HPV-ASSOCIATED EPITHELIAL ATYPIA IN ORAL WARTS IN HIV+ PATIENTS

Reported are oral mucosal warts (HPV common antigen-positive) from 7 a dult HIV+ patients in which there was cytologic atypia and disordered growth. Lesions were papillary, white to red in color, and were locate d on the lip, gingiva, palate, tongue, and buccal mucosa. Histological ly, the keratinocytes in the lesions exhibited atypical features in th e form of hyperchromatism and karyomegaly. Koilocytes were frequently seen in the upper level keratinocytes where HPV common antigen was ide ntified. The dysplastic areas, which ranged from mild to severe, typic ally showed abrupt limiting margins. All lesions exhibited intense PCN A reactivity from basement membrane to surface. Nuclei of mid-level an d basal keratinocytes of 3 specimens stained positively for p53 protei n. We believe that the atypia found in these lesions represents cytolo gic change that has malignant potential. The subtype of the HPV in the se lesions has not yet been determined.