目的:人乳头瘤病毒(HPV)感染是最常见的性传播疾病,在世界各地的男性和女性。虽然HPV在女性疾病中的作用是众所周知的,并且大量研究,男性被忽略地包括在这些项目中,这也是因为患有和死于HPV相关疾病的女性比例比男性大得多。这篇综述的目的是关注男性患者中HPV相关疾病。
方法:我们对电子数据库PubMed进行了文献分析。我们考虑了随机试验,观察性和回顾性研究,以HPV男性感染与以下项目之间的关系为主题的原创文章:口服,肛门阴茎癌,疣,尖锐湿疣,男性不育,改变了精子参数,抗精子抗体(ASA)。我们还包括体外实验研究,重点是HPV感染对卵母细胞受精的影响,囊胚发育,和滋养细胞侵袭。此外,纳入了描述HPV疫苗的辅助给药作为促进受感染男性精液中HPV清除的可能策略的研究.
结果:关于头颈部HPV相关疾病,最重要的非肿瘤性疾病是复发性呼吸道乳头状瘤病(RRP)。关于肿瘤疾病,由于HPV引起的头颈癌的比例在全球范围内急剧增加.此外,如今,据认为,在美国,一半的头颈部鳞状细胞癌(HNSCC)病例是由高危型HPV感染引起的。HPV在男性实践中也是值得注意的。它被描述为具有高HPV患病率,在50%到70%之间,在男性阴茎轴上,龟头阴茎/冠状沟,精液以及阴囊,肛周,和肛门区域。此外,在男性患者中,HPV感染已经相关,在其他疾病中,患有阴茎癌。据报道,一般人群中约有10%的男性感染HPV精液,原因不明的不孕症男性中约有16%。尽管根据临床经验,这些数据似乎被广泛低估了。特别是,HPV精液感染似乎与弱精子症和抗精子抗体(ASAs)最相关。
结论:HPV感染代表了一种健康问题,具有有害的社会和公共影响。尽管有这些证据,迄今为止,在年轻男性中广泛推广疫苗接种的工作很少。
OBJECTIVE: Human papillomavirus (HPV) infection is the most common sexually transmitted disease, in males and females worldwide. While the role of HPV in female diseases is well known and largely studied, males have negligibly been included in these programs, also because the proportion of women suffering and dying from HPV-related diseases is much larger than men. The aim of this review is to focus on HPV-related diseases in male patients.
METHODS: We performed a literature analysis on the electronic database PubMed. We considered randomized trials, observational and retrospective studies, original articles having as topic the relationship between HPV male infection and the following items: oral, anal penile cancers, warts, condylomas, male infertility, altered sperm parameters, anti-sperm antibodies (ASA). We also included experimental in vitro studies focused on the effects of HPV infection on oocyte fertilization, blastocyst development, and trophoblastic cell invasiveness. In addition, studies describing the adjuvant administration of the HPV vaccination as a possible strategy to promote HPV clearance from semen in infected males were included.
RESULTS: Regarding head and neck HPV-related diseases, the most important non-neoplastic disease is recurrent respiratory papillomatosis (RRP). Regarding neoplastic diseases, the proportion of head and neck cancers attributable to HPV has increased dramatically worldwide. In addition, nowadays, it is thought that half of head and neck squamous cell carcinomas (HNSCCs) cases in the United States are caused by infection with high-risk HPV. HPV is noteworthy in andrological practice too. It was described as having a high HPV prevalence, ranging between 50 and 70%, in male penile shaft, glans penis/coronal sulcus, semen as well as in scrotal, perianal, and anal regions. Moreover, in male patients, HPV infection has been associated, among other diseases, with penile cancers. HPV semen infection has been reported in about 10% in men from the general population and about 16% in men with unexplained infertility, although these data seem widely underestimated according to clinical experience. In particular, HPV semen infection seems to be most related to asthenozoospermia and to anti-sperm antibodies (ASAs).
CONCLUSIONS: HPV infection represents a health problem with a detrimental social and public impact. Despite this evidence, little has been done to date to widely promote vaccination among young males.