Trichloroacetic acid in the treatment of human papillomavirus infection of the cervix without associated dysplasia.

Human papillomavirus-induced cytologic changes were found in 379 (10.9%) of 3461 Papanicolaou smears done at the Gynecology Clinic at Wayne State University. Of these 379 patients, 98 (25.8%) had no cytologic evidence of dysplasia. Forty-six of the 98 patients, who had colposcopic and histologic evidence of human papillomavirus without dysplasia, agreed to participate in this study. All patients underwent a Q-Tip application of 85% trichloroacetic acid to the entire cervix, including the endocervical canal and the transformation zone, until the mucosa turned white. Coexistent vaginal and vulvar condyloma were treated simultaneously in six patients. The patients were reexamined at two-week intervals to ascertain the need for reapplication of trichloroacetic acid. No colposcopic evidence of human papillomavirus was found in 18 patients at the first visit, whereas 28 patients required reapplication of trichloroacetic acid. Three months after treatment, a follow-up Papanicolaou smear and colposcopic examination revealed no human papillomavirus infection in 31 patients. Seven patients had persistent infection and eight patients were lost to follow-up. Our preliminary data from this study suggest that 85% trichloroacetic acid is effective treatment of human papillomavirus infection of the cervix without dysplasia.