engleski

What should be known about asymptomatic HPV infection?

Genital human papilloma virus (HPV) has risen dramatically over past 30 years, and it is now the most common viral sexually transmitted disease (STD). HPV are associated with spectrum of diseases, from benign vulgar verruca, genital warts, to malignant cervical, vulvar, anal or penile cancer. HPV is known to induce three different manifestations: clinical, subclinical, and latent infection. Although most infections are asymptomatic, usually years or decades are required for malignant transformation. Male patients generally present no clinical lesions, and those that have female partner with cervical intraepithelial neoplasia (CIN) might constitute a reservoir for high-risk HPV. Flat warts (condylomata plana) are subclinical lesions that are difficult to detect without the special techniques (colposcopy-peniscopy) which involves 3-5% acetic acid, applied for 5-10 minutes. The HPV infected areas, whitened by the acetic acid. Subclinical lesions show histological evidence of HPV infection, either by presence of koilocytosis, or less frequently, intraepithelial neoplasia. Latent infections are defined by presence of HPV DNA in areas with no clinical or histological evidence of HPV infection. They are probably the most common form of anogenital HPV infection, regardless of HPV type, and they present “ reservoir” for HPV. The infectivity from subclinical/latent HPV infection is not known, since its transmission studies are difficult to perform, and there are yet no consistently reliable diagnostic methods available for routine use. We suggest using peniscopy together with HPV DNA tests (Hybrid Capture II, PCR, in situ hybridization, Southern blots tests). Men are usually reservoir of the virus, which lives in latent form on genital mucous membranes, and this subclinical, asymptomatic infections can be oncogenic factor(s) in development of cervical cancer. Attention must be paid to control and early diagnosis to prevent neoplasic evolution.

asymptomatic Human papilloma virus infection in men; cervical cancer; colposcopy peniscopy

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