REGIONAL DISTRIBUTION AND INCIDENCE OF HUMAN PAPILLOMAVIRUS INFECTIONS AMONG HETEROSEXUAL MEN AND WOMEN WITH MULTIPLE SEXUAL PARTNERS - A PROSPECTIVE-STUDY

Objective-To assess prevalence, incidence and potential risk factors o f human papillomavirus (HPV) infection among heterosexual men and wome n with multiple partners and to identify niches of HPV-infection. Desi gn-A prospective study of heterosexual men and women with multiple par tners attending an STD clinic as participants in a study on HIV from M ay 1988 until January 1991. Routine STD examination and physical exami nation using colposcopy were performed, interviews with standardised q uestionnaires were administered. Specimens for HPV DNA detection by po lymerase chain reaction were collected from multiple sites of the geni tal, anorectal and oral regions. In women cervical cytology was perfor med. Setting-The STD Clinic of the Municipal Health Service of Amsterd am. Participants-162 women and 85 men entered the study, 110 women and 48 men were followed up. Results-At entry of the study 37 (23%) women and 24 (28%) men were found positive for HPV DNA at any site. Only in one woman was oral presence of HPV DNA found during follow-up. Abnorm al cervical cytology was observed in four women. In multivariate analy sis, diagnosis of condylomata [odds ratio (OR) 5.61, 95% confidence in terval (CI) 1.86 to 16.90)], reporting genital dermatological abnormal ities (OR 3.72, 95% CI 1.38 to 9.99) and age (OR per year 0.93, 95% CI 0.88 to 0.99) predicted independently the presence of HPV DNA in wome n at entry of the study. In women 59 of the 99 (60%) HPV infections we re observed in the genital region and 40% in the anorectal region: in men these figures were 65% and 35%, respectively. The incidence of HPV infection was 47.1 and 50.5 per 100 person-years for women and men re spectively. At least 20/99 (20%) infections in women were intermediate or long persistent and only 3/48 (6%) HPV infections in men (P = 0.03 ). No risk factor for persistency could be; determined, either in wome n or in men. Conclusions-HPV infection was found to be a multicentric genital and/or anorectal event both in women and men. The oral presenc e of HPV DNA was detected only once in one of the participants. In wom en persistent HPV infection was more common than in men. Independent p redictors for presence of HPV DNA in women were diagnosis of condyloma ta acuminata, reporting genital dermatologic abnormalties and age. Inc idence of HPV infection in women turned out to be 47.1 infections per 100 person-years and for men 50.5 per 100 person-years.