Genital human papillomaviruses. Studies of their occurrence, type spectrum and expression

Sammanfattning: The occurrence of genital human papillomavirus infection was determined in different categories of patients by means of PCR. In high proportion of young women attending an adolescent clinic, the presence of HPV DNA was demonstrated in simultaneously urethral and cervical samples, suggesting that genital HPV infections are often multifocal. Multiple HPV types were demonstrated in about half of these HPV-positive patients. The corresponding figure for women attending a health screening program or referred to a colposcopy clinic was about 23%. From supposedly healthy men, the prevalence of HPV DNA was 8% in urethra samples, as compared to 5% in simultaneously collected urine samples. The overall prevalence of HPV DNA in corresponding urethra and urine samples was higher among women than among males. Among female patients referred to a colposcopy clinic, 49% of the cervical samples and 38% of the urine samples were found to be HPV DNA positive. Among patients whose cervix samples were positive for HPV DNA simultaneous urine samples were also found to be HPV-positive in 65% of the cases. Eighteen percent of a group of women in a health screening program manifested HPV DNA in the cervix. Half of the colposcopy patients studied were characterized by benign histology, and the prevalence of HPV DNA was 27%, whereas of women with various grades of CIN, between 72% and 88% had HPV DNA. The cancer-related HPV types represented about 85% of the isolates identified among all women studied, HPV 16 being the most prevalent type. A simple non-radioactive reverse dot blot hybridization method was developed for the typing of HPV consensus primer generated amplimers. The complete nucleotide sequence and genomic organization of a new HPV type (HPV 70) was determined by cloning and DNA sequence analysis of overlapping PCR products. A quantification method, with dynamic ranges of 4 to 6 log10, was developed for PCR products, using microtiter plate based hybridization with an enzyme-labeled probe followed by colorimetric detection. Higher quantities of both HPV 16 DNA and mRNA were found in patients with CIN II or high-grade neoplasia than among women with CIN I or a normal diagnosis. However, measurements of HPV 16 mRNA relative to viral load can not be used as an indicator of disease activity.