Prevalence of the most common types of high-risk HPV and p16INK4a expression in the penile location of asymptomatic men in Poland

Introduction
Human papillomavirus (HPV) is a leading sexually transmitted pathogen with oncogenic potential. While extensive data exist on HPV prevalence in men globally, Central and Eastern Europe remain understudied.

Aim
This study investigates the prevalence of high-risk HPV types and p16INK4a expression – a surrogate marker of HPV oncogenic activity – in penile tissue from asymptomatic Polish men.

Material and methods
Post-mortem penile tissue samples from 52 men (aged 20–80) were collected from three anatomical sites: urethral meatus, coronal sulcus, and inner foreskin. HPV DNA was detected using SYBR Green-based qPCR and type-specific probe-based qPCR for HPV-6/11, -16, -18, -31, -33, -35, and -45. Expression of p16INK4a/p16INK4a was assessed immunohistochemically using the IRS scale.

Results
HPV DNA was identified in 13.5% of participants, with HPV-18 being the most prevalent type. One case exhibited co-infection with HPV-6/11 and HPV-16. Viral DNA copy numbers varied widely (1–2580/1000 cells). p16INK4a expression was generally low (median IRS: 2.6), and no statistically significant correlation was observed between HPV presence or viral load and p16INK4a levels. A single case showed strong p16INK4a expression with high-copy HPV-6/11 and low-copy HPV-16.

Conclusions
The study confirms the presence of high-risk HPV infections among asymptomatic Polish men and suggests low oncogenic activity based on p16INK4a expression. Findings support the need for standardized HPV screening methodologies and expanded vaccination programs for boys, particularly given low national vaccine uptake and significant regional disparities in coverage.