CLINICAL ASPECTS OF HPV 16/18-ASSOCIATED CERVICAL LESIONS

In 147 patients with suspected dysplasia, the effect of HPV 16/18 infection on the spontaneous course of the cervical intraepithelial neoplasia (CIN) and on the success of conisation and laser treatment was studied. The patients with PAP II smears had a high incidence of HPV (67%). This was accompanied, however, by a high rate of regression and fluctuation of the various virus types. Of the untreated cases of CIN, the lesions associated with HPV 16/18, particularly after repeat virus DNA identification of this type, had a higher persistence rate than HPV 16/18 negative CIN. After local therapy by laser surgery or conisation of HPV 16/18-related CIN, persistent disease must be expected in 30%. CIN recurrence was significantly more frequent in HPV 16/18 positive cases. According to the results of the investigations, HPV typing appears to be a useful tool in deciding on the appropriate therapy only in cases of persistent CIN and in determining an HPV 16/18 positive at-risk group after local (laser/conisation) therapy.