This is the 4921st article of Da Yi Xiao Nursing
Preface
Human papillomavirus (HPV) is one of the most common sexually transmitted viruses in the world, and in recent years, with the gradual improvement of people's health awareness, HPV vaccine has entered everyone's field of vision and has become very popular. Some areas even require a lottery queue to get there. At present, the HPV vaccine has achieved great success in protecting women's health. So is HPV just for women? The HPV virus is susceptible to infection of squamous epithelial cells of the skin and mucous membranes, and these cells are rarely protected by virus-specific antibodies. More than 4/5 of sexually active people can be infected with HPV, with young women at highest risk and men at relatively low rates. However, with the change of sexual orientation and sexual behavior in love, the rate of HPV infection in men is increasing year by year.
1. What is HPV?
Human papilloma virus (HPV) HPV is a large virus group containing more than 200 HPV genotypes, of which about 30~40 HPV species have affinity for the reproductive tract and regularly or occasionally infect the reproductive tract. HPV is classified as high-risk and low-risk according to the amount of carcinogenicity. High-risk HPV types include types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82; Low-risk HPV types include types 2, 3, 6, 7, 10, 11, 13, 32, 40, 42, 43, 44, and 57, although co-infection with high- and low-risk HPV forms is widespread.
2. How HPV is transmitted
The HPV virus is widespread and stable in the natural environment, so various types of HPV infection are very common in the population. There are four common ways of HPV transmission.
(1) Transmission of sexual acts
This is the most common mode of transmission. HPV cross-infection is common between husband and wife. People with high-risk behaviors such as unprotected measures, lack of cleanliness before and after the event, and chaotic private life are more likely to be infected with HPV.
(2) Indirect contact transmission
Contact with items used by people living with HPV, such as bath towels, washbasins, toothbrushes, underwear, etc. In addition, places such as hotels, swimming pools, and public bathhouses are also gathering places for the HPV virus.
(3) Mother-to-child transmission
If the mother has the HPV virus, the fetus is also at risk of HPV infection during vaginal delivery.
(4) Iatrogenic transmission
Infection caused by contact with utensils used by a person infected with HPV in a hospital.
3. What are the symptoms of HPV?
HPV infection in women is generally caused by gynecological diseases such as cervical, vaginal and vulvar cancer.
HPV infection in men is of little concern, but HPV infection rates are high in men, with genital HPV infection rates in men being higher than in women globally, especially among uncircumcised, HIV-positive, and homosexual men.
Possible symptoms of HPV infection in men:
(1) Genital warts
Genital warts are a sexually transmitted disease mainly caused by HPV6 and HPV11, which is mainly manifested by benign hyperplasia of the skin and mucous membranes of the genitals, anus and vulva, which is prone to recurrence and may become cancerous. Genital warts not only affect physiological function, cause psychological stress, and bring a huge financial burden to patients, but they are also highly contagious.
(2) Male infertility
HPV affects male fertility by infecting sperm. When a man is infected with HPV, sperm motility decreases, sperm morphology changes, and sperm motility decreases, resulting in a decrease in semen quality. Among them, the change of sperm motility is the most important feature after HPV infection.
(3) Penile cancer
Penile cancer is a rare disease that mainly occurs in middle-aged and elderly men, and has a high mortality rate. A recent data show that HPV infection can cause about 50.1% of pSCC, of which HPV16 is the most common pathogenic type. The penis is the most susceptible site for HPV infection in men, and a high rate of HPV infection is associated with a lower rate of circumcision.
(4) Anal cancer
Anal cancer is a rare malignant tumor with squamous cell carcinoma as the main type, and HPV infection is the main factor causing anal cancer, especially the high-risk HPV16. Anal HPV infection varies widely between sexes and sexual orientations, with females having a higher prevalence than males, and anal HPV infection is most common in HIV-positive individuals or men who have sex with men (MSM).
Fourth, if there is no abnormality in the body, whether the man will not carry HPV
The absence of abnormalities in a man's body does not mean that he does not carry HPV. Some HPV-infected men are invisible, with no abnormalities in the vulva and foreskin cavity, but they are infected but do not know it.
5. Is it necessary for men to get HPV vaccine?
Sexual transmission is one of the main modes of HPV transmission, and the spouse of a sexually active male and female spouse who is infected has a higher probability of being infected with the corresponding HPV, so the vaccine protection for both spouses should be emphasized. At the same time, based on the mode of transmission of HPV, the injection of HPV-related vaccines for men also has a protective and preventive effect on their male spouses and themselves. Therefore, in the current situation, it is necessary to emphasize the vaccination of male spouses of men, especially women, infected with HPV.
The quadrivalent and 9-valent HPV vaccines have been approved for male injections and have a good immune response in men, which can directly protect men. Current vaccines are able to cover most of the viral subtypes of HPV-related diseases. The HPV vaccine was 46.9% effective in preventing HPV16-related anogenital infection (continuous contact > 6 months), 88% in preventing persistent oral HPV infection, and 61.9% and 46.8% in preventing anal intraepithelial neoplasia grade 2 and 3, respectively, indicating that HPV vaccine can effectively prevent HPV infection and mucosal damage in men. In a study of 1,767 young people in the United States, the oral and anal HPV infection rate in the quadrivalent vaccination group (22.9%) was lower than that in the unvaccinated group (31.6%), and the effectiveness of vaccine protection decreased with age, indicating the effectiveness of HPV vaccination in men and the need for early vaccination.
The United States, Australia, Scotland, Austria, Canada, and many other countries recommend HPV vaccination for men. The HPV vaccine's contribution to reducing the burden of HPV-related diseases largely depends on vaccine coverage in the region, among which, Australia has the highest universal coverage of HPV vaccines, with vaccine coverage of up to 80% for women and 76% for men after nearly a decade of efforts, and the incidence of HPV infection and related diseases in its population has been significantly reduced, and it is expected to eliminate HPV-related diseases in the future. In terms of current vaccine coverage in most countries, vaccine protection for men is insufficient. The herd effect is optimal when the vaccine coverage of men and women reaches 70% in a region, and the transient vaccination rate fluctuations are not affected, however MSM is less protected by this effect, and strengthening the direct protective effect of HPV vaccine in men is necessary to reduce HPV infection in men and even the entire population
6. How to prevent HPV infection in men
(1) Circumcision
First of all, HPV likes to grow in a warm and humid environment, and after cutting the foreskin, the male genitalia are more hygienic and dry, resulting in a much lower probability of HPV infection; Secondly, when the foreskin covers the glans, the skin that touches the inner side of the glans is called the inner plate, and the exposed skin on the penis is called the outer plate. Therefore, circumcision is important for men to prevent HPV.
(2) Maintain vulvar hygiene
(3) Avoid having too many sexual partners, and take safe sexual intercourse and take protective measures.
Citations:
[1] Teng Qiuli, Niu Maoyuan, Liu Yuying, Ren Shurong. The harm of HPV infection to men and the protection of HPV vaccination on men[J].Chinese Journal of Immunology,2022,(No.4).
[2] Can men also get infected with HPV? Health and Wellness,2020,(Issue 1).
[3] Si Keyi. HPV vaccine in men can also prevent cancer[J].Rehabilitation,2022,(No.2).
Author: School of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine
Gu Yiwen 2022441009
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