Naslov
The natural history of HPV: from clinically invisible lesions to Buschke-Löwenstein

Autori
Skerlev, Mihael

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Proceedings of the 24th European Conference of the International Union against Sexually Transmitted Infections and HIV/AIDS, Milano, Italy, September 04-06, 2008 / M.Cusini, C. Heller-Vitouch - Milano, 2008

Skup
24th European Conference of the International Union against Sexually Transmitted Infections and HIV/AIDS

Mjesto i datum
Milano, Italija, 04.09.2008. - 06.09.2008

Vrsta sudjelovanja
Plenarno

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
HPV; males; Buschke-Loewenstein; HPV vaccine

Sažetak
Anogenital HPV infections are the most frequently diagnosed STIs of viral origin, and the HPV types associated with such lesions have been studied extensively during the last years. HPV genital infections are also one of the most frequent diagnoses in the STD Outpatient Clinic of our Department. The clinical variations, following, are presented in this paper ranging from clinically “ invisible” , “ asymptomatic” lesions to the bizarre forms of giant condyloma of Buschke-Löwenstein type. Besides, different diagnostic tools have been used including pathohistology and penoscopy. However, the results were not always precise enough whether the lesion is HPV-induced or not. Thus, we also wanted to evaluate the significance of viral tests (PCR, hybridization) for HPV-induced, clinically visible lesions (condylomata acuminata, condylomata plana, Buschke-Löwenstein) in men. According to our results, HPV 16 and 18 have been isolated from “ benign" HPV-associated genital lesions in 20% of patients, i.e. more than it is usually expected. These results were based on the “ natural history of the disease” , as no therapeutic or prophylactic interventions from our side have been performed before the results have been obtained. Therefore, the diagnostic approach to HPV genital infections needs to be complex including HPV DNA typing whenever it seems appropriate. Different methods are presented for the treatment of genital warts, such as cryotherapy, podophyllotoxin, curettage, podophyllin, and imiquimod. It can be concluded that no definite treatment method has been clearly found superior so far. Treatment should be guided by the available resources, the experience of the provider and the preference of the patient. Ultimately, within the spectrum of therapeutic options for condylomata, no method is really superior to others ; recurrences occurred in 30-70% of cases. Thus, considering the “ stubborn” nature of HPV, we definitely need the HPV vaccination programme to get rid of one of the oldest and up to now unsolved problems of mankind. The recent introduction of a HPV vaccine (especially the quadrivalent one considering the prevention of the anogenital warts in men, as well) has ushered in new hope of substantially reducing global prevalence of HPV disease.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Javno zdravstvo i zdravstvena zaštita

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