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

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.