**Question:** Genital warts are seen in: March 2013

**Core Concept:** Genital warts are caused by human papillomavirus (HPV) infections, predominantly types 6 and 11 (low-risk HPV), and types 16 and 18 (high-risk HPV). They are common sexually transmitted infections and can lead to cervical cancer if left untreated.

**Why the Correct Answer is Right:** Genital warts are primarily caused by high-risk HPV types, which have the potential to cause severe complications. In March 2013, the World Health Organization (WHO) classified HPV types 16 and 18 as the most oncogenic HPV types, meaning they have the highest potential to cause cancer. These types account for approximately 70% of cervical cancers worldwide.

**Why Each Wrong Option is Incorrect:**

A. Papillomavirus: This term is incorrect as "papillomavirus" refers to the family of viruses, not the specific HPV types responsible for genital warts.

B. HPV types 6 and 11: These are low-risk HPV types and do not typically cause severe complications or cancer. They primarily lead to genital warts due to their ability to evade the host's immune response.

C. HPV types 31 and 45: These are high-risk HPV types, but they are less common than types 16 and 18.

D. HPV types 31 and 45: These are high-risk HPV types, but they are less common than types 16 and 18.

**Clinical Pearl:** It is crucial for healthcare providers to consider HPV testing for high-risk HPV types, particularly types 16 and 18, when assessing patients with genital warts. Early detection and treatment can prevent severe complications like cervical cancer.

**Correct Answer:** D. HPV types 31 and 45.