A comparison of histopathologic diagnosis and the demonstration of human papillomavirus-specific DNA and proteins in penile warts.

The extent to which the clinical diagnosis of male condylomata acuminata (CA) will be improved by histopathologic examination, immunohistochemical demonstration of papillomavirus common antigen (BPV), or demonstration of human papillomavirus (HPV)-specific DNA was studied. The relation of nuclear atypia to local cytodestructive therapy and specific HPV types was also analyzed. Altogether, the diagnosis could be histologically verified in 116 of 133 (87%) patients with clinically suspected penile CA. Of these, 69 (59%) had a positive result in in situ DNA hybridization for one or more of HPV types 6/11, 16/18, 31/33/35, or 31/35/51. Atypical cells were observed in 53 CA biopsies (46%), and there was a statistically significant correlation between this finding and the high risk HPV types 16/18, 31/33/35, and 31/35/51. Seventeen patients had neither histologic signs of condyloma acuminatum, nor detectable BPV antigen, and in situ hybridization showed HPV type 31/33/35 DNA in one biopsy, and HPV type 6/11 DNA in another. No correlation between the atypical changes and the type of previous therapy for the warts was found. Our results indicate that histopathologic examination supplemented with new HPV-specific methods is an important tool in diagnosing HPV infections.     

Anal intercourse: a risk factor for anal papillomavirus infection in women?

OBJECTIVE--To determine whether anal intercourse is a risk factor for anal HPV infection in women. DESIGN--Results derived from clinical examination, anal cytology and HPV DNA hybridisation were correlated with data obtained from a questionnaire administered to the patients at the time of their clinical examination. SETTING--A sexually transmitted diseases (STD) clinic in Sydney, Australia. SUBJECTS--31 women attending the clinic for HPV related problems. METHODS AND RESULTS--A thorough history was elicited from each woman followed by physical examination of the anogenital region. Cervical and anal scrapes were collected for cytology and HPV DNA hybridisation. Of the 15 women who practised anal intercourse, a total of 12 (80%) had either clinical or subclinical HPV infection. Seven had overt anal warts, situated either internally or externally in the anal canal; and further 5 women had evidence of subclinical HPV infection as determined by positive cytological and/or HPV DNA hybridisation results on their anal scrapes. The women who did not have a history of anal intercourse had a lower (7/16, 43%), but not statistically significant, rate of anal HPV infection: five had anal warts and two had subclinical evidence of infection. No correlations were found between anal HPV infection and genital (cervical, vulval or vaginal) HPV infection; nor between the HPV typing patterns of women in either group. CONCLUSION--The results obtained from these women do not indicate a close relationship between anal intercourse and the presence of detectable anal HPV infection.     

Dual genitotropic human papillomavirus infections in genital warts.

BACKGROUND AND METHODS--We have carried out a prospective study of dual genitotropic human papillomavirus (HPV) infections by means of two different DNA detection methods in biopsy specimens obtained from patients who were examined for genital warts at the STD clinic of the School of Medicine in Seville, between January 1990 and December 1991. RESULTS--100 patients with a clinical diagnosis of condilomata acuminata were seen during the study period. DNA of the genitotropic HPV 6/11, 16/18 and 31/33/35 was detected by an in situ hybridisation method in 75 (77%) of the 98 evaluable samples; one of the genotypes tested in 59 (61%) samples, and two or more genotypes tested in the remaining 16 (15%) samples. In 21 (98%) of the 23 negative samples by in situ hybridisation, we were able to detect DNA of genital HPV using a polymerase chain reaction amplification method (PCR). Among the 34 samples where PCR was applied we confirmed the presence of two different HPV genotypes in eight samples. CONCLUSIONS--The frequency of dual infections with human genitotropic papillomavirus in genital warts was 8%, although we believe that this rate should be higher as we have not used the PCR method in all of the samples.     

Papillomavirus-associated balanoposthitis.

OBJECTIVE--To assess whether there might be an association between genital papillomavirus infection (GPVI) and balanoposthitis. DESIGN--Retrospective HPV DNA examination of biopsy specimens from 23 men suffering from balanoposthitis and exhibiting acetowhite lesions that were penoscopically and histologically concurrent with HPV infection. SETTING--The STD clinics at Karolinska Hospital and South Hospital, Stockholm, Sweden. PARTICIPANTS--Randomly selected men attending with long-lasting and/or recurrent penile symptoms and exhibiting a clinical picture of balanoposthitis, who revealed a penoscopical and histopathological picture of epidermal lesions that were concordant with accepted criteria for typical or conspicuous GPVI. Asymptomatic controls were selected retrospectively on the basis of identical penoscopy and histology criteria. RESULTS--A history of previous condylomata was obtained in eight (35%) of 23 men. At penoscopic evaluation tiny condylomatous lesions were observed in five (22%) patients. The in situ hybridisation (ISH) assay using specific probes for the HPV types 6/11, 16/18, 31/33 and 42 was positive in 13/23 (56%) of the patient samples, but in only 26% of the 19 control samples. In patient biopsies the oncogenic HPV types 16/18 and/or 31/33 were found in 7/13 samples, whereas HPV 6/11 and/or 42 were present in another six cases. PCR performed on the ten ISH negative patient biopsies, were negative in all cases. CONCLUSION--Symptoms included redness, itching, burning, tenderness, dyspareunia, fissuring and in two cases penile oedema and inguinal adenopathy. All patients fulfilled penoscopical and histopathological criteria for HPV infection. We demonstrate some tentative evidence that HPV might be associated with long-lasting balanoposthitis, although our data still are circumstantial for a causative association. The results also elucidate the diversity in clinical presentation of GPVI.     

The prevalence of "high-risk" HPV types in penile condyloma-like lesions: correlation between HPV type and morphology.

OBJECTIVE--To evaluate the prevalence of "high-risk" human papilloma virus (HPV) types in penile condyloma-like lesions and to correlate HPV types with clinical and histological features. DESIGN--The study included 94 male patients with signs of penile HPV infection. From acuminate, papular and macular lesions, specimens were collected for HPV DNA hybridisation, using the dot blot and Southern blot techniques. Biopsy specimens from 51 cases were examined by light microscopy for signs of koilocytosis and dysplasia. SETTING--The STD outpatient clinic of the Department of Dermatovenereology of Sahlgrenska Hospital, Göteborg, Sweden. RESULTS--In 79 (90%) of 88 patients HPV DNA was detected by dot blot. Of 51 cases examined by histology 88% disclosed an evident koilocytosis. "High-risk" HPV types (16, 18, 31, 33, 35) were demonstrated in 8% of acuminate, 24% of papular and 56% of macular lesions. In 29% of 51 lesions examined histologically moderate to severe dysplasia was observed. There was a significant correlation between "high-risk" HPV types and dysplasia. CONCLUSION--"High-risk" HPV types are prevalent in papular and especially macular penile condyloma-like lesions. The histological finding of koilocytosis concomitant with dysplasia strongly indicates infection with a "high-risk" HPV type. Although the risk of penile cancer is low, it is from an epidemiological point of view important to diagnose these lesions. Until simple tests for HPV typing are available, biopsy for light microscopy (histology) should be obtained liberally from papular and macular condyloma-like lesions. In atypical cases of balanoposthitis HPV aetiology should also be considered.     

原位分子杂交检测尖锐湿疣组织中HPV DNA的研究

本文采用HPV DNA原位分子杂交法检测了30例尖锐湿疣组织标本，结果显示HPV6/11型阳性检出率为86.6%，HPV16/18型为16.6%，HPV31/33/35则为阴性，总的阳性检出率为90%。阳性结果作见于表皮浅层外，还见于棘细胞层中下部及基底细胞层内，作者认为原位分子杂交法是目前检测HPV感染及其分型的一种敏感、特异、快速且相对简便的方法，又能进行感染的组织学定位，同时这一方法还适应于对以往病例进行回顾性调查。     

鲍温样丘疹病中hTERT蛋白表达与高危型HPV感染的相关性研究

目的研究hTERT蛋白在鲍温样丘疹病中的表达及与高危型HPV存在的相关性。方法通过原位杂交法研究HPV的存在和免疫组化法检测hTERT蛋白在鲍温样丘疹病中的表达,并探讨hTERT蛋白表达与高危型HPV存在的相关性。结果在26例鲍温样丘疹病标本中,18例(69.2%)为HPV16/18阳性,其中1例HPV16/18阳性标本也有HPV6/11阳性。3例(11.5%)为HPV31/33/35阳性,2例(7.7%)为未定型HPV阳性,21例有高危型HPV存在的标本是hTERT阳性,16例高危型HPV感染的标本呈现了强而弥漫性hTERT蛋白表达。hTERT蛋白表达与高危型HPV的存在显著相关。结论高危型HPV可能诱导了hTERT蛋白的高表达。     

Changes in HPV infection in patients with anogenital warts and their partners.

OBJECTIVES--To investigate the relationship between clinical findings and the detection of human papillomavirus (HPV) DNA in a range of anatomical sites in patients with and without anogenital warts. SUBJECTS--Men and women with a clinical diagnosis of anogenital warts, or a current partner with anogenital warts. SETTING--A department of genitourinary medicine in central London. METHODS--The anogenital areas of the patients were thoroughly examined using a colposcope before and after application of acetic acid. Different types of specimens were taken from a variety of anatomical sites. Superficial skin sampling was performed by the application of slides covered with "Superglue" (SG) to clinically normal and abnormal areas of anogenital skin. The presence of human cells in the SG samples was confirmed by detection of the beta-globin gene using the polymerase chain reaction (PCR). HPV DNA was extracted from the specimens and amplified by using consensus primers with the PCR. HPV types 6, 11, 16, 18, 31 and 33 were identified by Southern blotting followed by hybridisation. RESULTS--In women, HPV DNA was detected in 83% of wart biopsies, 29% of cervical biopsies, 36% of cervical scrapes, 25% of urethral loop specimens, 37% of vaginal washes and 33% of rectal swab specimens. In men, HPV DNA was detected in 67% of wart biopsies, 37% of urethral loop specimens and 12% of rectal swab specimens. Of the SG samples containing the beta-globin gene, 49% from women and 50% from men contained HPV DNA. HPV DNA was not detected in buccal scrapes and serum samples from women or men. Of all specimens with detectable HPV DNA, there was evidence of a single HPV type in 41%, multiple types in 48% and undetermined types in 11%. Samples taken from different sites of a patient tended to have HPV types in common. Sexual partners, however, did not consistently have HPV types in common. CONCLUSIONS--HPV DNA was distributed widely in the anogenital area, in warts, acetowhite areas and clinically normal skin. The SG technique was well tolerated by patients and produced results consistent with other findings. Sampling from a single site of the genitalia on one occasion may significantly underestimate the infection rate with HPV. Multifocal infection of the anogenital area with HPV should be taken into consideration when interpreting epidemiological studies and management strategies.     

性病门诊378例女性宫颈分泌物的HPV基因型分析

目的检测和分析性病门诊女性患者宫颈分泌物中人乳头瘤病毒(HPV)的基因型别。方法收集我院性病门诊就诊的女性患者378例,按患者有无高危接触和宫颈口有无尖锐湿疣症状划分为3组,即有接触有症状组(161例)、有接触无症状组(117例)和无接触无症状组(100例)。取3组患者脱落细胞,采用反向分子杂交法进行HPV基因分型检测。结果性病门诊378例女性宫颈分泌物HPV阳性率为56.61%(214/378),有接触有症状组、有接触无症状组和无接触无症状组的阳性率分别为98.75%(159/161)、40.17%(47/117)和8.00%(8/100),3组分别检出22种、14种和5种HPV基因型别,检出的主要型别是HPV6、11、16、58、56、18、33、68。有接触有症状组和有接触无症状组单一感染和复合感染的感染率差异无统计学意义(P0.05),在多重复合感染中,以二重和三重感染为主,最多发现八重感染。有接触有症状组低危型121例次(76.10%),高危型99例次(62.26%),有接触无症状组低危型35人次(74.46%),高危型26例次(55.32%),两组感染率较高,但差异无统计学意义(P0.05)。结论 HPV6、11、16、58、56、18、33、68是性病门诊女性患者宫颈感染HPV的主要型别,健康体检者中亦能查出,临床应加强对性病门诊女性就诊者宫颈HPV基因的检测,及对HPV阳性患者进行定期的跟踪随访,尤其是高危型和复合感染患者。     

性病高危人群HPV DNA分型检测结果分析

目的分析性病高危人群HPV-DNA分型检测的结果。方法采用荧光定量聚合酶链反应技术(FQPCR)对541例性病高危人群进行HPV-DNA分型检测。结果男、女HPV阳性率分别为38.69%和52.63%,141例疣体中HPV阳性率为73.76%,其中男、女疣体HPV阳性率分别为61.54%和80.90%,400例分泌物中HPV阳性率为38.25%,其中男、女分泌物HPV阳性率分别为30.61%和42.69%,两者差异均具有显著性。配偶患CA者、CA治疗后复查者和自检者的HPV阳性率分别为44.12%,45.88%和33.33%。结论性病高危人群HPV检出率均较高,且女性高于男性。配偶患CA者、CA治疗后者和自检者也存在较高的HPV感染,应重视对这些人群的HPV常规检测。     

Genital human papillomavirus infection among patients attending an STD clinic.

OBJECTIVES--To determine the prevalence of human papillomavirus (HPV) infection in patients, male and female, attending a clinic for sexually transmitted diseases (STDs). DESIGN--A randomly selected group of patients representative of the population studied and first-time visitors to the STD clinic, were asked to participate in the study. Samples from the skin and mucous membranes of the lower genital region were taken for cytological analysis by the polymerase chain reaction (PCR) method for HPV DNA. The patients then underwent colposcopy or peniscopy after acetic acid application. SETTING--Department of Dermatology and Venereology, University Hospital, Uppsala, Sweden. SUBJECTS--A total of 131 patients, 66 women and 65 men, attending the clinic for various reasons. RESULTS--At colposcopy/peniscopy, 18 patients (10 men and 8 women) had lesions typical of, and 24 (12 men and 12 women) suspicious of HPV infection. With the PCR technique HPV DNA was detected in 72% of the patients with typical lesions and in 54% of those with suspicious lesions. CONCLUSION--Nearly one-third or 30.5% of these randomly selected patients in a Swedish STD clinic were infected by HPV. The diagnosis was made by clinical inspection and/or by HPV DNA analysis with PCR.     

Factors associated with clinical and sub-clinical anal human papillomavirus infection in homosexual men.

OBJECTIVES--(I) to determine the relative sensitivities of clinical examination, cytology and HPV DNA hybridisation for the detection of anal human papillomavirus infection; and (ii) to examine various factors which may influence presentation of anal human papillomavirus infection in homosexual men. METHODS AND RESULTS--112 unselected homosexual men attending a Sydney STD clinic for routine screening underwent a complete anogenital and physical examination, during which blood samples (for haematological, serological and immunological investigations), rectal swabs (for culture of anal pathogens) and anal scrapes of the dentate line (for cytology and HPV DNA hybridisation) were collected. Papanicolaou-stained anal smears were examined for cytological abnormalities, including those indicative of HPV infection or anal intraepithelial neoplasia (AIN). HPV DNA was detected by high stringency dot hybridisations using radiolabelled HPV 6, 11, 16 and 18 DNA probes. Visible anal condylomata, situated either externally or in the anal canal, were present in 26% of these men; 46% had cytological evidence of HPV infection, and 19% of the smears showed evidence of mild to moderate dysplastic changes (AIN I-II). Detectable HPV DNA was present in 40% of the anal scrapes. By combining these results, a total of 73 men (65%) were found to have at least one of the indicators of HPV infection. These data, together with that relating to HIV antibody, immune status and past or present infection with other STDs, was correlated with information obtained from a questionnaire administered to the patients at the time of their clinical examination. CONCLUSIONS--In this study cytology was found to be slightly more sensitive than HPV DNA dot hybridisation for the detection of HPV infection in the anal canal, providing the full range of HPV-associated cytological changes were accepted as a basis for diagnosis. Clinical anal lesions were more likely to be detected in young men, men who had symptomatic HIV infection and those with a history of past anal wart infection. The latter group also had a higher incidence of cytologically apparent HPV infection in their anal smears. There was a significant association between the detection of HPV 16/18 and the presence of anal dysplasia, but there were no significant correlations between HPV infection or anal dysplasia and HIV antibody, immune function status, sexual practices or history of other STDs.     

Prevalence of serum antibodies to human papilloma virus in patients with genital ulcer disease in an urban population of Tanzania

BACKGROUND: The epidemiology of human papillomavirus (HPV) in Tanzania is largely unknown both in risk groups and in the general population. OBJECTIVE: To determine the cumulative seroprevalence of selected HPV types in order to evaluate exposure to HPV in urban Tanzania. METHOD: In a cross-sectional study, sera of 200 patients of both sexes with genital ulcer disease (GUD) and sera of 60 male blood donors and 60 pregnant women were tested for antibodies to the oncogenic HPV types 16, 18, 31, 33, 35, 51 and 52 using an ELISA based on virus-like particles (VLP). RESULTS: The overall seroprevalence of HPV types for all patients with GUD was 83% and 77% for women and men, respectively. For pregnant women and male blood donors, the corresponding percentages were 55% and 15%, respectively. The most common HPV types were 16, 18 and 52. Infection with multiple types was more than 10 and 5 times more frequent than infection with a single type 16 in patients with GUD and in pregnant women, respectively. The seroprevalence to HPV types 16, 18, 51 and 52 was considerably higher in HIV-positive patients with GUD than in HIV-negative patients. CONCLUSIONS: Infections with the oncogenic HPV types 16, 18 and 52 are common among patients with GUD and pregnant women in urban Tanzania, emphasising the need for control, treatment and implementation of appropriate HPV vaccine programmes.     

Prevalence of genital human papillomavirus infection in Wellington women.

OBJECTIVES--To determine prevalence of human papillomavirus (HPV) in Wellington women, to identify risk factors for HPV infection, to correlate presence of HPV with cervical cytology, and to identify characteristics of women infected with HPV but with normal cytology. DESIGN--Demographic, social, personal and clinical data were collected by a confidential self-administered coded questionnaire. The presence of DNA from HPV types 6/11, 16 + 18 and 31 + 33 in cervical scrapes was determined by dot-blot DNA hybridisation. All data were correlated with cervical cytology results. SETTING AND SUBJECTS--Two thousand and twenty one women attending family planning clinics in the Wellington region participated in the study. The mean age of participants was 26 years, 33.3% currently smoked, 72.3% used hormonal contraceptives, 31.4% were married, and 91.4% were of European origin. RESULTS--We found 10.9% of the study group infected with HPV. HPV types 16 and/or 18 predominated, being detected in 71.5% of HPV-positive women either alone or with other types. Of those infected 26.2% had multiple infections. Dysplasia (n = 87) or atypia (n = 84) were observed in 26.7% of infected women (n = 221) and 6.25% of uninfected women (n = 1792). Over 8% of women with normal smears were HPV positive, and types 16/18 were most common in these women. CONCLUSIONS--Women with cervical dysplasia or atypia were six times more likely to have HPV infection than other women. The main risk factor for HPV infection, particularly with types 16 and/or 18, was multiple (> 5) sexual partners in the last year independent of other variables. Multivariate analysis of data showed no independent association between HPV infection and ethnicity, educational background, smoking history, marital status, contraceptive use, age at first sexual intercourse, or number of lifetime sexual partners.     

Subclinical human papilloma virus infection in condylomata acuminata patients attending a VD clinic.

In 37 (77%) of 48 patients with external genital warts, application of 5% acetic acid revealed areas of acetowhite epithelium. The lesions were not clinically apparent before acetic acid was applied but were easily detected without the use of a colposcope. In a control group of 20 patients with chlamydial urethritis and no history of genital warts, none had acetowhite genital lesions. Histological examination of biopsy specimens from the flat acetowhite lesions showed HPV infection with koilocytosis in 29 (78%) and in 3 (8%) intra-epithelial neoplasia grade II-III. Using in situ hybridization with commercially available biotinylated DNA probes, HPV types 16/18 could be detected in 7 (24%) patients with koilocytosis and in 3 (100%) patients with dysplasia. Simultaneous infection with HPV types 6/11, 16/18, and 31/33/35 was found in 8 of the 13 HPV DNA-positive patients. It is concluded that subclinical HPV-induced acetowhite lesions are common among patients with genital warts and that these flat lesions may be associated with a high grade of dysplasia. Consequently, routine use of the acetic acid test on the genital epithelium is recommended in patients with condylomata acuminata in order to diagnose and treat all HPV-infected areas.     

Detection of human papillomavirus in verrucous carcinoma from HIV-seropositive patients

Anogenital squamous cell carcinoma has been noted with increased frequency in HIV-seropositive patients. Verrucous carcinoma is a variant of squamous cell carcinoma that tends to be locally invasive and non-metastasizing. Although human papilloma-virus (HPV) has been strongly implicated in other squamous neoplasms, it has been variably associated with verrucous carcinoma and has not been examined in these lesions in the HIV-positive population. The aim of this study was to examine the association of HPV with anal verrucous carcinoma in patients with the human immunodeficiency virus (HIV). HPV DNA in situ hybridization for HPV Types 6/11, 16/18, and 31/33/35 was performed on formalin-fixed, paraffin-embedded tissue from six cases of verrucous carcinoma and four cases of condyloma acuminatum in perianal specimens from HIV-seropositive patients. HPV DNA sequences were identified in five of six cases of verrucous carcinoma and in all cases of condyloma acuminatum. Of the five verrucous carcinomas that harbored detectable HPV DNA, four contained HPV 6/11 and two contained HPV 16/18. One contained both HPV 6/11 and HPV 16/18. All four cases of condyloma acuminatum were positive for HPV 6/11. One patient included in this series had three chronologically separate verrucous carcinomas. The initial lesion was negative for HPV DNA. Subsequent verrucous carcinomas were positive for HPV type 6/11 and type 16/18, respectively. The data presented support the concept that verrucous carcinoma in the HIV-seropositive population is associated with HPV, which may indeed play an important role in its pathogenesis.     

5490例性病门诊患者HPV检测结果分析

目的：了解山东地区人乳头瘤病毒(HPV)感染情况，为HPV的防治提供依据。方法：采用实时荧光定量PCR方法(FQ-PCR)对2012年8月至2016年8月期间就诊于山东省皮肤病医院性病门诊的5490例患者进行LR-HPV(6,11型)和HR-HPV (16、18、31、33、45、52、56、58型)检测。 结果：HPV（6,11型）阳性2016例(36.72%) ,其中女753例（32.81%），男1263例（39.53%），男女阳性率差异有统计学意义（P＜0.01）；HR-HPV阳性1715例(31.24%),其中女925例（40.31%），男790例（24.73%），男女阳性率差异有统计学意义（P＜0.01）；HPV（6,11 型）合并HR-HPV阳性768例(13.99%)，其中女358例（15.6%），男410例（12.83%），男女阳性率差异无统计学意义（P >0.05）。女性HPV（6,11 型）及HR-HPV 感染率高峰出现在20岁以下及50岁以上，不同年龄段女性HPV感染率均有显著差异（P＜0.05），而不同年龄段男性HPV感染率均无显著差异。结论：山东地区男性LR-HPV（6,11型）感染率明显高于女性，而女性HR-HPV的感染率高于男性；山东地区女性HPV感染率随着年龄的变化成“U”型分布,男性HPV感染率与年龄无关。     

Human papillomavirus DNA detection in primary anogenital warts and cervical low-grade intraepithelial neoplasias in adults by in situ hybridization.

In this study, 58 consecutive patients with primary anogenital warts were selected from patients attending a genitourinary clinic. Patients were grouped on the basis of clinical lesion site, i.e. patients with genital warts only, patients with perianal or anal canal warts only, and patients with concurrent perianal and genital warts. Of these patients, 38% of the men (12/31) and 33.3% of the women (9/27) had other anogenital infections, such as nonspecific urethritis (NSU) or nonspecific genital infection, which were the most common. Of the patients who had perianal warts, 37% of the men (7/19) and 25% of the women (4/16) also had warts in the anal canal. Of the women who had anogenital warts, 63% (17/27) had concurrent subclinical low-grade cervical intraepithelial neoplasia (CIN) lesions. Human papilloma virus (HPV) DNA (either 6 or 11, 16 or 18, or 31 or 33 or 35) was detected in 53.3% (40/75) of the anogenital wart biopsy samples, and in 35.2% (6/17) of the low-grade CIN lesions. HPV types 6 or 11 were the most common types in anogenital warts (45.3%); and in CIN lesions HPV types 6 or 11 and 16 or 18 were found with equal frequency (17.6% each). There were no significant differences in HPV types between patients with genital warts and patients with perianal and anal canal warts. Anogenital infection with HPV is multicentric; external anogenital warts and subclinical CIN lesions often exist concurrently. The low prevalence of HPV DNA detected in anogenital warts and CIN biopsy samples may be due to insensitivity of the in situ hybridization technique used in this study.     

Genital human papillomavirus infections in patients attending an inner-city STD clinic.

One hundred and sixteen consecutive women attending a Baltimore City STD clinic were studied for the prevalence of human papillomavirus (HPV) infection of the genital tract using three criteria: presence of clinically recognized (visible) genital warts, cytopathologic evidence suggestive of HPV infection in a Papanicolaou smear, and analysis of cervical scrapes for genital tract HPV genomic sequences by Southern hybridization. The women were young (median age: 22 years) and more than 80% had a history of one or more STDs. The prevalences were 17% for visible warts, 41% for cytologic findings suggestive of HPV infection, and 12% for HPV DNA in cervical scrapes. Comparing the results of the three techniques, HPV DNA was found significantly more often in cytopathology-positive women than in cytopathology-negative women (18% vs. 5%, P = 0.05) and in women with visible warts than in women without visible warts (29% vs. 6%, P = 0.01). Visible warts were more common in women with HPV-DNA-positive cervical scrapes than in HPV-negative women (50% vs. 14%, P = .01). Although 52% of women were judged as infected by at least one of the three criteria, only 4% were infected by using all three criteria. The prevalence of infection was 23% if cytopathology alone was excluded as evidence of HPV infection. These results indicate the difficulty in an accurate estimation of the prevalence of HPV infections, even in a high-risk population.     

Human papillomavirus DNA in the urogenital tracts of men with gonorrhoea, penile warts or genital dermatoses.

OBJECTIVE--To assess the presence of human papillomavirus (HPV) DNA in urethral and urine specimens from men with and without sexually transmitted diseases. DESIGN--Prospective study. SETTING--Two London departments of genitourinary medicine PATIENTS--100 men with urethral gonorrhoea, 31 men with penile warts and 37 men with genital dermatoses. METHODS--Urethral and urine specimens were taken, HPV DNA extracted and then amplified using the polymerase chain reaction. HPV types 6, 11, 16, 18, 31 and 33 were identified using Southern blotting followed by hybridisation. RESULTS--HPV DNA was detected in 18-31% of urethral swab specimens and in 0-14% of urine specimens. Men with penile warts had HPV detected in urethral swabs more often than did men in the other two clinical groups. "High risk" HPV types were found in 71-83% of swab specimens and in 73-80% of urine specimens containing HPV DNA. CONCLUSIONS--HPV is present in the urogenital tracts of men with gonorrhoea, penile warts and with genital dermatoses. In men with urethral gonorrhoea, detection of HPV in urethral specimens is not related to the number of sexual partners, condom usage, racial origin or past history of genital warts. HPV DNA in the urethral swab and urine specimens may represent different aspects of the epidemiology of HPV in the male genital tract. The preponderance of HPV types 16 and 18 in all three groups of men may be relevant to the concept of the "high risk male".