Latent Papillomavirus and Recurring Genital Warts

After anogenital condylomata and intraepithelial neoplasms are removed, they frequently recur. Since these lesions are related to papillomaviruses, it has been suggested that latent papillomavirus infection is responsible for recurrence. We studied 20 cases of anogenital lesions that were treated by laser therapy and analyzed biopsy specimens of margins of normal skin adjacent to the lesions for papillomavirus sequences by Southern blot hybridization. In nine cases (45 per cent), papillomavirus sequences were detected in the normal skin margin; lesions recurred in 6 of the 9 patients (67 per cent), in contrast to only 1 of 11 patients (9 per cent) whose margins were negative for the presence of papillomavirus sequences. All but one recurrence developed within 15 mm of the treatment area. Our results demonstrate that clinically and histologically latent papillomavirus exists beyond the treatment area and that its presence influences subsequent recurrences. (N Engl J Med 1985; 313:784–8.) RECENT studies using molecular hybridization indicate that a high percentage of precancers and invasive squamous neoplasms of the female genital tract contain DNA sequences homologous to those of human papillomavirus. 1 2 3 Reports correlating certain histologic features with the presence of particular papillomavirus strains have demonstrated that most benign-appearing condylomata contain papillomavirus types 6 and 11 or papillomaviruses other than type 16, whereas higher-grade precancers and invasive neoplasms usually contain types 16 or 18. 1 2 3 4 5 6 These results suggest a close link between certain papillomaviruses and the neoplastic process. Although most condylomata and precancerous changes of the anogenital region do not progress to become . . .