ABSTRACT
NATURAL HISTORY Genital warts result from HPV infection of basal keratinocytes. Studies demonstrate that infection is dependent upon microabrasion of the genital epithelium, in a manner which results in epithelial denudation but preservation of the epithelial basement membrane3. HPV initially binds to the exposed basement membrane before infiltrating keratinocytes, which most likely occurs as keratinocytes migrate to the basement membrane to reepithelialize a wound3. Most HPV infections are subclinical; however, the virus can also replicate within actively dividing keratinocytes, ultimately
manifesting as exophytic clinical lesions known as genital warts. The typical incubation period is 3 weeks to 8 months, with most warts appearing approximately 2-3 months after HPV infection1. Warts are highly contagious and an estimated 65% of noninfected individuals who engage in sexual intercourse with an infected partner will develop warts1. Approximately 20-30% of genital warts will spontaneously regress, but relapse of lesions is common1.
