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March 17, 1989

Papillomavirus Infection and an Allergic Response to Candida in Women With Recurrent Vaginitis

JAMA. 1989;261(11):1584. doi:10.1001/jama.1989.03420110058023

To the Editor.—  A large percentage of asymptomatic women harbor latent human papillomavirus (HPV) in their genital tracts. In a recent study1 using in situ hybridization, 57% of cervical smears with a normal morphology contained HPV DNA sequences. Expresssion of HPV DNA and proliferation of the virus at these sites result in the appearance of condyloma acuminatum (genital warts). The mechanism leading to HPV proliferation in the female genital tract remains unclear, but may involve immune suppression. In women with condyloma, lymphocyte proliferation2,3 and natural killer cell activity4 are decreased, numbers of T-suppressor cells are increased,3,4 and production of interleukin 2 and interferon gamma is impaired.4Recurrent vulvovaginitis is also associated with transient suppression of cell-mediated immunity.5-7 In some women with this disorder, an allergic response to vaginal yeast, contraceptive spermicides, or semen components7,8 may induce histamine and prostaglandin E8,9—mediated immunosuppression.