Witold Owczarek1, Monika Slowinska1, Irena Walecka2, Magdalena Ciazynska3, Dorota Nowicka4, Leszek Walczak1, Elwira Paluchowska1. 1. Department of Dermatology, Military Institute of Medicine, 01-755 Warsaw, Poland. 2. Clinic of Dermatology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of the Interior, 02-097 Warsaw, Poland. 3. Department of Proliferative Diseases, Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology, 87-100 Torun, Poland. 4. Department of Dermatology and Venereology, Medical University of Warsaw, 02-091 Warsaw, Poland.
Abstract
BACKGROUND: Genital warts are the manifestation of the human papillomavirus (HPV) infection, which may last for weeks or months before the clinical presentation. The primary aim of the study was the correlation of the DNA HPV genotypes eradication with the treatment response in male patients with persistent genital warts. METHODS: Twenty-one male patients (age range: 22-58) after failure of cryotherapy and podophyllotoxin treatment were enrolled in the study. Genetic tests (Real Time - PCR method) analyzed the presence of DNA-HPV before and 6 months after four sessions (4 weeks apart) of photodynamic therapy with 5-aminolaevulinic acid (ALA-PDT). The treatment efficacy was evaluated before each PDT session and at the end of the study. RESULTS: The single HPV DNA type was present in 15/21 of the patients (13/15 HPV6). The high-risk HPV types were found in 8/21 subjects, of which 6/8 had several types. Six months after four sessions of PDT, complete response was found in 16/21 (76.19%; p = 0.0007) of patients, and DNA HPV clearance was found in 66.67% (p = 0.03). The eradication rate differed among patients with primary low-risk and high-risk HPV types-76.92% (10/13; p = 0.0003) and 50% (4/8; p = 0.05) respectively. CONCLUSION: ALA-PDT is an effective treatment even after the failure of previous modalities. The persistence of clinical lesions and high oncological risk HPV types should be an indication for treatment prolongation.
BACKGROUND: Genital warts are the manifestation of the human papillomavirus (HPV) infection, which may last for weeks or months before the clinical presentation. The primary aim of the study was the correlation of the DNA HPV genotypes eradication with the treatment response in male patients with persistent genital warts. METHODS: Twenty-one male patients (age range: 22-58) after failure of cryotherapy and podophyllotoxin treatment were enrolled in the study. Genetic tests (Real Time - PCR method) analyzed the presence of DNA-HPV before and 6 months after four sessions (4 weeks apart) of photodynamic therapy with 5-aminolaevulinic acid (ALA-PDT). The treatment efficacy was evaluated before each PDT session and at the end of the study. RESULTS: The single HPV DNA type was present in 15/21 of the patients (13/15 HPV6). The high-risk HPV types were found in 8/21 subjects, of which 6/8 had several types. Six months after four sessions of PDT, complete response was found in 16/21 (76.19%; p = 0.0007) of patients, and DNA HPV clearance was found in 66.67% (p = 0.03). The eradication rate differed among patients with primary low-risk and high-risk HPV types-76.92% (10/13; p = 0.0003) and 50% (4/8; p = 0.05) respectively. CONCLUSION:ALA-PDT is an effective treatment even after the failure of previous modalities. The persistence of clinical lesions and high oncological risk HPV types should be an indication for treatment prolongation.
Entities:
Keywords:
ALA-PDT; DNA HPV; genital warts; real-time PCR; treatment efficacy