Presence of human papillomavirus in semen of healthy men is firmly associated with HPV infections of the penile epithelium

Objective To study the source of human papillomavirus (HPV) in semen. Design Observational study (CCMO-NL3248800010). Setting Academic hospital-based laboratory. Patient(s) Healthy male volunteers (n = 213). Intervention(s) One penile scrape and three semen samples were obtained per participant for HPV-DNA testing by both GP5+/6+ polymerase chain reaction (PCR) and SPF10-PCR to detect moderate/high and low viral loads, respectively; flat penile lesions (FPL) were detected by penoscopy. Main Outcome Measure(s) HPV-DNA presence in semen and penile scrapes, and the presence of FPL. Result(s) HPV-DNA at moderate/high viral loads (i.e., GP5+/6+ PCR-positive) was detected in ≥1 semen sample(s) in 27% of participants. Most men with moderate/high viral loads in the penile scrape also had moderate/high viral loads in semen (85%). Men with a HPV-negative penile scrape were very unlikely to have moderate/high viral loads in semen (3%). The presence of HPV in semen was associated with the presence of HPV in the penile scrape also on a genotype-specific level. Having FPL was a risk factor for HPV presence in semen. Conclusion(s) HPV-DNA presence in semen of healthy men is common and associated with HPV infections of the penile epithelium. HPV-DNA presence in semen may result from desquamation of HPV-infected penile cells.