Issue: March 2019
February 15, 2019
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Hand-to-genital contact unlikely to cause HPV transmission

Issue: March 2019
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HPV transmission is unlikely to occur from hand-to-genital contact, and most infections are caused by genital-to-genital sexual transmission, according to a recent study published in The Lancet Infectious Diseases.

“While hand-to-genital transmission has long been hypothesized as a mode of HPV transmission, little data have been published on the prevalence and incidence of HPV on hands to test this hypothesis,” Talía Malagón, PhD, postdoctoral researcher in the division of cancer epidemiology at McGill University in Montreal, and colleagues wrote.

Previous research has shown that male virgins who did not have penetrative sex were nonetheless infected with HPV — albeit at a slower rate than nonvirgins — suggesting that HPV can be transmitted by means other than sexual intercourse.

To establish whether hand-to-genital transmission of HPV is likely or if the detection of HPV in the hand is incidental to genital infections, Malagón and colleagues performed a cross-sectional and prospective cohort study of female university students aged 18 to 24 years and their male sexual partners. Participants in the study were recruited for the study between June 5, 2006, and April 4, 2013, and were considered eligible if they had initiated sexual activity in the past 6 months. The partners in the study provided hand and genital swab samples, which researchers tested for DNA of 36 HPV types using PCR. In total, 264 women and 291 men had valid hand samples.

Results of the study showed that the HR of incident detection of HPV in genital samples from women was 5.0 (95% CI 1.5-16.4) when the male partner was positive for the same HPV type on his hand vs. negative, but after the researchers adjusted their analysis for the male partner’s genital HPV status, the HR was reduced to 0.5 (95% CI, 0.1-1.8). Similarly, the HR of incident detection of HPV on men's genitals was 17.4 (95% CI 7.9-38.5) when his partner was positive for the same HPV type on her hand vs. negative, but adjustment for her genital HPV status reduced the HR to 2.3 (95% CI, 0.9-6.2).

According to the study, the HR of type-specific incident detection of HPV in genital samples associated with the partner’s genital HPV positivity was 19.3 (95% CI 11.8-31.8) for women and 28.4 (95% CI, 15.4-52.1) for men after adjustment for their hand HPV status.

Researchers added that that the results do not necessarily mean that it is impossible to transmit HPV through hand-to-genital contact. However, they added that if hand-to-genital transmission occurs, it is unlikely to be an “important” mode of HPV transmission.

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“The high cumulative incidence of detection of HPV in the hand suggests that genital-to-hand HPV deposition is common,” Malagón and colleagues wrote. “However, detection of HPV in the hand should not be cause for concern, because it is unlikely to substantially increase the risk of genital HPV transmission to oneself or to one's partners.” – by Caitlyn Stulpin

References:

Liu Z, et al. J Infect Dis. 2017;doi:10.1093/infdis/jix588.

Malagon T, et al. Lancet Infect Dis. 2019;doi.org/10.1016/S1473-3099(18)30655-8.

Disclosures: The authors report no relevant financial disclosures.