Human Papillomavirus 3°
Human Papillomavirus
After confirming possible environmental sources[1],[2] for the Human Papillomavirus infection I couldn’t do but wait in order to understand whether such a transmission modality might be called upon in those cases of genital condylomatosis where the origin of the infection was otherwise inexplicable.
I happened to observe the first case, I started researching the solution of the problem with, in the department of St. Filippo Neri Hospital in Rome where I worked as a gynaecologist: it was the case of a very young nomadic girl who was a prisoner in the near juvenile prison of Casal del Marmo. The girl, who was virgin, was affected by vulvar condylomatosis (an Infection by Human Papillomavirus). Because of the cicumstances I could effect only a cytological sample on the lesion which proved to be positive for the cytopathic effects by virus.
St. Filippo Neri Hospital
As for the clinical history circumstances didn’t let me study the case in depth, yet it seemed it were sure the young woman hadn’t had any kind of intercourse. Besides the hygienic conditions of her life could be supposed not to be good, but in any case I didn’t draw any conclusion.
My intuition grew stronger when I happened to see another virgin girl affected by vulvar condylomatosis.
This time I could quietly carry out my research. The anamnesis excluded any evidence of intercourses or sexual abuses. The cytology of the lesions proved equally to be positive for cytopathic effects by virus, but what stroke me more was the fact that the girl said she had shared the toilet with a foreign girl of the same age affected by an unspecified gynaecological infection. Now I was near the solution.
The solution arrived with one of my private patients under treatment because she was without her periods. She also was virgin and after an external gynaecological examination she resulted to be affected by vulvar condylomatosis extending to the hymen.She was subjected to a cytological and histological sample of the lesion and both of them resulted to be positive for viral infection. I took also a macrophotographic documentation showing the presence of a little condiloma just on the hymen. I completed the research with the PCR (Reaction of the Polymerase Chain) fot the DNA of HPV.
Acuminated condylomata
The PCR resulted positive for HPV 6 and 11subtypes. At the anamnesis no kind of sexual intercourses, no use of private toilets but assiduous frequenting of swimming pools and beaches.
A little after I found, in literature, the case [3] of a vulva verrucous carcinoma associated with HPV in a virgin girl of twenty years of age.
Then I decided to effect the research of the Papillomavirus on all the cases of genital condylomatosis and cutaneous verrucae which might have come to my observation: in a cutaneous verruca of a pregnant young woman, besides the subtypes from one to five (cutaneous), I found also the HPV 6 type which, normally, should have been present only in genital lesions. I examined, with the PCR, also the patient’s vulva and vagina resulting to be positive for the 6 and 11 types, though without any lesion. All this wasn’t unusual because, in America, a group of symptomless university female students, after being subjected to the virus research on vulvar and vaginal cells, had revealed a high percentage of positivity[4]. On the contrary what I considered interesting was the presence of a genital subtype in a cutaneous verruca[5].
[1] Pao C. C, Tsai P.L., Chang Y.L., Asieh T.T., Jin J. Y., Non sexual Papillomavirus routes. Lancet 339(8807): 1479-80 Jun 1992.
[2] Tay S K, Ho T H, Lin S K. Is genital Human Papillomavirus infection always sexually transmitted? Australian-New Zealand Journal of Obstetrics Gynecology30(3):240-2
[3] Valente P T, Hurt M A, Jelen I. Human papillomavirus-associated vulvar verrucous carcinoma in a 20 years old with an intact himen:a case report. Journal of reproductive medicine 36(3):3-12 Mar 1991.
[4] Bauer H M, Ting Y ,Greer J C, Chamber J C, Tashiro C J,Caimera J,Reigold A, Mands M M. Genital Human Papillomavirus infection female university student as determined by a PCR-Based method. Jama 265(4): 427-7 Jan 1991.
[5] Ostrow R S, Shaker M K, Turnquist S, Viksnins A, Bender M, Vance G, Kaye V, Faras A J. Human Papillomavirus-16-DNA in a cutaneous invasive cancer. Arch Dermatol 25(5).666-9 May 1989.
Translated from “Il Virus Intelligente” by Enrica Narducci
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