Latent Papillomavirus and Recurring Genital Warts

Abstract
After anogenital condylomata and intraepithelial neoplasms are removed, they frequently recur. Since these lesions are related to papillomaviruses, it has been suggested that latent papillomavirus infection is responsible for recurrence. We studied 20 cases of anogenital lesions that were treated by laser therapy and analyzed biopsy specimens of margins of normal skin adjacent to the lesions for papillomavirus sequences by Southern blot hybridization. In nine cases (45 per cent), papillomavirus sequences were detected in the normal skin margin; lesions recurred in 6 of the 9 patients (67 per cent), in contrast to only 1 of 11 patients (9 per cent) whose margins were negative for the presence of papillomavirus sequences. All but one recurrence developed within 15 mm of the treatment area. Our results demonstrate that clinically and histologically latent papillomavirus exists beyond the treatment area and that its presence influences subsequent recurrences. (N Engl J Med 1985; 313:784–8.)