaft samples.

CONCLUSION

Male circumcision reduced the risk of HPV acquisition and reinfection, and increased HPV clearance in the glans.

IMPACT

Providing voluntary, safe, and affordable male circumcision should help reduce HPV infections in men, and consequently, HPV-associated disease in their partners.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Rohner, Eliane

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1055-9965

Publisher:

American Association for Cancer Research AACR

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

19 May 2021 19:18

Last Modified:

05 Dec 2022 15:51

Publisher DOI:

10.1158/1055-9965.EPI-20-1272

PubMed ID:

33972367

BORIS DOI:

10.48350/156414

URI:

https://boris.unibe.ch/id/eprint/156414

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