  
Some HPV types may be part of commensal microflora of genital mucosa
Last Updated: 2001-04-27 16:45:03 EDT (Reuters Health)
By Karla Gale
WESTPORT, CT (Reuters Health) - A total of 45 human papillomavirus (HPV) genotypes, including 15 types never before characterized, have been isolated from a cohort of HIV-infected women, according to a presentation at the fifth annual AIDS Malignancy Conference in Bethesda, Maryland.
"It appears that whenever an individual is immunosuppressed or chronically ill, even in individuals supposedly at the lowest risk for HPV infection, HPV becomes detectable," Dr. Thomas R. Broker told Reuters Health. This raises the possibility that rather than being sexually transmitted, HPV may comprise part of the commensal viral microflora of the anogenital mucosa, he said.
Dr. Broker and associates at the University of Alabama at Birmingham collected more than 750 cervicovaginal lavage specimens from 225 women over a period of 56 months. DNA sequencing was performed when the researchers were unable to identify HPV isolates based on DNA restriction polymorphism.
The prevalence of HPV positivity ranged from 63% to 78% over the course of the study, with individuals demonstrating from zero to four different virus types at a time. Over time, several patients had eight or nine types observed, Dr. Broker told Reuters Health. "We saw 45 different HPVs in almost every conceivable combination," he added.
These results "raise a flag of caution that one has to be sensitive to extreme polymorphism in this group of viruses," Dr. Broker said.
The research team observed that improved immune status correlated with a reduction in the detectability of HPV by Pap smear.
Dr. Broker's group has been monitoring HPV in other immunocompromised populations, including bone marrow transplant recipients and renal transplant candidates. Here again, they found that the prevalence of HPV was approximately 70%.
Dr. Broker suggests that two groups of HPV viruses may exist, one that is benign and protective, and "may stimulate the immune system enough to let it know what HPV looks like and have cross-protection against worse types." The other group would comprise types that lead to the development of dysplasia and cancer.
"The whole question of vaccinating against a large array of viral types becomes problematic," he pointed out. "What do you select as your target?"
-Westport Newsroom 203 319 2700
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