Prevalence of human papillomavirus types in the cervices of women before and after laser ablation

Screening for cervical abnormalities in women with anogenital warts in an STD clinic: an inappropriate use of colposcopy

An audit of the use of colposcopy in women with anogenital warts was performed. Fifty women attending a clinic for sexually transmitted diseases in a District General Hospital with anogenital warts were examined by cervical cytology and colposcopy for cervical infection by human papillomavirus (HPV) or epithelial abnormality indicating cervical intraepithelial neoplasia (CIN) or both. Collated results showed a high prevalence of both conditions in these 50 women; 20 (40%) had evidence of cervical infection by HPV and 11 (22%) epithelial abnormalities consistent with CIN 1 or 2. However, neither CIN 3 nor invasive disease was detected. Colposcopy in this setting was shown to be a specific but insensitive tool and its role in the routine management of women with anogenital warts at our institution is not warranted.

Dual infection with human papillomavirus in a population with overt genital condylomas

BACKGROUND

Multiple human papillomavirus (HPV) genotypes have been demonstrated in individual patients; usually, different genotypes occur in different anatomic sites.

OBJECTIVE

Our purpose was to evaluate the prevalence of multiple HPV types from the same anatomic site.

METHODS

During the course of a study evaluating topical versus ablative therapy for external genital HPV, sequential biopsies on patients with external genital warts were performed. HPV DNA content was determined by Southern hybridization. Ninety-two specimens from 63 patients (48 women, 15 men) with genital warts were evaluated.

RESULTS

Dual infection with two HPV genotypes was documented in each of four specimens (6.3%). Sequential biopsy specimens from the same anatomic site in the same person revealed dual infection in 5 of 12 sampled patients (41%). Overall, 14% of patients had dual genitourinary HPV infection.

CONCLUSION

Counseling and follow-up of long-term complications, such as transmission and the risk of subsequent genitourinary carcinoma, should be performed on all patients with HPV because of the possibility of undetected HPV DNA types in the individual patient.

Genital human papillomavirus infection in women

OBJECTIVE

To enhance nurse clinicians' knowledge of genital human papillomavirus infection in women.

DATA SOURCES

Several literature searches using the following terms, dating back to 1986: human papillomavirus (HPV), females, human, cervical neoplasia, risk factors, condylomata acuminata, detection, epidemiology, pathology, psychology, Papanicolaou test, immunosuppression, HIV infection, and AIDS.

STUDY SELECTIONS

Forty-three formal research studies regarding the association of various types of HPV infection with cervical intraepithelial lesions, the putative precursor lesions for cervical neoplasia; the outcomes of diagnostic techniques for HPV types; the outcomes of diagnostic/screening techniques for abnormal cervical cells; the association of risk factors for acquiring HPV infection; or the outcomes of therapy. Some additional references were chosen for their presentation of epidemiologic or surveillance data, others for their scientific discussions on related topics.

DATA EXTRACTION

Data were abstracted according to summary measures of the parameter of interest in the sample studied. In most instances, it was the prevalence of HPV, cervical neoplasia, or frequency of use of screening tests.

DATA SYNTHESIS

Immunosuppressed clients are at particular risk for HPV-mediated cervical neoplasia.

CONCLUSION

Because Papanicolaou tests are an effective screening tool, cervical cancer is easily detectable. The nurse may facilitate treatment. This is an especially important issue for young women, among whom sexual activity is growing--with attendant increases of HPV and HIV infection.

Genital papillomavirus infection after treatment for cervical intraepithelial neoplasia (CIN) III

Genital human papillomavirus (HPV) infection was studied in 150 women after conization for cervical intraepithelial neoplasia grade three (CIN III). Colposcopically directed biopsies were taken from the cervix and vulva for histopathological diagnosis. 77 specimens were further analyzed immunohistochemically for the presence of HPV capsid antigen. In ten randomly selected cervical biopsies cellular DNA was dot blot hybridized with HPV 6/11 and 16/18 DNA probes. Genital warts were seen in 10 (7%) of the patients. Among the routine cytological smears, HPV infection was only reported in 3 (2%). In 87/142 (61%) of the cervical tissues koilocytes were found. A further 9/142 (6%) associated with CIN. Of the vulvar biopsies 91/145 (63%) contained koilocytes. A further 12/145 (8%) were associated with vulvar intraepithelial neoplasia. HPV capsid proteins were detected in 35/77 (45%) of the cervical and in 20/41 (49%) of the vulva biopsies. All cervical DNA samples hybridized with probes for HPV 6/11 and two also reacted with the HPV 16/18 probes.

CONCLUSION

A latent HPV infection of the cervix or vulva, can be detected in 85% of the women previously treated for CIN III by conization.