Abstract Background Human papillomavirus (HPV) is one of the most common sexually transmitted infections and a major risk factor for anal and oropharyngeal neoplasms.¹ In women with inflammatory bowel disease (IBD), immunosuppressive therapy has been associated with increased risk of HPV-related cervical dysplasia,² but data in male patients remain scarce.³ This study aimed to assess anal and oral HPV prevalence in male IBD patients and identify associated demographic, clinical, and behavioural factors. Methods Men aged 18–79 years with confirmed ulcerative colitis or Crohn’s disease were prospectively recruited between February 2024 and October 2025. Oral and anal swabs were analysed by PCR for low- and high-risk (HR) HPV genotypes, and cytology was performed in HR-positive cases using the Bethesda classification. Participants completed a self-administered questionnaire on sexual behaviour and history of sexually transmitted infections (STIs). Results Among 109 patients (median age 52 years IQR 40–60; 66.4% ulcerative colitis, 33.6% Crohn’s disease), anal HPV infection was detected in 15 (13.8%, 95% CI 8.6–21.4). HR genotypes were identified in 13 cases (mainly types 31 and 52), and low-risk types in 11 (most frequently type 6). Among HR-positive patients, 4 (30.8%) showed cytological abnormalities (1 low-grade squamous intraepithelial lesion and 3 atypical squamous cells of undetermined significance). Anal HPV prevalence was highest in men aged 26–40 years (14.8%) and 41–65 years (15.6%), and lower in those 65 years (7.1%). Oral HPV was detected in 4 patients (3.7%, 95% CI 1.0–9.1), all with concomitant anal infection. Two oral samples harboured HR genotypes (51 and 82), with no cytological abnormalities observed. No significant differences were found according to IBD type (p = 0.397), current and prior exposure to immunosuppressive therapy (p = 0.660 and p = 0.542, respectively), current anti-TNF therapy (p = 0.176), or other biologic or small-molecule therapies (p = 0.443). Smoking habit (p = 0.349) was also not associated with infection. Fourteen patients (12.8%) reported other STIs, including gonorrhoea (n = 7), Chlamydia trachomatis (n = 4), syphilis (n = 3), HIV (n = 2), and hepatitis B virus (n = 2). HPV infection was significantly more frequent among men who have sex with men (75%) and bisexual men (50%) than among heterosexual men (8.2%; p 0.001). Conclusion In this interim analysis, anal and oral HPV infection was detected in a notable proportion of men with IBD. No associations were observed with IBD type or medical therapy, whereas infection was substantially more frequent among men engaging in high-risk sexual behaviours. These findings support consideration of targeted HPV prevention strategies in at-risk male IBD populations. References: 1. Hewavisenti RV, Arena J, Ahlenstiel CL, Sasson SC. Human papillomavirus in the setting of immunodeficiency: Pathogenesis and the emergence of next-generation therapies to reduce the high associated cancer risk. Front Immunol. 2023 Mar 7;14:1112513. 2. Kucharzik T, Ellul P, Greuter T, Rahier JF, Verstockt B, Abreu C, et al. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. J Crohns Colitis. 2021 Jun 22;15(6):879-913. doi: 10.1093/ecco-jcc/jjab052. Erratum in: J Crohns Colitis. 2023 Jan 27;17(1):149. 3. Bruni L, Albero G, Rowley J, Alemany L, Arbyn M, Giuliano AR, et al. Global and regional estimates of genital human papillomavirus prevalence among men: a systematic review and meta-analysis. Lancet Glob Health. 2023 Sep;11(9):e1345-e1362. Conflict of interest: Giordano, Antonio: Antonio Giordano received educational funds from Johnson and Johnson, Abbvie, Alfasigma, Ferring, Kern Pharma, and Dr. Falk. Szafranska, Justyna: No conflict of interest Gordillo Abalos, Jordi: Jordi Gordillo has received financial support for attendance at scientific meetings and/or honoraria for teaching activities from Janssen, Takeda, Abbvie, MSD, Pfizer, Falk Pharma, and Tillotts Pharma. González Muñoza, Carlos: Carlos González-Muñoza has received educational funding from Abbvie, Janssen, Kern Pharma, MSD, Tillots Pharma, and Lilly. Gely Vila, Cristina: No conflict of interest Bertoletti, Federico: Federico Bertoletti has served as a speaker or advisory board member for Pfizer, Tillots Pharma and Schwabe and has received financial support for travelling and educational activities from AbbVie, Dr. Falk Pharma, Ferring, Janssen, Kern Pharma, MSD, Norgine, Pfizer, Takeda, and Tillots Pharma. Ricart Gomez, Elena: E. Ricart has received support for congress and conference attendance, speaker fees, research support or consulting fees from MSD, Abbvie, Ferring, Janssen, Otsuka, Pfizer, Takeda, Faes Farma, Galapagos/Alphasigma, Kern Pharma, Lilly, J&J, Dr Falk Pharma, and Fresenius-Kabi. Garcia Planella, Esther: Esther Garcia Planella has served as a speaker and has received research or educational funds from MSD, Abbvie, Kern, Gebro, Pfizer, Takeda, Jansen, Ferring, Shire Pharmaceuticals, Faes, Tillotts Pharma, and Pfizer.
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