Sexually transmitted papillomavirus infections: epidemiology pathogenesis, clinic, morphology, important differential diagnostic aspects, current diagnostic and treatment options

Abstract

The family of human papilloma viruses (HPV) comprises more than 100 genotypes. Approximately 30 of the genotypes are responsible for infections in the human anogenital area. A precisely defined algorithm with the goal of diagnosing and removing HPV for a prolonged or indefinite length of time, as well as to protect the patient from any malignant ransformation, does not currently exist. The identification of HPV strains by PCR or DNA hybridization in lesional tissue provides higher security for the patients. In high-risk patients additional colposcopy, rectoscopy, and rethroscopy/cystoscopy increase the probability of proper diagnosis and the application of a reliable therapeutic strategy. Removal of lesions by means of invasive methods, such as electrodessication, cryosurgery, and/or laser therapy, may be successful and could be combined pre- and postoperatively with the local application of podophyllotoxin, Trichloroacetic acid, 5-fluorouracil epinephrine gel, imiquimod, cidofovir or interferon. The administration of vaccine to young patients prevents to a significant extent the clinical manifestation of the most frequent viral strains, being HPV-6,-11 and -18. The different therapeutic methods must be applied in accordance with the clinical picture, taking into account the patient's general status, the presence of concomitant diseases, as well as the local and systematic compatibility of the side effects of each remedy. The review focuses on the diagnosis and treatment options of sexually transmitted HPV-infections and includes synopsis of the most recent literature regarding new data of epidemiology, pathogenesis, ifferential diagnosis and morphology of HPV infections in humans.

Decrease Recurrence Rate of Condylomata Acuminata by Photodynamic Therapy Combined with CO₂ Laser in Mainland China: A Meta-Analysis

“…These therapies are likely to be painful and lead to a high recurrence rate, because HPV may persist in normal-appearing epithelium adjacent to treated lesions [38]. CA and the high relapse rate thereof seriously affect the quality of life and treatment confidence of patients, as well as their family stability and welfare [39]. …”

Papiloma invertido (Papiloma Schneideriano) com envolvimento da cavidade oral: relato de caso incomum

“…8,9 The remo val of papil lo ma lesions by inva si ve methods, such as elec tro dis sec tion, cryo sur gery and/or laser the rapy may be suc cess ful and could be com bi ned with topi cal appli ca tion of podophyl lo toxin, trich lo roa ce tic acid, 5-fluo rou ra cil gel, epi neph rine, topi cal che mo the rapy, cido fo vir or inter fe ron. 10 In the pre sent study, sur gery was con ser va ti ve and no sign of relap se was obser ved during two years of proser va tion. It should be empha si zed that the nasal septum was not invol ved.…”

Tratamento do papiloma vírus humano na infância com creme de imiquimode a 5%

“…1 Modulation of the immune response by systemic, topical or intralesional medication represents an alternative treatment for viral infections. The efficacy of this modulation is based on the regression of Imiquimod is a synthetic immunomodulator for topical use.…”

“…Imiquimod also acts on cell immunity by activating Langerhans cells, thus increasing the presentation of antigens for the T-cells. 1,11,13 Imiquimod treatment of lesions resulting from a viral infection such as condyloma acuminatum in adults and viral warts and mollusca contagiosa in children has shown good results. 13 Complete regression of the lesions is achieved in 72-84% of cases, local recurrence rates ranging from 5 to 19%.…”

“…1 The principal sites affected by the human papillomavirus (HPV) in children are the extremities and the face, anogenital warts being less common in childhood. 2 The mode of HPV transmission remains controversial, but includes perinatal transmission, auto-and hetero-inoculation, sexual abuse and possibly indirect transmission via fomites.…”