The Detection of Genital Human Papillomavirus Infection Using Polymerase Chain Reaction

To the Editor.—  Readers who are interested in the detection and clinical implications of genital human papillomavirus (HPV) infection may appreciate an alternative interpretation of the recent JAMA article by Bauer et al,¹ which compares polymerase chain reaction (PCR), as performed in a research laboratory, with the Vira Pap/ViraType dot blot system run in a commercial reference laboratory.The article states that PCR detected HPV DNA in 46% of their female university students, as opposed to only 11% detected by the dot blot test. The implicit assumption here (which is by no means proven) is that higher sensitivity is superior. It should be emphasized that PCR detected a wide range of different HPV types. Many of these HPVs are not associated with high-grade cervical intraepithelial neoplasia or cancer, and many others we know absolutely nothing about. It is, in fact, uncertain whether all of these "unknown" HPVs are even genital