genital warts
Human papillomavirus types in cervical biopsy specimens from Pap-smear-negative women with external genital warts.

Petersen CS, Lindeberg H, Thomsen HK.

Department of Dermatology and Venereology, Bispebjerg Hospital, University of Copenhagen, Denmark.

Cervical biopsy specimens were taken from 55 Pap-smear-negative women with external genital warts in order to diagnose a concomitant cervical human papillomavirus (HPV) infection. HPV-DNA was demonstrated by in situ hybridization in 17 (31%) of the samples: HPV types 16/18 in 9, HPV types 6/11 in 5 and double infection (16/18 and 6/11) in 3. HPV-DNA was found in 10 (43%) of 23 biopsy specimens with koilocytotic atypia and in 5 (29%) of 17 specimens showing chronic inflammatory reaction, whereas only 2 (13%) of 15 women with normal cervical histology had HPV-DNA in the biopsy specimen. Overall histology and in situ hybridization indicated the presence of a cervical HPV infection in at least 30 (55%) of the 55 women examined. Colposcopic examination revealed abnormal acetowhite epithelium in 17 (74%) of 23 women with koilocytosis and/or HPV-DNA positivity, compared with 7 (32%) of 22 HPV-DNA-negative women with histology showing either chronic inflammatory changes or normal epithelium (p less than 0.01). It is concluded that a cervical focus of HPV infection is frequent among Pap-smear-negative women with external genital warts.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1650114&dopt=Abstract genital wart


genital warts
Manifestations of anogenital HPV infection in the male partners of women with anogenital warts and/or abnormal cervical smears.

Law C, Merianos A, Thompson C, Rose B, Cossart Y, Grace J.

Sydney STD Centre, Sydney Hospital, Australia.

The prevalence and manifestations of anogenital human papillomavirus (HPV) infection in 154 men, all of whom were the sexual partners of women with either overt anogenital warts or cervical HPV-related abnormalities, were assessed using clinical, histopathological and molecular criteria. Detailed examination of the anogenital region using a colposcope was supplemented by the use of 5% acetic acid to detect possible foci of subclinical HPV infection. Biopsies of warts and aceto-white lesions were examined histopathologically and by HPV DNA hybridization using radiolabelled HPV 6/11 and 16/18 DNA probes. More than two-thirds of the men had clinical indications of genital HPV infection: 37% had apparent macroscopic warts, almost invariably in combination with aceto-white lesions; while 34% had aceto-white lesions only. The overwhelming majority of these lesions (92%) were located on the penis only. However, only 49% of the macroscopic and 29% of the aceto-white lesions showed histological features consistent with a conclusive diagnosis of HPV infection; while the corresponding figures for HPV DNA positivity were 72% and 56% respectively. Current HPV infection was strongly associated with a past history of anogenital warts, but there was little or no correlation between the manifestations of HPV infection in the male and female sexual partners.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1650588&dopt=Abstract genital wart


genital warts
The cellular immune system in female patients with or without genital warts: a study of peripheral white blood cell components.

Opaneye AA.

Department of Genito-urinary Medicine, Middlesbrough General Hospital, Cleveland, UK.

The immune system plays a vital role in the fight against infections. The commonest viral infections treated in the genitourinary medicine (GUM) departments are genital warts. Knowledge about the status of the immune system in these patients may help in their clinical management. This study compares the values of various blood cell components in the peripheral blood of 2 groups of female patients--those with genital warts against those without genital warts. The mean monocyte count was lower among patients with genital warts.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10639064&dopt=Abstract genital wart


genital warts
Screening colposcopy in genitourinary medicine.

Nathan PM, Moss TR.

Genitourinary Medicine Department, Doncaster Royal Infirmary, UK.

A prospective study of new female patients attending the Genitourinary Medicine Department in Doncaster was carried out to look at the value of colposcopic examination at their first attendance. Of the 100 randomized patients studied 41 showed evidence of colposcopically detected cervical abnormality. Twenty-seven patients had colposcopically directed biopsies. These showed evidence of cervical intraepithelial neoplasia (3 cases), flat condyloma (16 cases), exophytic wart (2 cases), chronic inflammation (2 cases) and normal epithelium (4 cases). Colposcopic cervical abnormalities were significantly associated, with a history of anogenital warts, sexual contact with anogenital warts and the presence of anogenital warts at presentation. Despite this, less than half the group showing colposcopic abnormalities had an association with anogenital warts. Demonstration of cervical abnormalities by colposcopy resulted in a greater patient compliance during follow-up. Screening or primary colposcopy may be incorporated into a genitourinary screen at the first visit. The procedure is both acceptable and beneficial to the patient, facilitating the detection of a range of cervical disease and enhancing the doctor-patient relationship.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1659913&dopt=Abstract genital wart


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

Sand Petersen C, Albrectsen J, Larsen J, Sindrup J, Tikjob G, Ottevanger V, Karlsmark T, Fogh H, Mellon Mogensen A, Wolff-Sneedorff A.

Department of Dermatology, University Hospital, Copenhagen, Denmark.

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.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1678233&dopt=Abstract genital wart