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To the Editor: Dr Moscicki and colleagues¹ found a strong association between the frequency of sexual behavior and human papillomavirus (HPV) infection. They claim that this "supports the hypothesis that HPV is a sexually transmitted virus and that most ‘new' infections in young females are predominantly due to exposure, rather than the ‘transient' upregulation of latent infections in nonimmunocompromised hosts."

However, Moscicki et al do not include immunological data to support their hypothesis regarding new and latent infections. There are no immunological data that document that all of the patients in their study are nonimmunocompromised hosts. Moscicki et al also have recently reported² that the rates of HPV infection and squamous intraepithelial lesions were higher among young women infected with human immunodeficiency virus (HIV) than among those who were not infected, despite similar sexual risk behaviors and the relatively healthy state of the HIV-infected group.

Relapses in immunocompromised hosts may . . . [Full Text of this Article]

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Risks for Incident Human Papillomavirus Infection and Low-Grade Squamous Intraepithelial Lesion Development in Young Females
Anna-Barbara Moscicki, Nancy Hills, Steve Shiboski, Kim Powell, Naomi Jay, Evelyn Hanson, Susanna Miller, Lisa Clayton, Sepideh Farhat, Jeanette Broering, Teresa Darragh, and Joel Palefsky
JAMA. 2001;285(23):2995-3002.
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