[Human papillomavirus infections in the lower genital tract of women].
Viral infections of the lower female genital tract have gained increasing clinical, epidemiological and cyto-histopathological relevance in the last few years. From January 1981 to December 1990, 14,090 patients who referred to the center of cervical-vaginal-vulvar physiopathology of the Ob/Gyn Institute (University of Florence), underwent a cytologic, colposcopic and, if necessary, histologic examination. Patients were divided in two groups: the first group consisting of 8635 women and relating to the period 1981-1986, the second group consisting of 5455 patients and relating to the period 1987-1990. This division in groups was necessary because vulvoscopy (after 3-5% acetic acid application) was performed as a routine examination starting in 1987, so that the former period could not be considered homogeneous to the latter for vulvar results. About genital condylomatosis were made some observations: localization, morphology and the different prevalence in the various age groups verifying the statistic reliability using chi 2 test. Finally the association of intraepithelial neoplasias to HPV infection was related to the age of patients, localization and morphology of condylomatous lesions. In the first group 466 patients (5.4%) were affected by genital condylomatosis, 1041 patients (19.1%) were affected in the second group. The yearly prevalence of HPV infection increased during the decade of observation changing from 1.9% of 1981 to 21% of 1990. The prevalence of condylomatous lesions reduces significantly as the age increases (p < 0.0001) showing a maximum of prevalence under twenty-five years of age. Genital condylomatosis is localized in most cases (76%) in a single seat of the lower genital tract and cervical localization is the most commonly involved (43.13% in the first group; 42.65 in the second). Sporadic is the vaginal localization as the sole one. The vulvoperineal seat, after the cervical, is the most frequently involved (1st group: 29.82%; 2nd group: 31.03%). It seems that HPV infection assumes different morphologies according to its localization, generally flat on the cervix and florid at vulvo-vaginal level.(ABSTRACT TRUNCATED AT 400 WORDS)
Istituto di Ostetricia e Ginecologia, Università degli Studi di Firenze.
M G
MG
Fallani
C
C
Penna
R
R
Gordigiani
L
L
Sonni
M
M
Maggiorelli
M
M
Marchionni
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003127:Colposcopy; D003218:Condylomata Acuminata / Q000175:diagnosis; D005260:Female; D006558:Herpes Genitalis / Q000175:diagnosis; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D027383:Papillomaviridae; D011247:Pregnancy; D015995:Prevalence; D014412:Tumor Virus Infections / Q000150:complications / Q000453:epidemiology*; D002577:Uterine Cervical Diseases / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis; D014623:Vaginal Diseases / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*