The spectrum of cervical diseases induced by low-risk and undefined-risk HPVS: implications for patient management.
BACKGROUND
The natural history and carcinogenicity of rare and novel HPV types is unclear.


METHODS
From a total of 5,964 women tested for HPV by PCR and sequence analysis, Pap smears from 293 patients harbouring mono-infection with low-risk, undetermined-risk or novel HPV genotypes were investigated.


RESULTS
Sixty-three percent of patients had ASC-US, 23% LSIL, 9% were negative and 5% had HSIL in cytology. Of 30 HPV types detected, 19 were of unknown risk (UR)-types including 3 novel genotypes. Four of the UR-HPVs (HPV 69, 30, 67 and 34) could be assigned as probable high-risk types and eight as low-risk types based on phylogenetical relationship. Morphology was not discriminative with regard to HPV type, but non-classical HPV-signs were generally present even in "normal" cytologies.


CONCLUSIONS
HPV-typing is important for risk-adapted individual patient management. Women harbouring novel high-risk or probably high-risk HPVs require more intensive care than those bearing non high-risk infections.
Várnai
Alinda D
AD
Institute of Pathology, Bonn-Duisdorf, Germany.
Bollmann
Magdolna
M
Bánkfalvi
Agnes
A
Griefingholt
Harald
H
Pfening
Natalie
N
Schmitt
Christoph
C
Pajor
László
L
Bollmann
Reinhard
R
D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics* / Q000254:growth & development; D030361:Papillomavirus Infections / Q000150:complications* / Q000821:virology; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D002577:Uterine Cervical Diseases / Q000209:etiology* / Q000628:therapy; D014626:Vaginal Smears
D004279:DNA, Viral