Molecular and serological prevalence of high-risk human papillomavirus among asymptomatic men in Georgia

Abstract

Objectives

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide, associated with a range of anogenital and oropharyngeal cancers in men. Despite this, male populations are often underrepresented in HPV surveillance and prevention programs, particularly in Eastern Europe and the Caucasus. This study aimed to assess the prevalence of high-risk HPV in asymptomatic men in Georgia using both serologic and molecular diagnostics.

Methods

We conducted a cross-sectional study of 372 asymptomatic men aged 25-65 years, recruited from urban outpatient clinics in Tbilisi. Serum samples were analyzed using a commercial enzyme-linked immunosorbent assay kit (DiaPro) to detect immunoglobulin G antibodies specific to HPV16 and HPV18. Simultaneously, HPV DNA was extracted and genotyped using the Anyplex™ II HPV28 Detection Assay (Seegene), which identifies 28 genotypes, including 14 high-risk types.

Results

Only five participants (1.34%; 95% confidence interval: 0.6-3.1%) tested positive for HPV16/18-specific immunoglobulin G antibodies. In contrast, HPV DNA was detected in 165 participants (44.4%). The most common genotypes were HPV31 (15.1%), HPV16 (10.0%), HPV33 (5.4%), and HPV18 (4.8%). All detected genotypes were high-risk. Among seropositive individuals, three had HPV16, one had HPV31, and one had HPV18.

Conclusions

These findings reveal a high prevalence of high-risk HPV genotypes in asymptomatic Georgian men, despite low seropositivity. The results support the need for gender-neutral HPV vaccination and underscore the limitations of serological testing in male populations.