# Co-infection of Oncogenic Human Papillomavirus 16 Genotype in Genital Warts: A Case Report

## TL;DR

A case report describes a patient with genital warts found to also have a high-risk HPV 16 infection, highlighting the need for detailed testing beyond clinical appearance.

## Contribution

This case illustrates the potential for co-infection with high-risk HPV 16 in genital warts, emphasizing the limitations of clinical diagnosis alone.

## Key findings

- A patient with genital warts was found to have HPV 16, a high-risk strain not typically associated with such lesions.
- Histopathologic and molecular testing revealed co-infection despite benign clinical appearance.
- The case underscores the importance of molecular testing in atypical or persistent lesions.

## Abstract

Human papillomavirus (HPV) is globally one of the most common sexually transmitted infections (STIs). HPV 6 and 11, which are low-risk subtypes, are commonly associated with condyloma acuminatum. These benign lesions are typically described as papillary or cauliflower-like. We present the case of a 28-year-old uncircumcised male patient with these lesions on his foreskin. They were surgically removed, and upon histopathologic evaluation, the diagnosis of condyloma acuminatum was made. Real-time polymerase chain reaction (RT-PCR) was performed on the excised tissue for investigational purposes, and a high-risk HPV (hr HPV) strain was identified. Testing of this specimen did not influence the immediate clinical management in this case. Even though HPV subtype 16 is not generally associated with genital warts, its detection in an otherwise benign lesion illustrates the limitations of relying on clinical appearance alone and suggests the possibility of evaluating and managing these lesions on a case-by-case approach. This case highlights the role of histopathologic evaluation and selective molecular testing in carefully selected patients and clinical scenarios, such as persistent lesions and atypical appearance. As this is a single case report, the findings depicted here cannot be generalized and do not support changes to current screening or management guidelines. HPV vaccination remains the most effective method for preventing HPV-related disease.