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. 1993 Dec;69(6):450–456. doi: 10.1136/sti.69.6.450

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

R J Hillman 1, B K Ryait 1, M Botcherby 1, D Taylor-Robinson 1
PMCID: PMC1195150  PMID: 8282299

Abstract

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.

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Selected References

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  1. BARRETT T. J., SILBAR J. D., McGINLEY J. P. Genital warts-a venereal disease. J Am Med Assoc. 1954 Jan 23;154(4):333–334. doi: 10.1001/jama.1954.02940380043010c. [DOI] [PubMed] [Google Scholar]
  2. Barrasso R., De Brux J., Croissant O., Orth G. High prevalence of papillomavirus-associated penile intraepithelial neoplasia in sexual partners of women with cervical intraepithelial neoplasia. N Engl J Med. 1987 Oct 8;317(15):916–923. doi: 10.1056/NEJM198710083171502. [DOI] [PubMed] [Google Scholar]
  3. Beckmann A. M., Sherman K. J., Myerson D., Daling J. R., McDougall J. K., Galloway D. A. Comparative virologic studies of condylomata acuminata reveal a lack of dual infections with human papillomaviruses. J Infect Dis. 1991 Feb;163(2):393–396. doi: 10.1093/infdis/163.2.393. [DOI] [PubMed] [Google Scholar]
  4. Campion M. J., Clarkson P., McCance D. J. Squamous neoplasia of the cervix in relation to other genital tract neoplasia. Clin Obstet Gynaecol. 1985 Mar;12(1):265–280. [PubMed] [Google Scholar]
  5. Campion M. J., McCance D. J., Mitchell H. S., Jenkins D., Singer A., Oriel J. D. Subclinical penile human papillomavirus infection and dysplasia in consorts of women with cervical neoplasia. Genitourin Med. 1988 Apr;64(2):90–99. doi: 10.1136/sti.64.2.90. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cann A. J., Zack J. A., Go A. S., Arrigo S. J., Koyanagi Y., Green P. L., Koyanagi Y., Pang S., Chen I. S. Human immunodeficiency virus type 1 T-cell tropism is determined by events prior to provirus formation. J Virol. 1990 Oct;64(10):4735–4742. doi: 10.1128/jvi.64.10.4735-4742.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fairley C. K., Chen S., Tabrizi S. N., Quinn M. A., McNeil J. J., Garland S. M. Tampons: a novel patient-administered method for the assessment of genital human papillomavirus infection. J Infect Dis. 1992 Jun;165(6):1103–1106. doi: 10.1093/infdis/165.6.1103. [DOI] [PubMed] [Google Scholar]
  8. Ferenczy A., Mitao M., Nagai N., Silverstein S. J., Crum C. P. Latent papillomavirus and recurring genital warts. N Engl J Med. 1985 Sep 26;313(13):784–788. doi: 10.1056/NEJM198509263131304. [DOI] [PubMed] [Google Scholar]
  9. Fuchs P. G., Girardi F., Pfister H. Human papillomavirus DNA in normal, metaplastic, preneoplastic and neoplastic epithelia of the cervix uteri. Int J Cancer. 1988 Jan 15;41(1):41–45. doi: 10.1002/ijc.2910410109. [DOI] [PubMed] [Google Scholar]
  10. Griffiths M., Penna L. K., Tovey S. J. Aceto-white change of the glans penis associated with balanitis not human papillomavirus infection. Int J STD AIDS. 1991 May-Jun;2(3):211–212. doi: 10.1177/095646249100200315. [DOI] [PubMed] [Google Scholar]
  11. Hillman R. J., Botcherby M., Ryait B. K., Hanna N., Taylor-Robinson D. Detection of human papillomavirus DNA in the urogenital tracts of men with anogenital warts. Sex Transm Dis. 1993 Jan-Feb;20(1):21–27. doi: 10.1097/00007435-199301000-00005. [DOI] [PubMed] [Google Scholar]
  12. Hillman R. J., Ryait B. K., Botcherby M., Taylor-Robinson D. Human papillomavirus DNA in the urogenital tracts of men with gonorrhoea, penile warts or genital dermatoses. Genitourin Med. 1993 Jun;69(3):187–192. doi: 10.1136/sti.69.3.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hillman R. J., Walker M. M., Harris J. R., Taylor-Robinson D. Penile dermatoses: a clinical and histopathological study. Genitourin Med. 1992 Jun;68(3):166–169. doi: 10.1136/sti.68.3.166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hippeläinen M., Yliskoski M., Saarikoski S., Syrjänen S., Syrjänen K. Genital human papillomavirus lesions of the male sexual partners: the diagnostic accuracy of peniscopy. Genitourin Med. 1991 Aug;67(4):291–296. doi: 10.1136/sti.67.4.291. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Jenison S. A., Yu X. P., Valentine J. M., Koutsky L. A., Christiansen A. E., Beckmann A. M., Galloway D. A. Evidence of prevalent genital-type human papillomavirus infections in adults and children. J Infect Dis. 1990 Jul;162(1):60–69. doi: 10.1093/infdis/162.1.60. [DOI] [PubMed] [Google Scholar]
  16. Katelaris P. M., Cossart Y. E., Rose B. R., Thompson C. H., Sorich E., Nightingale B., Dallas P. B., Morris B. J. Human papillomavirus: the untreated male reservoir. J Urol. 1988 Aug;140(2):300–305. doi: 10.1016/s0022-5347(17)41588-6. [DOI] [PubMed] [Google Scholar]
  17. Kirchner H. Immunobiology of human papillomavirus infection. Prog Med Virol. 1986;33:1–41. [PubMed] [Google Scholar]
  18. Kiviat N. B., Koutsky L. A., Paavonen J. A., Galloway D. A., Critchlow C. W., Beckmann A. M., McDougall J. K., Peterson M. L., Stevens C. E., Lipinski C. M. Prevalence of genital papillomavirus infection among women attending a college student health clinic or a sexually transmitted disease clinic. J Infect Dis. 1989 Feb;159(2):293–302. doi: 10.1093/infdis/159.2.293. [DOI] [PubMed] [Google Scholar]
  19. Koutsky L. Role of epidemiology in defining events that influence transmission and natural history of anogenital papillomavirus infections. J Natl Cancer Inst. 1991 Jul 17;83(14):978–979. doi: 10.1093/jnci/83.14.978. [DOI] [PubMed] [Google Scholar]
  20. Law C. L., Qassim M., Thompson C. H., Rose B. R., Grace J., Morris B. J., Cossart Y. E. Factors associated with clinical and sub-clinical anal human papillomavirus infection in homosexual men. Genitourin Med. 1991 Apr;67(2):92–98. doi: 10.1136/sti.67.2.92. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Marks R., Dawber R. P. Skin surface biopsy: an improved technique for the examination of the horny layer. Br J Dermatol. 1971 Feb;84(2):117–123. doi: 10.1111/j.1365-2133.1971.tb06853.x. [DOI] [PubMed] [Google Scholar]
  22. Morris B. J., Flanagan J. L., McKinnon K. J., Nightingale B. N. Papillomavirus screening of cervical lavages by polymerase chain reaction. Lancet. 1988 Dec 10;2(8624):1368–1368. doi: 10.1016/s0140-6736(88)90906-3. [DOI] [PubMed] [Google Scholar]
  23. Muñoz N., Bosch X., Kaldor J. M. Does human papillomavirus cause cervical cancer? The state of the epidemiological evidence. Br J Cancer. 1988 Jan;57(1):1–5. doi: 10.1038/bjc.1988.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Oriel J. D. Natural history of genital warts. Br J Vener Dis. 1971 Feb;47(1):1–13. doi: 10.1136/sti.47.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Pao C. C., Lin S. S., Lin C. Y., Maa J. S., Lai C. H., Hsieh T. T. Identification of human papillomavirus DNA sequences in peripheral blood mononuclear cells. Am J Clin Pathol. 1991 Apr;95(4):540–546. doi: 10.1093/ajcp/95.4.540. [DOI] [PubMed] [Google Scholar]
  26. Rosemberg S. K., Greenberg M. D., Reid R. Sexually transmitted papillomaviral infection in men. Obstet Gynecol Clin North Am. 1987 Jun;14(2):495–512. [PubMed] [Google Scholar]
  27. Rosemberg S. K. Sexually transmitted papillomaviral infection in men. An update. Dermatol Clin. 1991 Apr;9(2):317–331. [PubMed] [Google Scholar]
  28. Rymark P., Forslund O., Hansson B. G., Lindholm K. Genital HPV infection not a local but a regional infection: experience from a female teenage group. Genitourin Med. 1993 Feb;69(1):18–22. doi: 10.1136/sti.69.1.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Snijders P. J., van den Brule A. J., Schrijnemakers H. F., Snow G., Meijer C. J., Walboomers J. M. The use of general primers in the polymerase chain reaction permits the detection of a broad spectrum of human papillomavirus genotypes. J Gen Virol. 1990 Jan;71(Pt 1):173–181. doi: 10.1099/0022-1317-71-1-173. [DOI] [PubMed] [Google Scholar]
  30. Southern E. M. Detection of specific sequences among DNA fragments separated by gel electrophoresis. J Mol Biol. 1975 Nov 5;98(3):503–517. doi: 10.1016/s0022-2836(75)80083-0. [DOI] [PubMed] [Google Scholar]
  31. Steinberg B. M., Topp W. C., Schneider P. S., Abramson A. L. Laryngeal papillomavirus infection during clinical remission. N Engl J Med. 1983 May 26;308(21):1261–1264. doi: 10.1056/NEJM198305263082104. [DOI] [PubMed] [Google Scholar]
  32. Syrjänen K. J. Epidemiology of human papillomavirus (HPV) infections and their associations with genital squamous cell cancer. Review article. APMIS. 1989 Nov;97(11):957–970. doi: 10.1111/j.1699-0463.1989.tb00504.x. [DOI] [PubMed] [Google Scholar]
  33. Toon P. G., Arrand J. R., Wilson L. P., Sharp D. S. Human papillomavirus infection of the uterine cervix of women without cytological signs of neoplasia. Br Med J (Clin Res Ed) 1986 Nov 15;293(6557):1261–1264. doi: 10.1136/bmj.293.6557.1261. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Wickenden C., Hanna N., Taylor-Robinson D., Harris J. R., Bellamy C., Carroll P., Malcolm A. D., Coleman D. V. Sexual transmission of human papillomaviruses in heterosexual and male homosexual couples, studied by DNA hybridisation. Genitourin Med. 1988 Feb;64(1):34–38. doi: 10.1136/sti.64.1.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Wikström A., Lidbrink P., Johansson B., von Krogh G. Penile human papillomavirus carriage among men attending Swedish STD clinics. Int J STD AIDS. 1991 Mar-Apr;2(2):105–109. doi: 10.1177/095646249100200205. [DOI] [PubMed] [Google Scholar]
  36. de Villiers E. M. Laboratory techniques in the investigation of human papillomavirus infection. Genitourin Med. 1992 Feb;68(1):50–54. doi: 10.1136/sti.68.1.50. [DOI] [PMC free article] [PubMed] [Google Scholar]

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