Critical appraisal of commonly used treatment for genital warts

Abstract

Genital warts are one of the most commonly reported sexually transmitted diseases worldwide. A variety of treatment options are available but few have been assessed in large-scale, randomized, placebo-controlled trials. Provider-applied surgical and non-surgical treatments have traditionally been the therapies of choice. Surgical therapies, including cryotherapy, electrotherapy, laser surgery and surgical excision, are generally equivalent in terms of wart clearance rates, but are associated with high rates of wart recurrence. Trichloroacetic acid is a widely used non-surgical therapy, but little is known about its efficacy, and it is associated with unpleasant side-effects. The patient-applied treatments imiquimod and podophyllotoxin are newer therapy choices which are more acceptable to both patients and practitioners. The wart clearance rates for these two treatments are similar, although imiquimod is associated with lower recurrence rates. In the face of increasing pressures on genitourinary clinic services, patient-applied home therapy represents an attractive option for the treatment of genital warts.

Regression of Human Papillomavirus Intraepithelial Lesions Is Induced by MVA E2 Therapeutic Vaccine

“…Although these ablative therapies are effective in initial treatments where elimination of lesions can be as high as 80% (Lacey et al, 2013), removal of damaged tissue does not always guarantee elimination of viral DNA. Particularly, in precancerous lesions, surgical procedures alone are not very effective, since recurrences occur at rates of 20-30% or more with lesions both at previously treated sites because of failure of the procedure to eliminate the HPV, and at new sites because of new infections (Lacey et al, 2013), even after several treatments (Maw, 2004). Persistence of high-risk HPV can lead to the development of cancer lesions.…”

Pulsed dye laser treatment of genital warts

“…The choice of therapy is based on the number, size, site, and morphology of lesions, as well as patient preferences, cost, convenience, adverse effects, and clinician experience [1,5,6]. No definitive evidence suggests that any of the available treatments are superior to the others, and no treatment is ideal for all patients or all warts [1,5,6].…”

“…Patient self-applied topical treatments such as imiquimod cream or podofilox are increasingly recommended but they require good patient compliance in order to be effective [1,5,6].…”

“…To date surgical excision, cryotherapy, and electrocautery are commonly exercised, efficient treatment options [1,5,6]. They require local anesthesia and produce superficial wounds that need special care and a healing time of 7-10 days.…”

Konservative Behandlungsmethoden anogenitaler HPV-Infektionen

“…In den USA stieg in den Jahren 1948-2001 die Zahl genitoanaler Warzen von 118 pro 100.000 Personen auf 205 Fälle pro 100.000 Personen pro Jahr an [26]. Etwa lastungen werden bei Befragungen vor rein körperlichen Beschwerden genannt [29]. Klinisch tätige Ärzte müssen sich über mögliche psychische Verknüpfun-gen bewusst sein, wenn auf HPV untersucht wird [33].…”