The Natural History of Human Papillomavirus Related Condyloma In a Multinational Cohort of Men

Background: Data on the natural history of human papillomavirus (HPV) infection progression to genital warts (GW) in men are sparse. We described the distribution of HPV types in incident GW and estimated GW incidence and time from type-specific incident HPV infections to GW detection in a multinational cohort of men ages 18-70. Methods: Participants included 2,487 men examined every 6 months and followed for a median of 17.9 months. Samples obtained from 112 incident GW were tested for HPV DNA by PCR. Genotyping tested for the presence of 37 HPV types. Findings: Incidence of GW was 2.35 per 1,000 person-years with the highest incidence rate observed among men ages 18-30 (3.43 per 1,000 person-years). HPV 6 (43.8%), 11 (10.7%), and 16 (9.8%) were the most common types detected in GW. The 24 month cumulative incidence of GW among men with incident HPV 6/11 infections was 14.6% (95% CI: 7.5-21.1). The median time to any GW detection was 17.1 months (95% CI: 12.4-19.3), with the shortest time to detection observed among men with incident infections with HPV 6/11 only (6.2 months; 95% CI: 5.6-24.2). Interpretation: HPV 6/11 plays an important role in GW development with the highest incidence and shortest time to GW development observed among men with incident HPV 6/11 infections. Funding: National Cancer Institute.