Cutaneous warts

• Prevalence ~30% in primary schoolchildren, declines thereafter
• Transmission: direct via skin contact, or indirect via contaminated surfaces
• Majority regress spontaneously in 1-2 years & reinfection with same HPV type is uncommon
• High recurrence → autoinoculation

Genital condylomata

• Most common sexually transmitted infection in the United States
• Prevalence ~40% (19-59 years of age)
• Women 14-19 years-old: decline in HPV 6,11,16, & 18 prevalence to ~5% due to quadrivalent HPV vaccination
• Men: prevalence in men who have sex with men 75%, less prevalent in circumscribed men, & uncommon in prepubertal children
• Risk factors: sexual intercourse at early age, number of lifetime sexual partners
• Transmission: intimate contact
• Majority resolve spontaneously
• Median duration of high-risk HPV infections in women is 8 months, & persistence is found in 30% after 1 year & 9% after 2 years
• Recurrence rate 20-50%
• HPV-16 detected in ~50% of cervical cancers & high-grade cervical intraepithelial neoplasia
• HPV types (16,18,31,33,45,52,58) identified in ~90% of cervical cancers
• Risks for cervical cancer: lack of screening programs, smoking, cervical inflammation, parity, oral contraceptive pills
• Immune suppression in organ transplant & HIV (Human immunodeficiency virus) with low CD4 & high viral load → more frequent & persistent HPV, & likely progress to intraepithelial neoplasia (antiretroviral treatment → no +/- mild benefit)

Recurrent respiratory papillomatosis (RRP)

• Most common benign laryngeal tumor