HPV Sexually Transmitted Disease - Study

Cox JT, Petry KU, Rylander E, Roy M. Student Health Service, University of California, Santa Barbara, California 93106, USA. cox-t@sa.ucsb.edu

Genital warts (GW) are the manifestation of infection with specific types of human papillomavirus (HPV), one of the most common sexually transmitted viral infections in the world. Genital warts can be either raised (exophytic) or flat. Exophytic genital warts are most commonly secondary to inoculation of the basal epithelium with nononcogenic HPV types 6 and 11, whereas flat warts are usually secondary to potentially oncogenic HPV types 16 and 31. Genital warts can occasionally cause irritation and discomfort, particularly during intercourse, although most cases are asymptomatic. It is the psychosocial effects of infection, such as a sense of shame, depression, and anxiety, that represent the more significant toll for most patients with GW. Current therapies for GW are mainly ablative and do not directly enhance the immune response to HPV. Therefore, recurrence is a problem for many patients. Imiquimod 5% cream is a patient-applied therapy that directly enhances the immune response to HPV and is safe and effective for the treatment of GW. A reduction in viral load is observed following treatment. Low recurrence rates compared to other treatment modalities may be due to the stimulation of the cell-mediated immune response by imiquimod.

Publication Types:
• Review
• Review, Tutorial

Adolesc Med Clin. 2004 Jun;15(2):301-21, ix.

Human papillomavirus and cervical cytology in adolescents.

Kahn JA, Hillard PA. Division of Adolescent Medicine, ML-4000, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. jessica.kahn@cchmc.org

Human papillomavirus (HPV) infection is highly prevalent in adolescent girls and young women and may be associated with substantial morbidity and mortality. HPV infection may lead to condylomata (genital warts), cervical intraepithelial neoplasia (CIN), and cervical cancer. Recent research focused on the virology, natural history, and sequelae of HPV infection has led to evidence-based revisions of the system for classification of cervical cytology results, recommendations for cytologic screening, and guidelines for management of CIN. Vaccines to prevent HPV infection and its sequelae are under investigation.

Publication Types:
• Review
• Review, Tutorial

Acta Paediatr. 2003 Dec;92(12):1445-52.

Anogenital human papillomavirus in non-abused preschool children.

Myhre AK, Dalen A, Berntzen K, Bratlid D. Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway. arne.k.myhre@medisin.ntnu.no

AIM: To estimate the prevalence of human papillomavirus (HPV) in anogenital samples from children selected for non-abuse. METHODS: A letter of invitation was sent to 2731 girls and 1042 boys, all of them aged 5 or 6 y. Inclusion was based on self-selection, whereby parents who did not suspect any occurrence of sexual abuse of their child gave informed consent to participate. Several mechanisms were undertaken to exclude abused children. A complete examination was done of each child, including anogenital examination with a colposcope and microbiological sampling from the genitals and anus. Polymerase chain reaction (PCR) using primers MY09 and MY11 was used to identify HPV, and sequencing was done on each positive amplicon. RESULTS: PCR was performed on 325 adequate specimens from 211 children enrolled. Seven samples from 5 girls were HPV-positive, making 2/161 (1.2%) of the anal and 5/164 (3.0%) of the genital specimens positive. HPV was not detected in any of the boys. In four girls strong associations with HPV 6 genotypes were found, while one girl probably had a mixed infection with HPV 6 and 16. Three girls (1.8%) had clinically detectable anogenital warts. CONCLUSION: Since our results are comparable with a prevalence reported from allegedly abused children, and higher rates have been reported from the oral cavity in healthy children, we find detection of HPV unreliable as an indicator of sexual abuse in 5-6-y-old children. The rate of anogenital warts found in our study is comparable with a rate reported in abused children.

Zhonghua Kou Qiang Yi Xue Za Zhi. 2003 Nov;38(6):426-8.

Infection of human papillomavirus in oral benign epithelial proliferation in children.

HPV Sexually Transmitted Disease - Article in Chinese

OBJECTIVE: To investigate the presence of HPV infection of oral mucosa proliferative lesions in children and determine the associations of HPV types with oral mucosa lesions in children. METHODS: Immunohistochemical method and in situ hybridization techniques were applied to detect human papillomavirus (HPV) infection in biopsies taken from clinical lesions in oral mucosa of 30 children. RESULTS: The most frequent lesions detected were SCP (66.7%), followed by CA and FEH. The HPV viral antigen was present in 73.3% (22/30) of the oral benign epithelial proliferative lesions in children. A high frequency HPV was found in CA (6/6) and SCP (15/20) by means of IHC. In the ISH positive case, high risk HPV 16/18 was observed in 77.3% (17/22). CONCLUSION: This study demonstrates a high prevalence of HPV infection in children's oral mucosa proliferative lesions, and high-risk HPV16/18 are predominant in children's oral mucosa proliferative lesions.

Laryngorhinootologie. 2003 Nov;82(11):790-3.

Laryngeal papillomatosis - first recognition in Germany as an occupational disease in an operating room nurse.

HPV Sexually Transmitted Disease - Article in German

BACKGROUND: The CO (2)-Laser is an established and well-proven tool in the excision and vaporisation of laryngeal papillomatosis. Actually there exists only one report of an iatrogenous infection with the Human Papillomavirs (HPV) in a gynecological laser surgeon. CASE REPORT: A 28-year-old gynecological operating room nurse, who assisted repeatedly in electrosurgical and lasersurgical excisions of anogenital condylomas, developed a recurrent and histologically proven laryngeal papillomatosis. The expert opinion of a virological institute confirmed a high probability of correlation between the occupational exposition and the laryngeal papillomatosis so that it was accepted as occupational disease. INFECTIVITY OF LASER PLUME: HPV-DNA has been repeatedly detected in laser-plume after excision of papillomas and condylomas. As of the present an exact proof that these particles are infectious has not been brought forward. CONCLUSION: When following the recommended protective measures the potential risk of infection is estimated as very low for surgeons and nurses. The risk of exposition seems to be higher in gynecological interventions than in ENT because of the much larger tissue masses and because laser plume escapes easier into the room air when applying an open approach.

Publication Types:
• Case Reports

Ther Umsch. 2003 Oct;60(10):595-604.

Human papillomaviruses

HPV Sexually Transmitted Disease - Article in German

Human papillomaviruses (HPV) infect exclusively the basal cells of the skin and of mucosal epithelia adjacent to the skin such as the mouth, the upper respiratory tract, the lower genital tract and the anal canal. HPV does not lead to a viremia. Basically there are three different types of HPV infection: Clinically visible lesions, subclinical HPV infections and latent HPV infections. Distinct HPV types induce morphologically and prognostically different clinical pictures. The most common HPV associated benign tumor of the skin is the common wart. Infections of the urogenitoanal tract with specific HPV-types are recognised as the most frequent sexually transmitted viral infections. So-called "high-risk" HPV-types (HPV16, 18 and others) are regarded by the world health organisation as important risk-factors for the development of genital cancer (mainly cervical cancer), anal cancer and upper respiratory tract cancer in both genders. Antiviral substances with a specific anti-HPV effect are so far unknown. Conventional therapies of benign skin warts and of mucosal warts are mainly nonspecific. They comprise tissue-destroying therapies such as electrocautery, cryotherapy and laser. In addition cytotoxic substances such as podophyllotoxin and systemic therapy with retinoids are in use. Systemically and topically administered immunotherapies represent a new approach for treatment. Both interferons and particularly the recently developed imiquimod, an interferon-alpha and cytokine-inductor lead to better results and are better tolerated then conventional therapies. HPV-specific vaccines have been developed in the last 5 years and will be used in future for prevention and treatment of benign and malignant HPV-associated tumors of the genitoanal tract in both sexes.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Oct;96(4):420-8.

The histologic differentiation of oral condyloma acuminatum from its mimics.

Anderson KM, Perez-Montiel D, Miles L, Allen CM, Nuovo GJ. Department of Oral Pathology, Ohio State University Medical Center, Columbus 43210, USA.

OBJECTIVE: The purpose of this study was to determine which histologic features could enable one to distinguish oral condyloma, as defined by the detection of human papillomavirus (HPV) DNA through in situ hybridization, from its mimics. STUDY DESIGN: Thirty-two paraffin-embedded specimens from 28 patients that were clinically suggestive of oral condyloma were analyzed histologically and through in situ hybridization with a consensus HPV probe. RESULTS: HPV DNA was detected in 17/32 (53%) of the lesions; no additional positive cases were detected after polymerase chain reaction amplification. Only 5 of the 17 virus-positive cases were considered to be histopathologically unequivocal for condyloma. The histologic features significantly associated with HPV detection were nonuniform perinuclear halos, often in association with epithelial crevices (P =.02), and papillomatosis (P =.02). Each of the 17 patients who were HPV-positive had either HPV-6 or HPV-11, a finding that is similar to those for condyloma involving the penis and vulva/vagina. CONCLUSION: Differentiation between oral condyloma and its mimics is best accomplished by using a combination of histologic, clinical, and in situ viral studies.

HPV Sexually Transmitted Disease - Study of HPV Links

MDX Services - Here you can find a table of all tests available from the Division of Molecular Diagnostics, including HPV tests.

National HPV & Cervical Cancer Prevention Resource Center - The HPV and Cervical Cancer Prevention Resource Center has an affiliated network of local support groups for people concerned about HPV.