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Comments and Opinions
February 2006

5% Imiquimod Suppositories Decrease the DNA Load of Intra-anal HPV Types 6 and 11 in HIV-Infected Men After Surgical Ablation of Condylomata Acuminata

Arch Dermatol. 2006;142(2):243-253. doi:10.1001/archderm.142.2.243

Human papillomavirus (HPV) infections of the anogenital tract belong to the most common group of sexually transmitted diseases worldwide. So far, more than 90 different HPV types have been isolated from cutaneous and mucosal lesions.1 Mucosal HPV-6 and -11 are the most frequent types found in patients with genital warts or condylomata acuminata (CA).2 In human immunodeficiency virus (HIV)–infected individuals, standard therapies for CA often fail, probably because of the suppressed cellular immune response leading to an insufficient control and increased replication of HPV.3,4 In this context, intra-anal CA in HIV-infected men represents a special therapeutic challenge, as both ablation and follow-up are difficult to perform because of the local anatomical situation. Imiquimod, a topical immune response modifier, has been approved for the treatment of CA in the United States and Europe. In 2002, Kaspari et al5 reported that the use of suppositories containing imiquimod successfully prevented recurrences of intra-anal CA after surgical ablation in HIV-negative men. We report the effects of the use of 5% imiquimod suppositories on HPV-6 and -11 DNA load in the management of CA in HIV-infected men who have sex with men.

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