HUMAN PAPILLOMA VIRUS INFECTION (VENEREAL WARTS) – INVESTIGATION AND DIAGNOSIS; INCUBATION PERIOD

Genital warts can usually be diagnosed on clinical grounds and may be confirmed by histology. Cervical HPV infection will commonly be diagnosed by cervical cytology with or without colposcopy and biopsy. There are no suitable serological tests and the virus cannot be isolated from clinical material by cultural methods. HPV may be undetectable except by hybridisation using nucleic acid probes.

Warts must be distinguished from the condylomata lata of secondary

syphilis by serological tests for syphilis and dark ground examination. If the lesion is large, fungating or ulcerated, a biopsy should be taken to exclude carcinoma. Warts should also be differentiated from molluscum contagiosum (p.45), vulval skin tags and penile papules (sebaceous glands).

Genital HPV infection is usually sexually acquired but autoinoculation can occur. Lesions may develop from one to six months or more after infection. HPV infection may be subclinical. Latent infection is usual after spontaneous regression or treatment and there is considerable recurrence.

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