From the Guidelines
Human papillomavirus (HPV) infection in males does not require treatment for the virus itself, but rather for the conditions caused by HPV, such as genital warts. The approach to managing HPV in males should focus on preventing transmission, monitoring for potential complications, and treating symptoms when they arise. According to the guidelines from 1, treatments are available for conditions caused by HPV, like genital warts, but not for the virus itself. Key points to consider in managing HPV in males include:
- Most HPV infections clear spontaneously without causing health problems 1.
- Genital warts can be treated with topical medications or removed through procedures like cryotherapy, surgical excision, or laser treatment.
- Prevention through HPV vaccination, recommended for males up to age 26, and consistent condom use during sexual activity is crucial in managing HPV risk 1.
- Regular monitoring may be recommended for high-risk HPV infections, especially in immunocompromised individuals, to prevent potential complications like penile, anal, or oropharyngeal cancers.
- Counseling should include information on the commonality of HPV, its modes of transmission, the importance of condom use, and the availability of vaccines to prevent certain types of HPV 1. Treatment should be aimed at managing symptoms and preventing transmission, rather than curing the HPV infection itself, as the virus often resolves on its own. In clinical practice, the focus should be on educating patients about HPV, its implications, and the preventive measures available, as well as providing appropriate treatment for any conditions that arise from the infection, such as genital warts, as outlined in the guidelines from 1.
From the Research
HPV Infection in Males
- Human Papillomavirus (HPV) infection is a common sexually transmitted infection that can cause various anogenital diseases, including warts, dysplasia, and squamous cell carcinoma in males 2, 3, 4.
- The risk of acquiring a new HPV infection is linked to sexual behavior, with the most commonly infected sites being the prepuce, shaft, glans, corona, and scrotum 3.
- HPV infection can lead to more serious consequences, including cancer, with up to 50% of penile cancers estimated to be either directly or indirectly driven by HPV 3.
Treatment and Prevention
- Treatment modalities are available to treat anogenital warts, including patient- and provider-applied methods, but lesions can recur 2.
- Prophylactic vaccines, such as the quadrivalent HPV vaccine, are approved to prevent HPV infection and are indicated to prevent genital warts in males and females 2, 4, 5.
- HPV vaccination appears to be the only reliable method to provide protection against new HPV infections in men, with efficacy of up to 80% against external genital lesions 3.
- Inclusion of males in prophylactic HPV vaccination programs is likely to have significant health and economic benefits, reducing HPV-related disease in males and females 5.
Management and Recommendations
- Providers should clearly explain the natural history and potential sequelae of HPV disease, counsel patients on prevention strategies, and recommend vaccination as an effective method of prevention 2.
- Treatment of both partners is necessary to eliminate the virus from the population, and approaches include prophylactic vaccines such as the quadrivalent HPV vaccine for both men and women 4.
- Comprehensive cost-benefit analyses are needed to determine the efficacy of HPV vaccination programs in the overall population 5.