DETECTION OF HUMAN-PAPILLOMAVIRUS IN VERRUCOUS CARCINOMA FROM HIV-SEROPOSITIVE PATIENTS

Anogenital squamous cell carcinoma has been noted with increased frequ ency in HIV-seropositive patients. Verrucous carcinoma is a variant of squamous cell carcinoma that tends to be locally invasive and non-met astasizing. Although human papillomavirus (HPV) has been strongly impl icated in other squamous neoplasms, it has been variably associated wi th verrucous carcinoma and has not been examined in these lesions in t he HIV-positive population. The aim of this study was to examine the a ssociation of HPV with anal verrucous carcinoma in patients with the h uman immunodeficiency virus (HIV). HPV DNA in situ hybridization for H PV Types 6/11, 16/18, and 31/33/35 was performed on formalin-fixed, pa raffin-embedded tissue from six cases of verrucous carcinoma and four cases of condyloma acuminatum in perianal specimens from HIV-seroposit ive patients. HPV DNA sequences were identified in five of six cases o f verrucous carcinoma and in all cases of condyloma acuminatum. Of the five verrucous carcinomas that harbored detectable HPV DNA, four cont ained HPV 6/11 and two contained HPV 16/18. One contained both HPV 6/1 1 and HPV 16/18. All four cases of condyloma acuminatum were positive for HPV 6/11. One patient included in this series had three chronologi cally separate verrucous carcinomas. The initial lesion was negative f or HPV DNA. Subsequent verrucous carcinomas were positive for HPV type 6/11 and type 16/18, respectively. The data presented support the con cept that verrucous carcinoma in the HIV-seropositive population is as sociated with HPV, which may indeed play an important role in its path ogenesis.