genital warts
New therapies for the treatment of genital warts.

Barton S, Worlidge P.

The treatment of genital warts with cytodestructive agents such as podophyllin and trichloroacetic acid continues to impose a heavy burden on the workload of genitourinary medicine clinics. Consequently clinics are now looking to new, economical treatments that will improve the management of patients with genital warts. The most promising of these new agents is podophyllotoxin, which is now available in pharmaceutically pure form tailored for the home treatment of external genital warts in males and females.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8008579&dopt=Abstract genital wart


genital warts
Cervical-vaginal and intraanal human papillomavirus infection of young girls with external genital warts.

Gutman LT, St Claire KK, Everett VD, Ingram DL, Soper J, Johnston WW, Mulvaney GG, Phelps WC.

Department of Pediatrics, Duke University Medical Center, Durham, NC 27710.

To expand information regarding the epidemiology of genital human papillomavirus (HPV) infection in young girls, girls with external genital warts were examined for the prevalence of cervical-vaginal or intraanal HPV infection. Cervical-vaginal wash specimens and biopsies of external lesions were examined for HPV genotypes 1, 2, 4, 6, 11, and 16 using Southern transfer hybridization with restriction endonuclease fragment length analysis. Exfoliated cells from cervical-vaginal and intraanal canals were processed for cytologic study. Of 18 girls, 8 (44%) had cytologic or genomic evidence (or both) of cervical-vaginal or intraanal HPV infection. Five had cervical-vaginal wash specimens that were positive for HPV genome and showed mild dysplasia. As is true for adults, young girls with external anal-genital warts are also frequently infected with HPV at internal mucosal sites. Determining the immediate and long-term prognosis of infected children and those with intraepithelial neoplasia will require appropriate prospective studies.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8035020&dopt=Abstract genital wart


genital warts
Diet and genital warts: a case-control study.

Bairati I, Sherman KJ, McKnight B, Habel LA, Van den Eeden SK, Stergachis A, Daling JR.

Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington 98104.

BACKGROUND AND OBJECTIVES: Clinical observations support a substantial role for impaired immunity in the development of human papillomavirus (HPV) infections. Intake of vitamins, especially vitamins A and C, and alcohol consumption have been reported to influence immune response. GOAL OF THE STUDY: To examine the relationship between nutritional risk factors, including alcohol consumption, and the risk of genital warts. STUDY DESIGN: A case-control study was conducted among enrollees at four clinics of Group Health Cooperative in western Washington state. A total of 188 cases diagnosed with condyloma from April 1, 1987 to September 30, 1991 and 245 controls completed a semi-quantitative food frequency questionnaire. RESULTS: After adjustment for socioeconomic indicators, total energy intake, smoking and sexual behavior, a weekly consumption of two to four alcoholic drinks was associated with an almost doubled risk of genital warts (OR = 1.9, 95% confidence interval [CI] = 1.0-3.6). Consuming five or more alcoholic drinks per week was even more related to the risk of genital warts (OR = 2.4, 95% CI = 1.2-5.1). The risks tended to increase with the number of alcoholic drinks (P = 0.006). Vitamin A and C intakes as measured by a food frequency questionnaire did not alter the risk of condyloma. CONCLUSION: Moderately high consumption of alcohol is associated with increased risk of condyloma. Further biological and epidemiological studies are needed to explain this association.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8073343&dopt=Abstract genital wart


genital warts
Retention of low copy number human papillomavirus DNA in cultured cutaneous and mucosal wart keratinocytes.

Williams AT, Sexton CJ, Sinclair AL, Purdie KJ, Thomas MS, Hanna NA, Goh BT, Williams DM, Leigh IM.

Department of Experimental Dermatology, London Hospital Medical College, U.K.

Cultured wart keratinocytes have previously been described as having a limited proclivity to maintain episomal human papillomavirus (HPV) DNA. To investigate the nature of episome loss, and to determine keratinocyte-specific factors involved in it, we have examined a large series of anogenital and oral wart keratinocyte cultures, tracing episomal copy number with culture passage. We report that a higher proportion of oral wart keratinocytes maintain episomal HPV DNA to first passage (70% compared with 37% of anogenital wart cultures) when screened by slot blot hybridization. Furthermore, oral wart keratinocytes maintain episomal HPV copy through a greater number of passages (60% positive at passage 2 compared with 2% of anogenital wart cultures) with this technique. When anogenital cultures were examined at first passage for HPV infection by PCR with Southern blot hybridization of the product, a further 34% were found to be HPV-positive. To determine the mechanism of loss of episomal DNA from these cultures we examined the relative HPV copy number in cells which adhered to the culture vessel following passage and in those which did not adhere. Those which remained floating contained episomal HPV at high copy number whereas those which adhered were negative by slot blotting. The adherent cells, however, remained positive by PCR at subsequent passages until senescence. We conclude that a subpopulation of HPV-positive keratinocytes may be maintained in culture through serial passage until senescence.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8126448&dopt=Abstract genital wart


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

Hillman RJ, Ryait BK, Botcherby M, Taylor-Robinson D.

Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex, UK.

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.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8282299&dopt=Abstract genital wart