Human papillomavirus (HPV) is a very common virus that infects skin and mucous membranes. There are over 100 different types of HPV, with around 40 types affecting the genital area. HPV is typically cleared rapidly by the immune system within 1 to 2 years. However, sometimes HPV infection persists and can cause health problems like genital warts and cancer. HPV infection and clearance dynamics differ between men and women. Let’s take a closer look at what the research says about whether men clear HPV infection.
How common is HPV in men?
HPV is extremely common in both men and women. According to the Centers for Disease Control and Prevention (CDC), about 79 million Americans are currently infected with HPV, with approximately 14 million becoming newly infected each year.
Around half of sexually active men will get HPV infection at some point in their lives. One study found that the prevalence of genital HPV infection in men was around 50% overall. The prevalence was highest in men ages 18-28 years old at around 65%. Another study detected genital HPV infection in over 60% of sexually active college-aged men.
Do men clear acute HPV infection?
Yes, most men are able to clear an acute HPV infection through their natural immune response. Several large studies have shown that HPV infection is often transient in men.
In one study of over 1,150 men ages 18-70 years old, about 90% cleared a new genital HPV infection within 24 months. Median time to viral clearance was 6-12 months. Clearance rates were lower for high-risk HPV types 16, 18, and 31 compared to low-risk types. Age did not impact time to clearance.
Another study followed 463 male university students ages 18-24 years old who were repeatedly tested for HPV infection over 2 years. The results showed:
- 62% had HPV detected at least once
- Only 6% had persistent infection lasting the whole study
- Median duration of infection was 168 days (about 6 months)
- Older age was associated with slightly lower clearance rate
Other research studies have found similar clearance rates and duration of infection in men. Together, these study results illustrate that while HPV infection in men is common, the majority of men are able to clear the infection quickly through their natural immune response.
How does HPV infection clearance in men compare to women?
HPV tends to persist longer in women compared to men. According to a research review, the median duration of new genital HPV infection is 8 months in women versus 6 months in men. The review found that:
- Over 90% of HPV infections were cleared in 12 months in men
- Only 66% of infections were cleared in 12 months in women
One large study followed 1,767 women ages 18-24 years old who were tested regularly for HPV infection over 3 years. Results showed:
- Median duration of infection was 287 days (about 10 months)
- 34% had infection lasting the whole study
- Older age was associated with lower clearance rate
The longer duration of infection in women may be related to virus persistence in cervical tissue compared to penile tissue in men. Hormonal differences between women and men could also impact immune response and clearance rates.
Factors affecting clearance of HPV in men
Clearance of HPV infection in men seems to be affected by several factors:
HPV viral type
Some HPV types are more likely to persist than others. High-risk types 16, 18, and 31 tend to persist longer compared to low-risk types like HPV 6 and 11.
Age
Younger men tend to clear HPV infection more readily than older men. HPV infection duration was around 16 months in men ages 18-30 years old compared to over 18 months in men ages 31-44 years old in one study.
Circumcision status
Circumcised men clear HPV infection more quickly than uncircumcised men. One meta-analysis found that circumcised men were 34% less likely to have persistent high-risk HPV infection compared to uncircumcised men.
Immune status
People with weakened immune systems, such as those with HIV infection, tend to have lower HPV clearance rates and longer duration of infection.
Other genital infections
Co-infection with other sexually transmitted infections like chlamydia or gonorrhea is associated with decreased HPV clearance.
Sexual behaviors
High numbers of lifetime sexual partners or recent new partners correlates with lower HPV clearance rates in some studies.
Why does HPV infection persist in some men?
Most men are able to mount an immune response that successfully clears acute HPV infection. But in a minority of men, the virus is able to avoid immune elimination and persist. Persistence of HPV infection seems to be facilitated by:
- Integration of HPV genetic material into the host genome
- Ability of virus to evade immune detection and response
- Immune tolerance to HPV antigens
- Suppression of host anti-viral immune mechanisms
Chronic infection develops when the immune system is unable to recognize and destroy HPV-infected cells. Persisting infection with high-risk HPV types in particular raises the risk of progression to precancer or cancer.
Does HPV infection eventually clear in most men?
Yes, HPV infection will eventually clear in the majority of men. In a study of 240 male university students, less than 3% had evidence of persistent infection (over 6 months duration) with the same HPV type over 4 years. Other studies have found that over 70-90% of men will clear even high-risk HPV infection within 1-2 years.
However, a subset of men will develop a persistent HPV infection lasting for many years or even decades. One study detected persistent HPV in around 15% of men ages 18-70 years old over several years of follow-up. Persistence was highest in men over 49 years old.
Can HPV infection reoccur after clearance?
Yes, it is possible for HPV infection to come back after a man has cleared the virus, especially if he has a new sexual partner. One study found that 25% of men who cleared an HPV infection had a reoccurrence of the same HPV type within a year.
In a group of male university students, around 90% who cleared an initial HPV infection had at least one reinfection within 2 years. However, the duration of the second infection was shorter compared to the first infection.
Recurrent infections indicate that natural immunity after clearing HPV does not provide complete future protection against the virus. But the shorter duration of infection upon re-exposure hints that some immune memory remains.
How to help clear HPV infection
There are a few things men can try (in addition to letting their immune system work) that may help clear HPV infection faster:
- Avoid smoking – Smoking is associated with lower HPV clearance rates.
- Use condoms – Using condoms reduces HPV exposure and reinfection risk, which could aid clearance.
- Get circumcised – Circumcision is associated with faster HPV clearance.
- Treat co-infections – Treating any co-infections like STIs may improve HPV clearance.
- Eat healthy – A diet high in fruits, vegetables, and antioxidants promotes proper immune function.
- Reduce stress – Chronic stress weakens the immune system’s ability to clear infections.
- Avoid immunosuppression – Avoid drugs and behaviors that weaken the immune system and inhibit HPV clearance.
HPV clearance through immune enhancing drugs
Some preliminary research indicates certain pharmaceuticals and natural compounds may enhance clearance of HPV infection, such as:
- Imiquimod – Immune stimulating cream used to treat genital warts
- Interferon – Immune modulating cytokine proteins used to treat genital warts and cancer
- Green tea catechins – Antioxidants that may boost immune response against HPV
- Photodynamic therapy – Light therapy that activates antiviral immune cell activity
More clinical trials are needed to determine if these types of immune enhancing treatments can significantly improve clearance rates of HPV infection in men.
Does HPV infection in men always lead to health problems?
No, the vast majority of men who acquire HPV infection will clear it without any health problems. According to the CDC, around 90% of HPV infections cause no symptoms and are naturally cleared by the body.
However, sometimes persistent infection with high-risk HPV types in particular can lead to:
- Genital warts – Caused by HPV types 6 and 11
- Penile cancer – Associated with high-risk HPV types like 16, 18, 33
- Anal cancer – Linked to high-risk HPV infection
- Cancer of tonsils/base of tongue – Correlated with oral HPV infection
Studies suggest that most men clear even high-risk HPV infection before cancer can develop. But chronic infection for many years or decades increases the risk of HPV-associated cancers in men.
Conclusion
HPV infection is very prevalent in men, but the majority of men are able to clear acute HPV infection within 6-24 months through their natural immune response. Clearance rates are higher in younger men and lower with high-risk HPV types. Persisting infection occurs more frequently in older men or those with weakened immunity. Most men who clear initial HPV infection will get reinfected if exposed again, but the second infection is typically shorter. While HPV usually clears on its own without problems, chronic infection in some men can lead to genital warts or cancer over time.