Anal condylomas in men. 1. Histopathological and virological assessment.

Abstract

sumMARY A series of 128 biopsy specimens from anal condylomas in 73 homosexual or bisexual and 38 heterosexual men (mean (SD) age 31.8 (9.6) years) were subjected to histological assessment and human papillomavirus (HPV) typing by in situ DNA hybridisation with 11,16,18,31,and 33 probes. Most patients were also tested serologically for antibodies to human immunodeficiency virus (HIV). As evaluated on light microscopy, most (74%, 95/128) of the lesions were exophytic (papillary) acuminate warts, 15% (19) were flat, and 11% (14) were pigmented papulous lesions. No signs of anal intraepithelial neoplasia (AIN) were seen in 70% (90) of the 128 biopsy specimens (NAIN), 27% (35) were classified as showing AIN I, and another 2% (three) as AIN II. AIN was significantly (p < 0.05) more often associated with papulous lesions, only 43% (6/14) of which showed NAIN compared with 72% (68/98) of acuminate condylomas. The duration ofdisease was directly related to the presence and severity of AIN in the lesions; thus in 47 lesions that had been present for more than 12 months, NAIN was found in 31 (66%), AIN I in 14 (30%), and AIN II in two (4%).HPV DNA of at least one of the six types tested for was detected in 109/125 (87%) lesions. HPV 6 and HPV 11 were the two most common types, comprising 57% (62) and 37% (40), respectively, of the 109 HPV DNA positive cases. Only seven (6%) biopsy specimens were associated with any of HPV types 16, 18, 31, or 33, which carry a high risk of potential malignant transformation. No association was found between sexual preferences of patients and the incidence of any of the various HPV types. Neither did the distribution ofthe various HPV types differ between men with antibody to HIV and those without antibody. All the men with antibody to HIV were homosexual or bisexual. On microscopy, 93% (38) of41 lesions containing HPV 11 and 75% (48/64) of HPV 6 lesions were of the acuminate wart type; in comparison, the remaining 16 HPV 6 lesions were equally either flat or papulous (eight, 13% each). Of the 64 HPV 6 and 41 HPV 11 associated lesions, 73% (47) and 63% (26), respectively, were classified as NAIN. Only two lesions were associated with HPV 16, and both showed mild dysplasia. On the other hand, two HPV 6 induced lesions were associated with AIN II. No differences were found between HPV 6 and HPV 11 in duration of disease; (39%, and 37% respectively, had been present for more than 12 months). The results showed that overt anal wart disease was associated with HPV types 6 and 11 in most cases. Although HPV types considered as being of higher oncogenic potential were detected relatively rarely, the associated AIN in a relatively high proportion (31%, 32/105) of HPV 6 or 11 induced lesions indicated that a malignant potential, even for HPV 11 associated anal warts, cannot be excluded.Overt genitoanal warts (condylomata acuminata or (STD) that afflicts both sexes.'2 Human papillocondylomas) represent a sexually transmitted disease mavirus (HPV) has been established as the aetiological agent of th...

Genital Human Papillomavirus Infection and Associated Penile Intraepithelial Neoplasia in Males Infected with the Human Immunode.ciency Virus

“…1,28 This finding is not in agreement with reports demonstrating that the potentially oncogenic HPV types were no more common in men with antibodies to HIV than in those who were HIV seronegative. 26 High-risk HPV types were detected in both groups, mainly in smears with high grade lesions (PIN 2-3), and low-risk types (6/11) were associated essentially with HPV-PIN 1, as found by previous studies. HIV infection might promote the persistence or reactivation of HPV in the genital tract and the progression of neoplasia, 1,28,31 as previously reported by dot-blot and polymerase chain reaction in anal swabs from HIV-seropositive homosexual men, 3 and it might facilitate the primary HPV infection.…”

“…8,17 In men some types of HPV have been implicated as possible causative agents in the induction of anal dysplasia and carcinoma. 26 The penile area is also a site of dysplasia. Most of the benign condylomata acuminata of the male anogenital tract have been proven to contain HPV 6-11, whereas higher grade precancers and invasive tumors frequently contain HPV 16-18.…”

Oncogenic human papillomavirus is not helpful for cytology screening of the precursor lesions of anal cancers in Taiwanese men who are infected with human immunodeficiency virus

“…In our subjects, their mean ages were 31.46 years, so the predominance of HPV type 11 in this study may indicate young ages with active sexual behaviors. Second, evidence exists that nononcogenic HPV could cause also high-grade AINs and that genital warts are etiologically related to anal cancers [23,24]. In previous research, oncogenic products including ubiquitination of E6 protein and degradation of P53 were found in cells infected with HPV type 11 [25].…”

Molecular and serological studies of human papillomavirus among patients with anal epidermoid carcinoma

“…HPV types 16 and 18 have been found in anal dysplasias and carcinomas (Palmer et al, 1989;Wolber et al, 1990), whereas HPV types 6 and 11 are found in anal condylomas and in low-grade anal intraepithelial neoplasia (Duggan et al, 1989;Syrjanen et al, 1989).…”