Acetowhite Test for Detection of Papilloma Virus Infection in Men Sexual Partner of Women Diagnosed of High Grade Cervical Lesions

Background: Traditionally, men asked urologist for treatment of genital warts caused by low risk Papilloma virus (LR-HPV) but, recently, asymptomatic men also want to know if they are infected by high risk HPV (HR-HPV) and the benefits of HPV vaccine. The aims of this cross-sectional study were: (1) to evaluate acetowhite test usefulness for detection of asymptomatic and subclinical HRHPV infection in a high risk population of men and (2) to assess risk factors of HR-HPV infection in this population.
Methods: Healthy men (n=137) sexual partners of women with preneoplastic cervical lesions were recruited. Acetowhite test was performed (5% acetic acid solution, colposcopic examination under 4-fold and 7-fold magnification). Genital samples were obtained for HR-HPV DNA detection from different penile areas. (Linear Array HPV Genotyping Test, Roche Diagnostics, Mannheim, Germany). SPSS 19.0 (IBM, Chicago, USA) was used for statistical analysis.
Results: HR-HPV prevalence was 68/137 (49.6%). AW procedure was positive in 36/137 (26.3%) patients. Genital warts were present in 18/137 (13.1%) patients. Acetowhite test showed 25% sensitivity (95% CI: 13.9-36), 72.4% specificity (95% CI: 61.2-83.7), 47.2% predictive positive value (95% CI: 29.5-64.9) and 49.5% negative predictive value (95% CI: 39.2- 59.7) for the identification of HR-HPV infection. Subclinical lesions were detected in 16/68 (23.5%) infected males. Genital warts (p=0.010) were associated with an increased risk for HRHPV infection in men.
Conclusion: In our experience, acetowhite procedure sensitivity was low for HR-HPV detection in asymptomatic/subclinical genital infection and it was not specific indicator of HR-HPV infection. Genital warts detection was associated with HR-HPV infection in men.