The value of human papilloma virus typing

This editorial will review the currently available typing methods for human papilloma virus (HPV) and evaluate their clinical utility. HPV has been linked to anogenital (especially cervical) neoplasia in three ways. First, histological and cytological correlations were observed between HPV infection (condyloma or koilocytosis) and cervical intraepithelial neoplasia (CIN) and invasive neoplasia. Second, specific HPV types were linked to neoplasia, leading to the definition of high-risk (HPV 16, 18), low-risk (HPV 6, 11, 42-44), and intermediate-risk (HPV 31, 33, and 35) types. The third piece of evidence is the in vitro data that demonstrated that HPV types 16, 18, 31, and 33 (but not 6 or 11) can induce immortalization and aneuploidy in cultured keratinocytes. The strong association between the presence of HPV DNA and cervical neoplasia, coupled with the rapid development of molecular diagnostic technology, naturally leads one to speculate about the possible clinical role of detection of HPV nucleic acids.