PHYSICIANS STILL are working out the best approach to dealing with young women infected with human papillomavirus (HPV), alone or in conjunction with intraepithelial neoplasia (please see accompanying article).
Donald Goldstein, MD, of Boston's Children's Hospital says, "We treat [the infection site] with trichloroacetic acid, or we just follow the patient at sixmonth intervals." Ralph M. Richart, MD, professor of pathology at Columbia University College of Physicians and Surgeons in New York City, tells clinicians to "follow that patient [with HPV and a normal smear] prospectively, because we [don't yet] know what's going to happen. My bet is that we will find that there's a group... identified as high risk because they're shedding virus who will subsequently develop lesions. What we don't know is what proportion of that [high-risk] population will [do so]."
In a presentation at a conference on gynecologic cancer held in Atlanta last year, Richart pointed out