Age distribution of antibodies to human papillomavirus in children, women with cervical intraepithelial neoplasia and blood donors from South Africa

Sera from 95 women with cervical intraepithelial neoplasia (CIN), 95 age-matched female blood donors, and 155 children aged between 1 and 12 years were tested by enzyme-linked immunosorbent assay (ELISA) for levels of serum IgG to three human papillomavirus (HPV) peptides (HPV-16 E2 [E2-16], HPV-18 E2 (E2-18], HPV-16 L1 [L1-16]), as well as HPV-16 virus-like particles (VLP-16) and bovine papillomavirus type 1 virus-like particles (BPV-VLP). In the adult group antibodies to E2-16 and VLP-16 were significantly associated with CIN when compared to the blood donor controls (P = .039 and P = .002, respectively). In women with CIN there was an increase in seropositivity to E2-16 and a decrease in seropositivity to VLP-16 with age. Antibodies to HPV-16 E2 could therefore be an important marker of CIN in women over 40 years of age, whereas antibodies to VLP-16 could be a marker for CIN in younger women. There was no correlation with CIN and antibodies to E2-18, L1-16, and BPV-VLP. In the children's sera antibodies were detected to E2-16 (44.5%), E2-18 (18.7%), L1-16 (20%), VLP-16 (4.5%), and BPV-VLP (5.1%). Between the ages of 3 and 12 years the prevalence of antibodies to E2-16 decreased with age. The presence of antibodies to HPV-16 in young children indicated infection with either HPV-16 or a related virus. HPV DNA isolation from children could help resolve this question.

Infection control to quality improvement: the right time, the right place, the work to be done

Many infection control epidemiologists are moving into the quality improvement field. The marriage of epidemiology with quality improvement is a logical step. Several things have to happen for this union to be successful, however. Most importantly, collaborative relationships must be forged with a variety of healthcare providers and practical, reliable, and valid indicators, and the methods for measuring them must be developed. This will take time, but epidemiologists should insist on and support the development of a robust discipline that combines the best of both worlds.

An apparatus for ultraviolet B irradiation of small volumes of biological fluid under controlled oxygen tension

BACKGROUND

The design, construction, and calibration of a unique apparatus for ultraviolet (UV) B irradiation of small volumes of biological fluid under temperature-controlled open atmospheric or closed cell conditions of defined Po2 is described.

METHODS

The apparatus consists of a custom designed UV transmissible quartz silica 3 port spectrophotometric cuvette coupled to a deuterium UV B source by UV transmissible fiber optics. Fluid movement, temperature regulation, dosimetry, and miniaturized biosensors for oxygen, pH, and temperature are described along with a preliminary experiment.

RESULTS

The apparatus produces a known photochemical effect using an endogenous aqueous humor UV B photosensitizer-L tryptophan. UV B radiation is contained, thus protecting laboratory personnel. The system provides a continuous spectral UV B dose of 30 mJ/cm2/hr, which is equivalent to approximately 5.5 UV sunlight hours reaching an aliquot of mammalian aqueous humor.

CONCLUSIONS

This biophysical apparatus can be used to investigate antioxidant protective systems in ocular fluid (aqueous/vitreous humors and tears), and is also applicable to evaluating the interaction of radiation with ocular and nonocular tissue cell homogenate.

Intestinal absorption of water-soluble vitamins

Vitamin utility is a scientific/medical topic that appears to be pursued as ardently by the lay public as by scientists and medical practitioners. A group of epidemiologists evaluates the effects on health of vitamin intake in the natural diet and by supplementation. The role in ocular disease, cancer of the breast or colon, and cardiovascular disease are a few of the concerns. The results and recommendations concerning dietary vitamin intake will likely continue to change. However, the processes by which dietary vitamins are delivered from intestinal chyme to the blood are more certain. The concept of homeostasis might apply to various of the vitamins as it does to minerals, water, etc. This review will discuss some common methods used to study vitamin absorption and the proposed mechanisms of absorption, and will conclude with a section about dietary regulation.

The potential role of speech production models in automatic speech recognition

This paper investigates the issues that are associated with applying speech production models to automatic speech recognition (ASR). Here the applicability of articulatory representations to ASR is considered independently of the role of articulatory representations in speech perception. While the question of whether it is necessary or even possible for human listeners to recover the state of the articulators during the process of perceiving speech is an important one, it is not considered here. Hence, the authors refrain from posing completely new paradigms for ASR which more closely parallel the relationship between speech production and human speech understanding. Instead, work aimed at integrating speech production models into existing ASR formalisms is described.

Analysis of water-soluble antioxidants by high-pressure liquid chromatography

The measurement of endogenous substances that function as biological antioxidants is of importance because the values obtained might be an index of future health. We quantified three water-soluble antioxidants by high-pressure liquid chromatography with electrochemical detection (h.p.l.c.-e.c.). Current-voltage relationships made at various settings of the D2 porous graphite electrode help to identify ascorbic acid, glutathione and uric acid. The antioxidants are determined simultaneously and without need for derivatization. The method is seen to be useful for comparison of normal rat liver with liver that had undergone oxidative stress through ischaemia. Antioxidant levels in liver, kidney, pancreas and intestinal mucosa are presented and compared with literature values. Endogenous contents of oxidized forms of ascorbic acid and glutathione become apparent following exposure of tissue samples to a strong reductant such as 2-mercapthoethanol.

Serological differentiation of human papillomavirus types 11, 16 and 18 using recombinant virus-like particles

The L1 major capsid protein-coding sequences of human papillomavirus (HPV) types 11, 16 and 18 were expressed in the baculovirus system. Virus-like particles (VLPs) were purified from recombinant-infected Spodoptera frugiperda Sf9 cells and cell-free culture supernatants. Rabbits immunized with purified VLPs developed antibodies that reacted only with the specific VLP type used as the immunogen. In addition, rabbit antibodies raised against infectious HPV-11 virions only reacted with HPV-11 L1 VLPs and not with VLPs derived from either HPV-16 or HPV-18. These results suggest that HPV-11, HPV-16 and HPV-18 virions are antigenically distinct from one another. This observation should be considered in future studies of immune responses to HPV.

Human papillomavirus (HPV) type 11 recombinant virus-like particles induce the formation of neutralizing antibodies and detect HPV-specific antibodies in human sera

Recombinant human papillomavirus type 11 (HPV-11) virus-like particles (VLPs) were tested for their ability to induce the formation of neutralizing antibodies, and were also tested for serodiagnostic capabilities in an ELISA in comparison with HPV-11 whole virions. VLPs, purified by CsCl density gradient centrifugation from the cell-free supernatant of Ac11L1-infected Sf9 suspension cell cultures, were used to immunize rabbits and anti-VLP antibodies were tested in the athymic mouse model of HPV-11 infection. Pretreatment of infectious HPV-11 virions with the immune serum of VLP-treated animals caused a marked reduction of graft growth (P < 10(-4)) and viral gene expression (P < 10(-4)), similar to the effects obtained using whole virion postimmune serum, and consistent with immune neutralization. To assess the serodiagnostic capabilities of VLPs, a VLP ELISA was developed and used to analyse sera that were tested previously in an HPV-11 whole virion ELISA. Specific antibodies were detected in 49% of patients' sera (P = 2 x 10(-4)), and individual VLP seroreactivities correlated with those previously obtained using whole virions as the antigen (r = 0.87; P < 10(-6)). These results indicate that recombinant VLPs can be used to elicit a neutralizing antibody response, and can substitute faithfully for native virions in the development of HPV-serodiagnostic immunoassays.

Evaluation of temperature sensitivity of human papillomavirus type 11 by using the human xenograft severe combined immunodeficiency mouse model

The temperature sensitivity of human papillomavirus type 11 was evaluated by using a human xenograft severe combined immunodeficiency mouse model. Incubation of the virus for 1 h at a temperature higher than 56 degrees C but lower than 72 degrees C was sufficient to inhibit the virally induced growth of infected human tissue. However, 100 degrees C was necessary to completely inactivate HPV type 11 genome expression.

Two E2 binding sites (E2BS) alone or one E2BS plus an A/T-rich region are minimal requirements for the replication of the human papillomavirus type 11 origin

Human papillomaviruses (HPVs) cannot be propagated in vitro, but the DNA can be replicated transiently in an assay in the presence of two trans-acting viral proteins, E1 and E2. Using this assay, we have defined the minimal cis-acting elements of the origin of replication of HPV type 11. Most HPV genomes are conserved at the origin of replication, and the core contains three E2 binding sites (E2BS) surrounding an A/T-rich spacer region. The present results show that the minimal requirement for replication is either two E2BS alone or the A/T-rich region plus one E2BS; in the latter case the relative position of the E2BS is important. In all the studies, the presence of both E1 and E2 proteins was essential for replication, yet only the E2BS was required at the origin. We have shown that E1, E2, and the origin of replication containing an E2BS from a complex in vitro, and our data are consistent with a model in which E2 acts to target E1 to the HPV type 11 replication origin.

Cerebral metabolism of oxidized ascorbate

The brain has a high level of ascorbic acid which is thought to act as a reducing agent, e.g. in protecting tissues against oxidative stress. The mechanism by which ascorbate is maintained in the useful, reduced state in the CNS is evaluated herein. Cerebrum from rat or calf was minced and homogenized in buffer. The endogenous levels of ascorbic acid, dehydro-L-ascorbic acid (DHAA) and reduced glutathione (GSH) were determined by HPLC with coulometric electrochemical detection. We also quantitated tissue capacity to regenerate ascorbic acid from DHAA, which is a product of electron transfer reactions of ascorbic acid. The homogenate was fractionated by centrifugation in steps up to 110,000 x g and dialyzed free of low molecular weight components. The activity for reducing DHAA was approximately equal in the various supernatants; resuspended pellets had little activity. The active component has several properties of a protein, including being precipitated by solid ammonium sulfate addition to the tissue extract; most activity appeared in the 40-80% saturated fraction. The activity was stable up to a temperature of 80 degrees C, but was lost at 95 degrees C. The protein was digested by trypsin. The results suggest that a cytosolic component of cerebrum regenerates ascorbic acid in a step that preferentially uses GSH and NADPH as reducing cofactors. At least one form of DHAA reductase exists in brain.

Propagation of human papillomavirus type 11 in human xenografts using the severe combined immunodeficiency (SCID) mouse and comparison to the nude mouse model

We report propagation of human papillomavirus (HPV) type 11 in human xenografts in the severe combined immunodeficiency (SCID) mouse and compare this new animal model for HPV infection to the previously established athymic nude mouse model. HPV-11-infected foreskin fragments grafted under the renal capsule of SCID mice formed large epithelial cysts that had the histologic and immunocytochemical features of HPV infection. This infection was successfully passaged to nude mice. Viral particles that reacted to an antibody directed to HPV-11 virions were identified from samples recovered from the SCID and nude mice. Viral DNA sequence analysis confirmed that the passaged virus was HPV-11. In a comparative experiment of the nude mouse and SCID mouse models, the latter produced HPV-11-infected xenografts that were larger and more often positive for HPV by immunocytochemistry and presence of viral mRNA than those propagated in the former model. Finally, we observed that growth of HPV-11-infected foreskin fragments in the SCID mouse model is not restricted to the kidney as in the nude mouse, but also can occur in the subcutis and the peritoneum.

Biology of free radical scavengers: an evaluation of ascorbate

Reactive free radical species (R.) are associated with several forms of tissue damage and disease, and also with the process of aging. Protection is thought to be available in the form of endogenous compounds that react with and thereby "scavenge" the R.. Because many R. are reactive forms of oxygen, an effective scavenger is often referred to as an antioxidant. To be an effective antioxidant physiologically, a substance must have certain chemical and biological properties: it must be present in adequate amounts in the body; it must react with a variety of R.; it must be suitable for compartmentation; it must be readily available; it might be suitable for regeneration; it must be conserved by the kidneys; and it must have tolerable toxicity. Several water-soluble candidates are mentioned, with most having no more than one or two of the attributes listed. Ascorbic acid is discussed in detail, and an analysis is made of whether it has the properties mentioned.

Ascorbic acid regeneration by bovine iris-ciliary body

Ocular tissues appear to require high levels of ascorbic acid and the elucidation of the mechanisms by which those tissues maintain the vitamin in its reduced state remains an important objective. The regeneration of ascorbate from its oxidative by-product, dehydroascorbic acid (DHAA), was studied in bovine iris-ciliary body. Iris-ciliary body was removed by scalpel, weighed, minced, and homogenized in 20 mM MOPS, 62 mM sucrose, and 0.1 mM EDTA at pH 7.0. The homogenate was centrifuged and precipitated with ammonium sulfate such that maximal DHAA reducing activity was enhanced in a 50-75% ammonium sulfate fraction. This fraction was employed for subsequent characterization of DHAA reduction by iris-ciliary body. Results indicate that the iris-ciliary body enzymatically reduces DHAA to ascorbate at a rate significantly greater than can be accounted for by a nonenzymatic glutathione-dependent mechanism. In addition, saturation kinetics are observed, and the enzymatic activity is dependent on protein concentration, DHAA concentration, and reduced glutathione (GSH) concentration. The activity is sensitive to pH, to high temperature, and to digestion by trypsin and is greatest in the presence of both GSH and NADPH. The reducing activity is therefore attributed to one or more proteins that are distinct from the known ascorbate regenerating enzyme, GSH-dependent DHAA reductase (EC 1.8.5.1).

Evolution of the antibody response to human papillomavirus type 11 (HPV-11) in patients with condyloma acuminatum according to treatment response

To evaluate the variation over time of seroreactivity to human papillomavirus type 11 (HPV-11) according to disease outcome, we selected a sample of 42 condyloma acuminatum patients from a group of subjects enrolled in a placebo-controlled trial of three alpha-interferon preparations administered parenterally for the treatment of condyloma acuminatum. This sample included 14 subjects who were cured by the end of follow-up (cured group) and 28 subjects who were not (failed group). For each individual, the first and last sera collected in the study were tested with an intact HPV-11 virion-based enzyme linked immunosorbent assay (ELISA). The sera of 20 nuns with no lifetime sexual exposure served as controls. The median optical density (OD) value of the first serum samples (as well as that of the last samples) from the patients, 0.155, was higher than that of the control sera, 0.073 (P = 2 x 10(-4)). Sensitivity of the assay was 50%. To test if evolution of seroreactivity in the seropositive patients was related to disease outcome after treatment, we examined the average percentage of daily change in OD between the two serum collections. The median OD in the cured group (n = 7) dropped by 0.05% a day whereas in the failed group (n = 11) it increased by 0.07% a day, a highly statistically significant difference (P = 0.006). It is concluded that changes in the seroreactivity to HPV-11 virions are related to outcome of condyloma acumination after treatment. Therefore, improved serological assays may eventually contribute to the monitoring of HPV disease activity.

Expression of human papillomavirus type 11 L1 protein in insect cells: in vivo and in vitro assembly of viruslike particles

The L1 coat protein of human papillomavirus type 11 (HPV-11) was expressed in Sf-9 insect cells with the recombinant baculovirus vector Ac11L1. Viruslike particles (VLPs) were identified by electron microscopy in the nucleus and cytoplasm of Sf-9 cells infected with Ac11L1. The L1 protein was purified from Ac11L1-infected insect cells. The purified protein spontaneously assembled in vitro into various aggregates, including particles appearing similar to empty virions. Reaction of VLP-containing insect cell extracts with antisera directed against either denatured or nondenatured capsid epitopes in Western blot (immunoblot) and immuno-dot blot assays suggested that conformational epitopes present in native HPV-11 infectious virions were also present on the baculovirus-produced HPV-11 VLPs. Immuno-dot blot assays using human sera obtained from individuals with biopsy-proven condyloma acuminatum correlated closely with results previously obtained in HPV-11 whole virus particle-based enzyme-linked immunosorbent assays. These morphologic and immunologic similarities to native HPV-11 virions suggest that recombinant VLPs produced in the baculovirus system may be useful in seroepidemiology and pathogenesis studies of genital HPV infection and that they may also be potential candidates for vaccine development.

Lacrimal gland uptake and metabolism of ascorbic acid

Ascorbic acid is thought to contribute to protection against the potentially damaging effects of radiation, oxygen toxicity, and abrasion in the eye. The anterior surface of the cornea is particularly subject to insult from each threat. We considered the possibility that the lacrimal gland of pigs has transport and/or metabolic capability to sequester the reduced or oxidized form of ascorbic acid and prepare it for secretion in the tears. Slices of fresh lacrimal gland were incubated in a physiologic buffer and exposed to < or = 12 microM 14C-labeled ascorbic acid or dehydro-l-ascorbic acid over 40-min incubation periods. Dehydro-l-ascorbic acid was taken up to a greater extent than the reduced compound. 14C-Label recovered from the tissue was at least 75% in the form of ascorbic acid after incubation with either substrate. Uptake of both the reduced and oxidized substrates proceeded to a tissue to medium ratio in excess of unity; the former was prevented by the presence of nonlabeled ascorbate in the bathing medium, but was unaffected by the removal of Na+ from the bath. The uptake of both substrates was less after inhibition of cellular metabolic energy. The lacrimal gland in this diurnal animal species has transport and metabolic capabilities that could serve in secretion of ascorbic acid into tears. This might help to protect the corneal epithelium against various forms of damage.

Antibody response to human papillomavirus (HPV) type 11 in children with juvenile-onset recurrent respiratory papillomatosis (RRP)

We previously established, using an ELISA, the presence of specific antibodies directed at human papillomavirus (HPV) type 11 virions in the sera of patients with condylomata acuminata, mostly a disease of young adults that, like recurrent respiratory papillomatosis (RRP), is caused by two closely related HPVs, types 6 and 11. The present study was done to investigate if children with RRP can make viral-specific antibodies to an infection that is acquired at birth. Using the same ELISA, we studied the sera of 32 children with biopsy-documented juvenile-onset RRP and compared them to the sera of 31 control children. The median (and interquartile range) of the OD values in the controls and the cases was 0.078 (0.003, 0.101) and 0.230 (0.063, 0.725), respectively, a statistically significant difference (P = 0.001). Among the cases, there was no difference in seroreactivity between children with HPV-11-induced RRP and those with HPV-6-induced RRP (P = 0.31). Since HPV-11 viral particles do bind to the ELISA plate and remain intact and accessible to antibodies, we conclude that children with RRP, like adults with condylomata acuminata, develop antibodies directed at HPV-11 virions.

Antibody-mediated neutralization of human papillomavirus type 11 (HPV-11) infection in the nude mouse: detection of HPV-11 mRNAs

The nu/nu mouse xenograft is the only experimental system permitting the growth of human papillomaviruses (HPV). Previous studies demonstrating inhibition of HPV-11 infection by antibodies against HPV-11 virions have used indirect markers of infection, such as graft size and histopathologic features. The presence of HPV-11 mRNAs was used as a direct marker of infection: Infectious HPV-11 was incubated with rabbit serum raised against purified HPV-11 virions or with the corresponding preimmune serum (controls) before use in the mouse xenograft model, and HPV-11 mRNAs were detected by a method using reverse transcription and amplification by polymerase chain reaction. Graft size, histopathologic features, and the presence of capsid antigen were also assessed. Six weeks after infection, 1 of 23 grafts in the test group contained HPV-11 mRNAs compared with 19 of 20 controls (P less than .001). Therefore, antibody-mediated inhibition of infection by HPV-11 leads to blockade of genomic expression and is thus consistent with active prevention of viral penetration, that is, neutralization.

Short term effects of oxidized ascorbic acid on bovine corneal endothelium and human placenta

Studies on the toxic effects of dehydro-L-ascorbic acid (DHAA) have been extended to include evaluations over time periods up to 3 hr. and to test for specific effects on a membrane transport protein, a membrane-bound enzyme and a soluble intracellular enzyme. In studies on cultured corneal endothelial cells, DHAA concentrations of 1, 2, and 5 mM over 3 hr. had an inhibitory effect on subsequent uptake of DHAA present at a tracer level. Surviving fragments of human placenta and alkaline phosphatase activity of the placental brush-border membrane were susceptible to the effect of DHAA at a high concentration (10 mM). Because intracellular metabolism of DHAA was not affected, and an increase in membrane permeability was not detected, it is concluded that a specific membrane transport protein might be the site of DHAA-induced damage. These studies support the concept that the oxidized form of ascorbic acid (vitamin C) has potential toxic effects on biological systems and suggests that proteins that mediate transport and metabolism may be sites where DHAA causes damage.

Tissue-mediated regeneration of ascorbic acid: is the process enzymatic?

Ascorbic acid's function in animals is attributed in part to the ease with which it reduces potentially damaging components, such as reactive free radicals. After more than six decades of speculation and laboratory efforts, the mechanisms by which ascorbic acid is maintained in the useful, reduced state remain uncertain. Previous attempts to isolate the enzymes that reduce the partially and the fully oxidized metabolites of vitamin C are reviewed. Some speculation on why dehydroascorbate reductase (EC 1.8.5.1) has not been purified from animal tissues is presented.

Ascorbic acid uptake and metabolism by corneal endothelium

Ascorbic acid is concentrated in various ocular compartments where it is thought to protect diurnal animal species against damaging effects of ultraviolet radiation. The authors evaluated the possibility that corneal endothelial cells have specific transport and/or metabolic properties that deliver ascorbic acid to the stroma. Bovine corneal endothelial cells were grown to confluence in multiple-well plates. Individual groups of cells (approximately 10(4)) were then incubated at various times at 34 degrees C in a physiologic buffer that contained a 10 microM level of 14C-labeled ascorbic acid or the oxidized product, dehydro-L-ascorbic acid. Endothelial cells take up dehydro-L-ascorbic acid at least seven times as rapidly as they take up ascorbic acid. After 30 sec of incubation with 14C-dehydro-L-ascorbic acid, most of the label accumulated in the cell is in the reduced form. Uptake is inhibited by cyanide and iodoacetamide but is unaffected by ouabain. Exposure of cultured cells to various intermediates in the energy metabolism pathways reduced uptake of ascorbic acid but had a minor effect on uptake of the oxidized molecule. These results suggest that the cornea has transport and metabolic capacity to extract dehydro-L-ascorbic acid from aqueous humor and reduce it, thus providing a source of ascorbic acid for corneal protection. This also would maintain "total" ascorbic acid of aqueous humor in the reduced state.

Use of human papillomavirus type 11 virions in an ELISA to detect specific antibodies in humans with condylomata acuminata

Human papillomavirus types 6 and 11 (HPV-6 and HPV-11) are the major aetiological agents of condylomata acuminata. Serological studies of this disease have been difficult to perform and interpret because native, type-specific antigens have not been available. In particular, since these viruses have not been propagated in vitro and sufficient quantities of virions are not present in lesions, virus particles have been difficult to obtain. In the present study, we used HPV-11 particles, obtained from human tumours produced in athymic mice, as antigen in an ELISA to compare antibody responses between 46 patients with biopsyproven condylomata acuminata and 44 controls. The median [interquartile range] of the absorbance values for the condylomata acuminata and the control groups were respectively 0.324 [0.183, 1.029] and 0.118 [0.047, 0.286] (P = 0.0001). Thirty-three per cent of the absorbance values in the condylomata acuminata group were higher than any of those of the control group. Sera from patients whose biopsies contained the papillomavirus common antigen were more reactive than sera from patients whose biopsies did not contain it (P = 0.0014). This study demonstrates the presence of specific antibodies directed at native HPV-11 viral particles in the sera of patients with condylomata acuminata, and describes a test which can be used in future serological studies of this common sexually transmitted disease.

Detection of human papillomavirus types 6 and 11 E4 gene products in condylomata acuminatum

Polyclonal antiserum to an Escherichia coli-produced beta-galactosidase/E4 fusion protein of human papillomavirus type 6b (antiserum 256), and affinity purified HPV 11 anti-E4 antibodies were tested for reactivity in Western blots with bacterially expressed trpE/E4 fusion proteins of HPV types 6b, 11, 16, and 18. To further characterize the affinity purified anti-E4 antibodies, a dot-immunobinding assay was performed using overlapping synthetic HPV 11 E1E4 peptides as antigens. Protein extracts of condylomata acuminatum from 18 patients containing HPV type 6 or 11 DNA sequences were tested in Western blots using antiserum 256 or affinity purified HPV 11 anti-E4 antibodies. In the Western blots of the trpE proteins, antiserum 256 identified the HPV types 6b and 11 fusion proteins; the affinity purified HPV 11 anti-E4 antibodies identified only the HPV 11 fusion protein. In the dot-immunobinding assay, three HPV 11 peptides were recognized, each containing a shared 8 amino acid sequence that differs significantly from the corresponding sequences of HPV types 6b, 16, or 18. In the Western blots of protein extracts from 18 condylomata acuminatum samples shown to contain HPV types 6 or 11 DNA, putative E4 gene products were identified in six samples by antiserum 256. The affinity purified HPV 11 anti-E4 antibodies identified putative E4 gene products in one of these same six lesions, which was shown to contain HPV 11 sequences by the Southern blot method. All six samples containing E4 gene products were from women. Three of these women were pregnant, one had serum antibodies to the human immunodeficiency virus, and one was a renal transplant recipient receiving glucocorticoids.(ABSTRACT TRUNCATED AT 400 WORDS)