Genital Wart Recurrence Among Men Residing in Brazil, Mexico, and the United States

Background Genital wart (GW) incidence is high among men. The percentage and rate at which subsequent GW events occur are understudied. The purpose of this study was to describe the rate of subsequent GWs, associated human papillomavirus (HPV) types, and time to subsequent GW event among unvaccinated men. Methods The study was nested within a multinational prospective HPV natural history study of men aged 18-70 years in the United States, Mexico, and Brazil, examined every 6 months for a median follow-up of 50.4 months. Subsequent GW events were defined as GWs detected after 16 weeks of the prior event. Results Forty-four percent of men experienced 1 GW following the initial episode. Men with 2 subsequent events were at highest risk of continued GW experiences, with as high as 10 postinitial GW events. The incidence rate of each subsequent GW increased with increasing events (incidence of first subsequent event was 13.1 vs 36.6/1000 person-months for the fourth event). The proportion of GWs among HPV-6 and/or -11-positive patients remained constant across events. Approximately 63%-69% were positive for 1 of the 9-valent HPV vaccine types. Conclusions These data highlight the high burden of GWs among men across the lifespan and the need for vaccination to prevent multiple GW episodes. This is the first report to examine rates of genital wart (GW) recurrence among men. The high observed rate of GW recurrence supports the public health strategy of broadly vaccinating males to prevent multiple GW episodes and HPV transmission.