MP16-19 IMPACT OF THE QUADRIVALENT HPV VACCINE FOR MEN WHO EXPOSED TO HPV INFECTION

INTRODUCTION AND OBJECTIVES: Human papillomavirus (HPV) is one of the most common sexually transmitted infections. In 2009, FDA recommended HPV vaccine for the prevention of external genital lesions caused by HPV 6, 11, 16, or 18. There are conflicting results regarding cross protection from naturally occurring HPV infection. According to recent studies HPV vaccination can induce neutralizing antibodies across HPV species. Our purpose was to define the importance of immunization and its role in clearance of HPV infection and to assess infection-associated factors in men. METHODS: This prospective randomized trial enrolled 200 men with genital warts (GW), between June, 2009 and October, 2013. GW were diagnosed solely with their clinical features and their reaction to the aceto-white. Pathologic examination was performed in suspicious cases. Initial treatment was local excision with electrocautery or electrocautery alone in all patients. After the initial intervention, 200 patients were randomly assigned to receive a HPV vaccine in three doses (0, 2, 6 mos). Hundred patients were in the control (unvaccinated) group. All men were circumcised and reported only female sexual partners. Thirtynine men were excluded due to pre-existing medical disorders that needed chronic treatment or caused immunosuppression, follow-up (F/ U) less than 12 months and incomplete vaccination. Finally, 171 consecutive patients were included in study. There were 91 men in the vaccinated group and 80 men in the control group. One hundred-eleven were single and 60 men were married. The patients were assessed regarding age, marital status (MS), number of GW, physical examination and smoking status. Post-treatment F/U was monthly up to 6 months and one more at the 12th mo. GW recurrences were analyzed with Cox proportional hazards model. RESULTS: Mean age was 34 7.6. One hundred-fifteen (67.25%) patients were smokers. For the recurrence of GW, age, smoking, vaccination status (VS) were insignificant and MS was significant (p<.001) in the univariable analysis; MS (Figure) preserved significance (HR:2.0 CI:1.29-3.12 p1⁄4.002) in the multivariable analysis (with VS, MS). CONCLUSIONS: Among the investigated factors not VS but MS significantly influenced wart recurrence. Interestingly, married men had more recurences in our population.