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Rathod SP, Padhiar B, Shah B. Sexually transmitted infections and human immunodeficiency virus coinfection: Scenario in Western India. Indian J Sex Transm Dis AIDS 2020; 41:162-168. [PMID: 33817588 PMCID: PMC8000681 DOI: 10.4103/ijstd.ijstd_87_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/10/2019] [Accepted: 03/04/2019] [Indexed: 11/20/2022] Open
Abstract
Context: Sexually transmitted infections (STIs) have a well-established synergistic relationship with human immunodeficiency virus (HIV) infection. Coinfection with HIV and STI can increase the probability of HIV transmission to an uninfected partner by increasing HIV concentrations in genital lesions, genital secretions, or both. Concurrent HIV infection alters the natural history of the classic STIs. Aims: The aim was to study the current scenario of STIs with HIV co-infection, and to recognize different manifestations of STIs than the classical presentation in people living with HIV/AIDS (PLHIV). Settings and Design: It was an open, cross-sectional, descriptive study carried out in the setting of state government hospital with attached antiretroviral therapy referral center. Subjects and Methods: The sample size of the study was duration based (30 months). Inclusion Criteria: All PLHIV presenting to the department of dermatology with STIs were included in the study. Exclusion Criteria: Non-STI causes of genital ulceration were excluded in the study. Results: The study includes total (n = 484) patients living with HIV/AIDS, prevalence of different STIs was in the following order, herpes simplex virus infections 24.17%, human papillomavirus infections 8.88%, molluscum contagiosum 7.43%, secondary syphilis 4.33%, gonorrhea 1.85%, chancroid 1.44%, and granuloma inguinale 0.41%. Of all the patients with herpes simplex virus infections, 45.6% (n = 57) had multiple recurrences (>6/year). The incidence of mixed STI was 17.29% in the present study. Conclusions: The study represents decreasing trends in bacterial STIs and the rise of viral STIs. Atypical presentations of classic STIs were more frequent than non-HIV-infected individuals.
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Affiliation(s)
- Santoshdev P Rathod
- Department of Dermatology, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
| | - Bela Padhiar
- Department of Dermatology, GMERS Medical College, Gandhinagar, Gujarat, India
| | - Bela Shah
- Department of Dermatology, B. J. Medical College, Ahmedabad, Gujarat, India
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Looker KJ, Rönn MM, Brock PM, Brisson M, Drolet M, Mayaud P, Boily M. Evidence of synergistic relationships between HIV and Human Papillomavirus (HPV): systematic reviews and meta-analyses of longitudinal studies of HPV acquisition and clearance by HIV status, and of HIV acquisition by HPV status. J Int AIDS Soc 2018; 21:e25110. [PMID: 29873885 PMCID: PMC5989783 DOI: 10.1002/jia2.25110] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 03/27/2018] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Observational studies suggest HIV and human papillomavirus (HPV) infections may have multiple interactions. We reviewed the strength of the evidence for the influence of HIV on HPV acquisition and clearance, and the influence of HPV on HIV acquisition. METHODS We performed meta-analytic systematic reviews of longitudinal studies of HPV incidence and clearance rate by HIV status (review 1) and of HIV incidence by HPV status (review 2). We pooled relative risk (RR) estimates across studies using random-effect models. I2 statistics and subgroup analyses were used to quantify heterogeneity across estimates and explore the influence of participant and study characteristics including study quality. Publication bias was examined quantitatively with funnel plots and subgroup analysis, as well as qualitatively. RESULTS AND DISCUSSION In review 1, 37 publications (25 independent studies) were included in the meta-analysis. HPV incidence (pooled RR = 1.55, 95% CI: 1.29 to 1.88; heterosexual males: pooled RR = 1.95, 95% CI: 1.62, 2.34; females: pooled RR = 1.63, 95% CI: 1.26 to 2.11; men who have sex with men: pooled RR = 1.36, 95% CI: 1.01 to 1.82) and high-risk HPV incidence (pooled RR = 2.20, 95% CI: 1.90 to 2.54) was approximately doubled among people living with HIV (PLHIV) whereas HPV clearance rate (pooled RR = 0.53, 95% CI: 0.42 to 0.67) was approximately halved. In review 2, 14 publications (11 independent studies) were included in the meta-analysis. HIV incidence was almost doubled (pooled RR = 1.91, 95% CI 1.38 to 2.65) in the presence of prevalent HPV infection. There was more evidence of publication bias in review 2, and somewhat greater risk of confounding in studies included in review 1. There was some evidence that adjustment for key confounders strengthened the associations for review 2. Misclassification bias by HIV/HPV exposure status could also have biased estimates toward the null. CONCLUSIONS These results provide evidence for synergistic HIV and HPV interactions of clinical and public health relevance. HPV vaccination may directly benefit PLHIV, and help control both HPV and HIV at the population level in high prevalence settings. Our estimates of association are useful for mathematical modelling. Although observational studies can never perfectly control for residual confounding, the evidence presented here lends further support for the presence of biological interactions between HIV and HPV that have a strong plausibility.
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Affiliation(s)
- Katharine J Looker
- Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Minttu M Rönn
- Department of Infectious Disease EpidemiologyImperial College LondonLondonUK
- Department of Global Health and PopulationHarvard T.H Chan School of Public HealthBostonUSA
| | - Patrick M Brock
- Institute of Biodiversity, Animal Health and Comparative MedicineCollege of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Marc Brisson
- Centre de recherche du CHU de Québec‐Université LavalAxe santé des populations et pratiques optimales en santéQuébecCanada
| | - Melanie Drolet
- Centre de recherche du CHU de Québec‐Université LavalAxe santé des populations et pratiques optimales en santéQuébecCanada
| | - Philippe Mayaud
- Department of Clinical ResearchFaculty of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUK
| | - Marie‐Claude Boily
- Department of Infectious Disease EpidemiologyImperial College LondonLondonUK
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Pankam T, Kerr SJ, Teeratakulpisan N, Rodbamrung P, Wongkanya R, Keelawat S, Ruangritchankul K, Hongchookiat P, Watanapokasin R, Phanuphak N. Human papillomavirus in anal biopsy tissues and liquid-based cytology samples of HIV-positive and HIV-negative Thai men who have sex with men. PAPILLOMAVIRUS RESEARCH 2017; 3:149-154. [PMID: 28720449 PMCID: PMC5883198 DOI: 10.1016/j.pvr.2017.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 03/24/2017] [Accepted: 04/26/2017] [Indexed: 11/25/2022]
Abstract
Background Men who have sex with men (MSM) are at high risk of developing human papillomavirus (HPV)-related anal cancer. We compared HPV genotypes in anal tissues (Bx) and anal liquid-based cytology fluid (LBC) from HIV-positive and HIV-negative MSM. Methods Bx (32 normal, 41 low-grade squamous intraepithelial lesions (LSIL) and 22 high-grade squamous intraepithelial lesions (HSIL)), along with LBC from the same visit, were selected from 61 HIV-positive and 34 HIV-negative MSM who enrolled into a prospective cohort in Bangkok, Thailand. HPV genotyping was performed on Bx and LBC. Results Any HPV and high-risk HPV (HR-HPV) prevalence were 63.2% and 60.0% in Bx and 71.6% and 62.1% in LBC, respectively. HIV-positive MSM had higher rates of HR-HPV genotypes detection (70.5% vs. 47.1%, p=0.03) in LBC than HIV-negative MSM. HPV16 (27%) was the most common HR-HPV found in HSIL tissue. In HIV-positive MSM, the frequency of HR-HPV detection increased with histopathologic grading in both Bx and LBC samples. HSIL was associated with the presence of any HR-HPV(OR 7.6 (95%CI 1.8–31.9); P=0.006) in LBC and in Bx((OR 5.6 (95%CI 1.4–22.7); P=0.02). Conclusions Our data strongly support the integration of HR-HPV screening on LBC samples, along with HPV vaccination, into an anal cancer prevention program.
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Affiliation(s)
- Tippawan Pankam
- The Thai Red Cross AIDS Research Centre, Bangkok, Thailand; Department of Biochemistry, Faculty of Medicine, Srinakharinwirot University, Bangkok 10110, Thailand
| | - Stephen J Kerr
- HIV-NAT, Bangkok, Thailand; The Kirby Institute, University of New South Wales, Sydney, Australia
| | | | | | | | - Somboon Keelawat
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Komkrit Ruangritchankul
- Department of Pathology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | | | - Ramida Watanapokasin
- Department of Biochemistry, Faculty of Medicine, Srinakharinwirot University, Bangkok 10110, Thailand.
| | - Nittaya Phanuphak
- The Thai Red Cross AIDS Research Centre, Bangkok, Thailand; SEARCH, Bangkok, Thailand
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King EM, Gilson R, Beddows S, Soldan K, Panwar K, Young C, Prah P, Jit M, Edmunds WJ, Sonnenberg P. Human papillomavirus DNA in men who have sex with men: type-specific prevalence, risk factors and implications for vaccination strategies. Br J Cancer 2015; 112:1585-93. [PMID: 25791874 PMCID: PMC4453685 DOI: 10.1038/bjc.2015.90] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/02/2015] [Accepted: 02/07/2015] [Indexed: 11/09/2022] Open
Abstract
Background: Human papillomavirus (HPV) vaccination of girls will have relatively little effect on HPV-related disease in men who have sex with men (MSM). We determined HPV prevalence and risk factors in MSM to inform the potential effectiveness of vaccinating MSM. Methods: Cross-sectional study of 522 MSM aged 18–40 attending a London sexual health clinic who completed a computer-assisted self-interview. Urine and two swabs (anal and penile/scrotal/perianal) were collected and tested using an in-house Luminex-based HPV genotyping system. Results: Prevalence of DNA of the vaccine-preventable HPV types in ano-genital specimens of men was 87/511 (17.0%), 166/511 (32.5%) and 232/511 (45.4%) for the bivalent (HPV16/18), quadrivalent (HPV6/11/16/18) and nonavalent (HPV6/11/16/18/31/33/45/52/58) vaccine types, respectively. A total of 25.1% had one of the quadrivalent types, and 7.4% had 2+ types. Median age at first anal sex was 19 (IQR 17–23) and at first clinic attendance was 24 (IQR 20–27). The increase in the odds of any HPV infection per year of age was 4.7% (95% CI 1.2–8.4). Conclusions: On the basis of the current infection status, most MSM, even among a high-risk population attending a sexual health clinic, are not currently infected with the vaccine-type HPV. A targeted vaccination strategy for MSM in the UK could have substantial benefits.
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Affiliation(s)
- E M King
- Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK
| | - R Gilson
- 1] Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK [2] The Mortimer Market Centre, Central and North West London NHS Foundation Trust, London WC1E 6JB, UK
| | - S Beddows
- Virus Reference Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - K Soldan
- HIV/STI Department, Centre for Communicable Disease Surveillance and Control (CIDSC), Public Health England, 61 Colindale Avenue London, NW9 5EQ, UK
| | - K Panwar
- Virus Reference Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - C Young
- 1] Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK [2] The Mortimer Market Centre, Central and North West London NHS Foundation Trust, London WC1E 6JB, UK
| | - P Prah
- Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK
| | - M Jit
- 1] Modelling and Economics Unit, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK [2] Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - W J Edmunds
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - P Sonnenberg
- Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK
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Zou H, Tabrizi SN, Grulich AE, Hocking JS, Bradshaw CS, Cornall AM, Morrow A, Prestage G, Law MG, Garland SM, Chen MY, Fairley CK. Site-specific human papillomavirus infection in adolescent men who have sex with men (HYPER): an observational cohort study. THE LANCET. INFECTIOUS DISEASES 2014; 15:65-73. [PMID: 25435055 DOI: 10.1016/s1473-3099(14)70994-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) have an increased risk of anogenital human papilomavirus (HPV) infection, which can lead to HPV-related anogenital lesions such as warts, anal intraepithelial neoplasia, and anal cancer. Some of these HPV types are preventable with vaccines. We aimed to describe the incidence of anal, penile, and oral HPV infection, and to estimate the site-specific transmission probability per partner, for teenage MSM. METHODS In our observational cohort study, we enrolled teenage MSM (aged 16-20 years) with low sexual exposure and a low prevalence of HPV in Melbourne (VIC, Australia). At baseline, 3, 6, and 12 months, we took a swab from the anal canal, and participants self-collected a swab from the penis and an oral rinse. Our primary outcome was definite and probable incident HPV infection of the anus, penis, or mouth at any time in the 12 months from baseline, assessed through the presence of HPV DNA. We defined definite incident HPV infection as the same HPV type detected more than once from the same site in men who had a negative HPV test at baseline. We defined probable incident HPV infection as only one positive test. We estimated the probability of HPV transmission per partner using HPV prevalence in MSM with a similar age to partners of men in our cohort. This study is registered at the Australian New Zealand Clinical Trials Registry and ClinicalTrials.gov, numbers ACTRN12611000857909 and NCT01422356. FINDINGS We enrolled 200 MSM aged 16-20 years (median 19 years [IRQ 18-20; range 16-20]) between Sept 20, 2010, and Aug 24, 2012. Over the 12 month follow-up period, we detected 48 definite (107 possible) HPV infections in the anus, ten definite (34 possible) HPV infections on the penis, and no definite (six possible) infections in the mouth. Definite incidence rate per 100 person-years for any anal HPV infection was 57 (95% CI 46-68), and for any anal HPV type in the quadrivalent vaccine was 33 (23-44). Definite incidence rate per 100 person-years for any penile HPV was 12 (6-21) and for any HPV type in the quadrivalent vaccine was 5 (1-12). Estimated probabilities of HPV transmission from the penis to the anus were significantly higher than were those from the anus to the penis (p<0·05 for all HPV types in the quadrivalent vaccine). INTERPRETATION High incidence rates suggest that the vaccination coverage in MSM will need to be high. The transmission estimates will inform HPV modelling. FUNDING Merck.
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Affiliation(s)
- Huachun Zou
- Melbourne Sexual Health Centre, Alfred Health, Carlton, VIC, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Sepehr N Tabrizi
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia; Department of Microbiology and Infectious Diseases, Royal Women's Hospital, Melbourne, VIC, Australia; Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - Andrew E Grulich
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Catriona S Bradshaw
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Central Clinical School, Monash University, Carlton, VIC, Australia
| | - Alyssa M Cornall
- Department of Microbiology and Infectious Diseases, Royal Women's Hospital, Melbourne, VIC, Australia; Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - Andrea Morrow
- Melbourne Sexual Health Centre, Alfred Health, Carlton, VIC, Australia
| | - Garrett Prestage
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia; Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Matthew G Law
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Suzanne M Garland
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia; Department of Microbiology and Infectious Diseases, Royal Women's Hospital, Melbourne, VIC, Australia; Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Carlton, VIC, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Central Clinical School, Monash University, Carlton, VIC, Australia
| | - Christopher K Fairley
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Central Clinical School, Monash University, Carlton, VIC, Australia.
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The role of human papillomavirus in human immunodeficiency virus acquisition in men who have sex with men: a review of the literature. Viruses 2012; 4:3851-8. [PMID: 23250451 PMCID: PMC3528294 DOI: 10.3390/v4123851] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 12/14/2012] [Accepted: 12/17/2012] [Indexed: 11/19/2022] Open
Abstract
Human Papillomavirus (HPV) infection is the most common sexually transmitted infection (STI) worldwide. Incidence rates of HPV infection among human immunodeficiency virus (HIV)-infected individuals are well documented and are several-fold higher than among HIV-uninfected individuals. Few studies have demonstrated an increased risk for acquiring HIV infection in those with HPV infection, and this risk seems to be higher when HPV strains are of high-risk oncogenic potential. The estimated prevalence of high-risk oncogenic HPV infection is highest in men who have sex with men (MSM), a particularly vulnerable group with high prevalence rates of HIV infection and other STIs. In this paper, we provide a comprehensive review of the available literature on the role of HPV infection in HIV acquisition. Our review includes data from cross-sectional and longitudinal studies.
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Smith JS, Gilbert PA, Melendy A, Rana RK, Pimenta JM. Age-specific prevalence of human papillomavirus infection in males: a global review. J Adolesc Health 2011; 48:540-52. [PMID: 21575812 DOI: 10.1016/j.jadohealth.2011.03.010] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 03/17/2011] [Accepted: 03/19/2011] [Indexed: 11/29/2022]
Abstract
PURPOSE Global data on age-specific prevalence of human papillomavirus (HPV) infection in males, especially for oncogenic HPV types 16 and 18, are essential for future efforts to prevent HPV-related diseases, including expanded access to HPV prophylactic vaccines for boys and young men. METHODS A systematic review of peer-reviewed publications was conducted to summarize worldwide data on genital HPV-DNA prevalence in men. Studies using polymerase chain reaction or hybrid capture detection assays were included. RESULTS Approximately 6,600 abstracts were identified. Of them, 64 reported age-specific HPV prevalence and were included in the review. Of these, 38 were from populations at high risk of HPV infections, such as sexually transmitted infection clinic attendees, human immunodeficiency virus-positive males, and male partners of women with HPV infection or abnormal cytology. The largest proportions of studies were from Europe (38%) and North America (25%), with smaller proportions from Central and South America (19%), Asia (11%), and Africa (5%). Across all regions, data on HPV prevalence were generally limited to men >18 years of age. HPV prevalence was high among sexually active men in all regions but with considerable variation, from 1% to 84% among low-risk men and from 2% to 93% among high-risk men. Peak HPV prevalence spanned a wide range of ages and was generally not concentrated in the younger age groups. Age-specific prevalence curves were relatively flat or declined only slightly following peak prevalence. CONCLUSIONS Genital HPV infection in men varies widely, both between and within high- and low-risk groups and by geographic region. Compared with that in women, HPV prevalence in men seems to peak at slightly older ages and remains constant or decreases slightly with increasing age, suggesting persistent HPV infection or a higher rate of reinfection.
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Affiliation(s)
- Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
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Abstract
OBJECTIVE Due to higher rates of human papillomavirus (HPV) infection and anal cancer among gay and bisexual men, we aimed to characterize their willingness to get HPV vaccine and identify correlates of vaccine acceptability. METHODS We surveyed a national sample of men aged 18 to 59 who self-identified as either gay (n = 236) or bisexual (n = 70) during January 2009. We analyzed data using multivariate logistic regression. RESULTS Most men had heard of HPV vaccine (73%, 224/306) and were willing to get it (74%, 225/306). HPV vaccine acceptability was higher among men who believed their doctor would recommend getting the vaccine (OR = 12.87, 95% CI: 4.63-35.79) and those who were unsure (OR = 3.15, 95% CI: 1.47-6.76), as compared to men who believed their doctor would not recommend it. Acceptability was also higher among men who reported 5 or more lifetime sexual partners (OR = 3.39, 95% CI: 1.34-8.55), perceived greater severity of HPV-related disease (OR = 1.92, 95% CI: 1.18-3.14), perceived higher levels of HPV vaccine effectiveness (OR = 1.97, 95% CI: 1.27-3.06), or reported higher levels of anticipated regret if they did not get vaccinated and later developed an HPV infection (OR = 2.39, 95% CI: 1.57-3.61). CONCLUSIONS HPV vaccine acceptability was high among gay and bisexual men. These findings identify potentially important beliefs and attitudes for future communication efforts about HPV and HPV vaccine among gay and bisexual men.
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Ankerst DP, Diepolder H, Horster S. Topical treatment of anogenital human papillomavirus infection in male patients. Future Virol 2009. [DOI: 10.2217/fvl.09.57] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: Human papillomavirus (HPV)-associated anogenital warts have a prevalence of up to 78% in sexually active men. Some HPV subtypes bear a considerable oncogenic potential. Materials & methods: Original papers on the treatment of external anogenital warts were included in a meta-analysis to assess the most effective topical treatment. Results: Clearance rates were 0–6.5% for placebo treatment, 76.6% for podophyllotoxin 0.15% cream administered for 4 weeks, 61.5% for podophyllotoxin 0.5% solution (2–6 weeks) and 53.7% for imiquimod 5% cream (12–16 weeks). For male patients, the intent-to-treat analysis demonstrated statistically significant superiority of podophyllotoxin preparations versus imiquimod (p < 0.0001 and p < 0.005, respectively). Clearance rates of locally ablative treatments, such as surgery, cryotherapy, electrocautery and carbon dioxide laser, differed widely without clear superiority of a specific ablative technique. In HIV-positive patients, all treatment options yielded lower clearance rates and higher recurrence rates. Conclusion: While preventive vaccines might reduce HPV-associated morbidity for future generations, those with active HPV disease still need to be treated with customary treatment options. In male patients, podophyllotoxin preparations yielded higher response rates than imiquimod.
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Affiliation(s)
- Donna P Ankerst
- Department of Mathematics, Technical University Munich, Boltzmannstr.3, 85747 Garching, Germany
| | - Helmut Diepolder
- Medizinische Klinik und Poliklinik II Klinikum Großhadern der Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377 München, Germany
| | - Sophia Horster
- Medizinische Klinik und Poliklinik II Klinikum Großhadern der Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377 München, Germany
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[Anal HPV infections]. Wien Klin Wochenschr 2008; 120:631-41. [PMID: 19083168 DOI: 10.1007/s00508-008-1059-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Accepted: 09/03/2008] [Indexed: 10/21/2022]
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