The Use of Consensus PCR and Direct Sequence Analysis for the Identification of HPV

The human papillomaviruses (HPVs) form a large group of small double-stranded DNA viruses of about 7900 bp. The viruses infect mucosal and cutaneous epithelia and are associated with a number of benign and malignant lesions (1 –4 ) HPVs originally have been described to be present in skin warts. Strong evidence provided by molecular biological and epidemiological studies has shown that some HPV types are involved in the etiology of ano-genital warts and cancers. In addition, evidence suggests that these viruses are involved in the pathogenesis of skin cancers of immunosuppressed individuals with the rare heritable disease epidermodysplasia verruciformis (EV), in the development of lesions of the aerodigestive tract such as juvenile laryngeal papillomas and with some lesions of the ocular tract. Recent evidence indicates that particular HPV types belonging to the EV-related subgroup of viruses also are involved in the development of skin cancers of renal transplant recipients (5 ,6 ). Distinct clinical manifestations are caused by different HPV types. For instance, whereas the mucosal HPV types which infect the lower genital tract types 6, 11, 13, 42, and 44 are associated with benign condylomatas, types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, and 58 are associated with premalignant cervical lesions (cervical intraepithelial neoplasia; CIN) and cervical cancers (7 –10 ). Sensitive HPV DNA detection methods have been very useful for studying the pathogenesis of lesions caused by infections with HPV and the epidemiology of these viruses. Potentially an HPV DNA detection assay suitable for the detection of genital HPV types involved in the pathogenesis of cervical cancer could be used clinically for the screening of women at risk for the development of high grade cervical premalignant lesions and of cancer.