High-risk human papilloma virus infection of the foreskin in asymptomatic boys.

Objective: To evaluate the prevalence and genotypes of high-risk human papilloma virus (HPV) infection of the foreskin in asymptomatic boys before first sexual intercourse.

Materials And Methods: We collected 50 consecutive foreskin specimens after radical circumcision. Indication for surgery was phimosis. High-risk HPV status was determined by real-time polymerase chain reaction for the genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59. Immunohistochemistry for p16(INK4a) was performed.

Results: The median age at the time of surgery was 5.5 years (range, 5 months-15 years). High-risk HPV was detected in 6 of 50 foreskins (12%). All positive samples showed HPV16. No association with age or grade of phimosis was observed. Two samples were focally positive for p16(INK4a), both of which were HPV-negative.

Conclusion: In a significant proportion of boys, subclinical high-risk HPV infections are found in the foreskin, which could be a reservoir for HPV-associated diseases. Our study generates the hypothesis that nonsexual routes play significant roles in HPV transmission. Because the human foreskin represents a high-risk HPV reservoir, vaccination may be also advised in boys.