In the recent years we have performed large population studies concerning the presence of HPV-DNA in males without symptoms related to HPV infection but affected by urogenital infections. HPV prevalence ranged from 27% to 39% according to populations. In 2008/2009 we have followed a cohort of positive male patients with at least three per year controls. Detection of E6/E7 transcripts of HPV-16,18,31,33,45 was added to HPV-DNA test, with a more strict follow-up for positive-testing patients. Aim of the study was to evaluate the persistence of HPV infection and shedding by HPV-DNA and the E6/E7 transcripts activation and its persistence by E6/E7mRNA test.

HR-HPVs positive males (292/1056) were included in the long-term follow-up study till HPVs definitive clearance, considered after three continuative negative results. 37 patients with at least 4, or more than 4 consecutive complete control steps were included. Biological material analysed were first-voided early-morning urine-FVEMUrine, total ejaculate-TE, urethral swabs-US and postprostate-massage urine-PPMU. Compliance at follow up was low, 26,3% (77 patients). Only 5,4% patients can be considered now negative. 100% TE, 27% FVEMUrine, 18,9% PPMU tested positive. Prevalent genotypes were HPV-16 35%; HPV-18 16%; HPV-31 21%; HPV-33 11%; HPV-45 2%; HPV-51 13,5%; HPV-52 19%; HPV-59 and 68 5,4%. Coinfection rate >=2 genotypes was 37,8%.

6/37 patients (16,2%) tested positive for E6/E7mRNA and show a persistent activation of E6/E7 transcripts. 50% are HPV-16.

We have proved HR-HPVs long lasting persistence, over 2 years, in 94,5% of males belonging to this cohort of positive HPV asymptomatic patients; our study shows a constant shedding of HR-HPVs in human ejaculate with consequent infectious role for sexual partners; additionally in 16,2% patients a not-transient activation of E6/E7 transcripts was found, postulating a stronger role of these genotypes in male oncogenesis of the upper genital tract. A new stone in HPV-male anogenital infections' natural history.