Genital human papillomavirus infections in patients attending an inner-city STD clinic

Although infections of the genital tract by human papillomavirus (HPV) may be associated with genital warts, they are not clinically obvious in many cases and must be diagnosed by sophisticated laboratory assays. To learn more concerning the prevalence of HPV infection in an inner-city group of women who visited a clinic that treated sexually transmitted diseases (STDs), a study of 116 patients was carried out. The patients were interviewed and underwent gynecological examinations during which specimens were collected. Tests were carried out for several STDs in addition to HPV infection. A comparison of the results of different tests for diagnosing HPV was made. STDs were common among this clinic population: 14 percent of the patients tested positive for gonorrhea; 15 percent were infected with Chlamydia trachomatis (which causes chlamydia); 21 percent had signs of Trichomonas vaginalis (which causes trichomoniasis); and 23 percent had bacterial vaginosis. Between 12 percent and 41 percent of the women were infected with HPV; the results varied according to the diagnostic test used. Evaluation of Pap smears for pathologic changes associated with HPV led to the highest estimation of the prevalence of HPV, while diagnoses based on the presence of warts led to a much lower estimate. Each diagnostic approach has strengths and weaknesses, and almost one-fifth of the specimens could not be evaluated for HPV by all methods. The difficulty in obtaining appropriate specimens hinders the accurate diagnosis of the disease. Diagnosing HPV infection presents an important problem for STD clinics. (Consumer Summary produced by Reliance Medical Information, Inc.)