Advantage of human papillomavirus typing in the clinical evaluation of genitoanal warts. Experience with the in situ deoxyribonucleic acid hybridization technique applied on paraffin sections.

Genitoanal warts are predominantly induced by human papillomavirus (HPV) types 6, 11, 16, and 18. A strong association has been established between infection by HPV 16 and HPV 18 and the subsequent development of cancer in the uterine cervix. Therefore, a clinical challenge exists with respect to identification of patients harboring the latter type of high-risk HPV types. The present study on 108 men with genitoanal warts focuses on whether reliable gross and/or histopathologic criteria exist to predict the presence of HPV 16 and HPV 18 or whether there is a need for HPV typing by deoxyribonucleic acid (DNA) hybridization assay in future epidemiologic studies. The high-risk HPV types were identified in 9 of 91 HPV DNA-positive lesions (11%). The gross appearance of the lesions appeared to be of limited predictive value for the presence of these HPV types. HPV 16 was most common in warts exhibiting some degree of dysplasia (p less than 0.001) and also occurred in the two lesions with a severe dysplasia. Lack of dysplasia correlated with the presence of HPV 6 and/or 11 (p less than 0.01). However, absence of dysplasia did not preclude infection with high-risk HPV types, and a mild to moderate dysplasia was associated with all of the four HPV types studied. Therefore, we emphasize the value of HPV typing in clinical routine in order to trace men harboring the high-risk HPV types 16 and/or 18.