[Genital papillomavirus infections]

The incidence of condyloma acuminata is increasing in all developed countries with highest rates recorded for young sexually males and females, between the ages of 16 and 25 years. Subclinical and latent genital human papillomavirus (HPV) infections are highly prevalent. Direct correlation between number of sexual partners and presence of HPV is evident. Clinical HPV infections such as condylomas (acuminata and papular) are easily recognized, but acetowhite flat macular condylomas require colposcopic examination. High grade IN (cervical CIN II, III, vulvar VIN, anal AIN, penile PIN) are considered to be related to HPV type 16 and 18 (less frequently other types 31, 33, 35, 51), the oncogenic potential of which was demonstrated by in vitro transformation assays and by the fact that they are detected in 50 to 90% of genital neoplasia. Clinical HPV infections (condylomas and low grade IN) are associated with "low risk" HPV types 6/11. The requirement for routine HPV-DNA typing is limited and in general, management is based on clinical and conventional light microscope evaluation. Immunosuppression is a most important risk-factor for the development, the progression and the recurrences of cervical and anal condylomas and neoplasia. Whatever treatment is applied a 30% recurrences rates occur, implying a regular clinical follow up after treatment to prevent recurrences development and neoplasia.