Bridging the Gap

Until a modern equivalent of spunk water is available, what are reasonable expectations of wart therapy? What is the oncogenic potential of human papillomavirus (HPV) and what should we tell patients to adequately inform them without terrorizing them? Despite a great increase in the number of publications and an ever growing body of information about HPV infection, HPV molecular biology, and virology, there remains a paucity of clinically applicable knowledge about this common infection. This brief overview summarizes the current knowledge relevant to common clinical issues in an attempt to bridge the gap between information and knowledge. It is clear that HPV produces a latent infection. Human papillomavirus(es) is a group (at least 60 types) of epithelialtrophic viruses that result in latent infection and a spectrum of clinical disease. 1,2 The latent nature of the infection is demonstrated by at least four observations. First, subjects with no clinical history of HPV infection have antibodies to HPV. 3 Second, HPV DNA is present in normal mucosa from patients with laryngeal papillomatosis." Third, HPV DNA is present in normal tissue obtained 0.5 to 1.0 cm beyond surgical margins in women with vulvar warts. 5