Human papillomavirus infection: a potentially carcinogenic sexually transmitted disease (condylomata acuminata, genital warts).

Human papillomavirus is a sexually transmitted virus that has been associated with intraepithelial neoplasia. The incidence and prevalence of the disease has risen dramatically, to epidemic proportions, within the last two decades. Risk factors for HPV are similar to those for intraepithelial neoplasia: early onset of sexual activity, multiple sexual partners, high-risk sexual practices, and poor hygiene. Health care workers need to screen all patients for HPV through the use of a comprehensive history, including sexual history, a thorough physical examination, and appropriate laboratory methods. Pregnant women must be thoroughly screened because they are at increased risk for HPV, plus there has been an association between genital warts at the time of delivery and subsequent laryngeal papillomas in their infants. Treatment is aimed at the elimination of the lesions. Although in some cases lesions spontaneously resolve without treatment, in other cases there is a significant incidence of recurrence, even with treatment. Cell-mediated immunity seems to play a role in recurrence and regression as well as transformation to atypical cells. Transformation of HPV to neoplasia also seems to be related to co-factors that act synergistically in the oncogenic process. Public education, identification of high risk groups, and prevention are mandatory if the spread of HPV is to be contained. Equally essential is to remain cognizant of the fact that HPV is an STD with potentially carcinogenic properties; thus, screening and treatment of sexual partners are mandatory!