Effectiveness of physically ablative and pharmacological treatments for anal condyloma in HIV-infected men

Abstract

BackgroundThere is limited information on the effectiveness of available treatments for anal condyloma acuminata in HIV-1-infected men.AimTo provide data on the effectiveness of electrosurgical excision, infrared coagulation and pharmacological (imiquimod) treatments for anal condyloma acuminata (peri-anal and/or intra-anal) in HIV-1-infected men based on authors’ practice.MethodsSingle-center, retrospective descriptive analysis of HIV-1-infected men, 18 years or older treated for anal condyloma acuminata. Standard treatments were offered: electrosurgery excision, infrared coagulation and topical imiquimod. Effectiveness was evaluated by the recurrence rate at 1 year after treatment. Recurrence was defined as any anal condyloma acuminata diagnosed after 3 months of condyloma-free survival post-treatment. Anal cytology and human-papillomavirus-infection (HPV) was assessed.ResultsBetween January 2005 and May 2009, 101 men were treated for anal condyloma acuminata: 65 (64%) with electrosurgery, 27 (27%) with infrared coagulation and 9 (9%) with imiquimod. At 1 year after treatment, the cumulative recurrence rate was 8% (4/65, 95%CI: 2–15%) with electrosurgery excision, 11% (3/27, 95%CI: 4–28%) with infrared coagulation and 11% (1/9, 95%CI: 2–44%) with imiquimod treatment. No predictive factors were associated with recurrence.Anal HPV-6 or HPV-11 was detectable in 98 (97%) patients and all had high-risk HPV genotypes, and 89 (88%) patients had abnormal anal canal cytology. Limitations: this was a retrospective descriptive analysis; limited to a single center; it cannot know if the recurrence is related to new infection.ConclusionRecurrence of anal condyloma after any treatment was common. Abnormal anal cytology and high-risk HPV-infection were highly prevalent in this population, therefore at high-risk of anal cancer, and warrants careful follow-up.

Male papillomavirus infection and genotyping in the Qingyuan area

“…HPV patients also need secondary prevention, and there is no specific method to cure HPV virus. At present the most important mode of treatment is to remove the local hyperplastic warts, which is effective, simple, safe, and scar-free [20]. HPV can also be treated by physical therapy, medicine, and vaccine.…”

SnapshotDx Quiz: October 2020

“…This treatment can be highly effective for condyloma acuminata. A study showed that in 64 patients undergoing surgical excision, there was only an 8% recurrence of their condyloma acuminata (Vela et al, 2018).…”

Comparison of the Effectiveness of the Chemosurgery and Cryosurgery for the Treatment of Patients with Condyloma Acuminatum

“…At Dr. Moewardi Hospital, Surakarta, CA, was ranked first in the visits of sexually transmitted infections polyclinic patients (Mawardi et al, 2019). Vela et al (2018) stated that the management of CA generally aims to eliminate the lesions and prevent recurrence with minimal side effects. Sharma et al (2017) reported a comparison of the effectiveness of cryosurgery as monotherapy and combination therapy using 25% podophyllin solution in CA patients, where the monotherapy group with cryosurgery provided a higher cure rate and lower recurrence rate than the combination therapy group.…”