HPV affects men too – So should boys also be vaccinated?
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The benefits of the human papillomavirus (HPV) vaccine for women in cervical cancer prevention are well-established. On the other hand, less work has been performed to understand the usefulness of the vaccine in men.
Evidence now suggests that the HPV vaccine may also be valuable in protecting men against various HPV-linked conditions. Many cancers in men have been associated with types of HPV, the most common sexually transmitted infection. A high percentage of penile and anal cancers are related to high-risk (HR) HPV strains, in particular HPV-16, a virus type that has also been directly linked to cervical cancer in women (3). HPV can also cause cancers of the oral cavity, oropharynx, and larynx in men (2;3).
Alongside cancers, HPV strains have also been connected to anogenital infections, such as penile infections (3). In certain groups, such as men who have sex with men (MSM) as well as HIV-positive individuals, an even higher prevalence of anal infections were observed in relation to HPV (4).
Given the impact of HPV on men’s health, researchers have been trying to understand whether, like girls in many countries, should boys also receive the HPV vaccine as part of the national vaccination program. Three different vaccines have been licensed against HPV. The most recent version can protect individuals against 9 types of HPV strains, including HR 16, 18 as well as five additional HR types (3).
At present, research is limited in the area of HPV vaccine efficacy in men; however, early work suggests that vaccination in males can be moderately effective in protecting men against anogenital infections and high-grade anal intraepithelial lesions (3). Higher vaccine efficiency was observed in men who had previously never been infected with any HPV type, supporting the recommendation that preteen vaccination, before onset of sexual activity is important for optimum protection (1;3).
Immunizing men against HPV also allows specific high-risk groups, such as MSM, who do not receive indirect protection against HPV from women to now directly be protected (2).
Despite the potential benefits, gender-neutral HPV vaccination is only performed in a few countries around the world. Australia, Canada, USA and Austria are a few that offer HPV vaccines to boys and young men alongside girls (3). Next to Scotland and Wales, England is also expected to implement the HPV vaccine program to males this year (2). Belgium also aims to extend HPV vaccination to boys by September 2019 (6).
While more work needs to be performed on understanding the overall economics and benefits of extending HPV vaccination programs across all gender, the initiative does have the potential to reduce the burden of HPV and prevent many HPV-linked conditions in the future (2;3).
Studies have shown that urine, in particular, first-void urine (first part of urine flow) collected through Colli-Pee, our innovative urine capturing, allows HPV DNA detection in females. Amounts of HPV found in urine can vary between genders (5) but this area needs further exploration.
Learn more about our innovative urine capturing device Colli-Pee.
References:
(1) CDC Features - HPV Vaccine is Cancer Prevention for Boys, Too! []. USA: Centers for Disease Control and Prevention; 2018 December. Available from: https://www.cdc.gov/features/hpvvaccineboys/index.html
(2) Green A. HPV vaccine to be offered to boys in England. Lancet. 2018 Aug 4;392(10145):374. doi: 10.1016/S0140-6736(18)31728-8. Epub 2018 Aug 2. PubMed PMID: 30152370.
(3) Harder T, Wichmann O, Klug SJ, van der Sande MAB, Wiese-Posselt M. Efficacy, effectiveness and safety of vaccination against human papillomavirus in males: a systematic review. BMC Med. 2018 Jul 18;16(1):110. doi: 10.1186/s12916-018-1098-3. Review. PubMed PMID: 30016957; PubMed Central PMCID: PMC6050686.
(4) Human papillomavirus vaccines: WHO position paper, May 2017. Wkly Epidemiol Rec. 2017 May 12;92(19):241-68. PubMed PMID: 28530369.
(5) Pattyn J, Van Keer S, Biesmans S, Ieven M, Vanderborght C, Beyers K, Vankerckhoven V, Bruyndonckx R, Van Damme P, Vorsters A. Human papillomavirus detection in urine: Effect of a first-void urine collection device and timing of collection. J Virol Methods. 2019 Feb;264:23-30. doi: 10.1016/j.jviromet.2018.11.008. Epub 2018 Nov 16. PubMed PMID: 30452931.
(6) Vlaanderen.HPV-vaccinatie ook voor jongens; 2018 December. Available from: https://www.zorg-en-gezondheid.be/hpv-vaccinatie-ook-voor-jongens.