Garolla, A., Graziani, A., Grande, G., Ortolani, C., & Ferlin, A. (2024). HPV-related diseases in male patients: an underestimated conundrum. Journal of endocrinological investigation. https://doi.org/10.1007/s40618-023-02192-3
Garolla A, Graziani A, Grande G, Ortolani C, Ferlin A. HPV-related diseases in male patients: an underestimated conundrum. Journal of endocrinological investigation. 2024. doi:10.1007/s40618-023-02192-3
Garolla, A., et al. "HPV-related diseases in male patients: an underestimated conundrum." Journal of endocrinological investigation, 2024.
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HPV in men is linked to cancers and to poorer sperm motility
This literature review of PubMed studies reports that HPV semen infection seems most related to weaker sperm motility and anti-sperm antibodies. The review also links HPV in men to head and neck and penile cancers. The review cites HPV in semen in about 16 out of 100 men with unexplained infertility.
Key Findings
High-risk HPV infection is thought to cause half of head and neck squamous cell carcinoma cases in the United States. The HPV-attributable share of head and neck cancers has increased dramatically worldwide.
In a recent study the review cites, HPV accounted for 50.8% of penile cancers and 79.8% of penile intraepithelial neoplasia.
One literature analysis cited in the review found seminal HPV infection in 20.9% of infertile men and 8.2% of the general population.
HPV semen infection seems most related to asthenozoospermia (low progressive sperm motility) and to anti-sperm antibodies, whose role in inducing male infertility the review calls controversial.
In one cited study, 86% of patients given HPV vaccination had complete clearance of HPV in semen and the genital tract.
Interpretation
The authors searched PubMed for studies on male infertility and male genital conditions from 2012 to 2022, and on head and neck disease from 2020 to 2022. The review sums up studies one by one, from several designs including lab experiments and animal work. The links between semen HPV and sperm motility are reported as associations. The authors say more studies are needed on vaccination and natural fertility.
RRM Context
RRM looks for a cause in both partners and treats unexplained infertility as undiagnosed. The review reports male factor as a main or contributing cause in 50% of infertile couples. Semen HPV infection adds one more male-side finding that can sit behind that label.
Our editorial summary of this paper, not the article's abstract.
Abstract
Purpose
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.
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