TREATMENT OF HPV INFECTION: MANAGEMENT-SURVEILLANCE

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

TREATMENT OF HPV INFECTION: MANAGEMENT-SURVEILLANCE

Serono Symp Publ Raven; 78:287-90 1990. Unique Identifier : AIDSLINE ICDB/92678077
Contou JF; Cope R; Rothschild Hosp., 33 Boulevard de Picpus, 75571 Paris Cedex 12,; France

Abstract: The correct therapeutic strategy in genital human papillomavirus (HPV) infection and when and how to employ the various available treatments are open questions. Because of the infectious and sexually transmissible nature of margino-canalar condylomatosis, five principles of venereology should be followed: recognition, screening, treatment, surveillance, and prevention. Employment of these principles in HPV-induced genital warts is discussed. Specific presentations of interest include Bowen's disease of the anus, carcinoma in situ (CIS), invasive anal cancer, and giant degenerated condyloma acuminatum. Bowen's disease leads to CIS. Treatment is local excision, with life-long follow-up because the risk of developing invasive carcinoma is considerable. CIS developing with condylomata acuminata also are treated by local excision. Invasive anal cancer is treated by a combination of chemotherapy and external irradiation, and possibly by radioactive implant insertion at surgery depending on staging and response. Giant degenerated condylomata acuminata require radiotherapy and abdomino-perineal resection. Better recognition of subclinical disease, appreciation of the risk of progression, and close surveillance are required to produce better therapeutic results. Marginal lesions outside the canal may be treated with topical therapy or preferably ablative therapy (especially when florid). Lesions in the canal should receive ablative treatment. Systemic treatments represent a solution for the future.

Keywords: Anus Neoplasms/*THERAPY Bowen's Disease/THERAPY Combined Modality Therapy Condylomata Acuminata/*THERAPY Female Genital Neoplasms, Female/*THERAPY Genital Neoplasms, Male/*THERAPY Human HIV Infections/COMPLICATIONS Male Neoplasm Recurrence, Local/THERAPY Opportunistic Infections/THERAPY *Papillomavirus Risk Factors Tumor Virus Infections/*THERAPY MONOGRAPH REVIEW
920430
M9240950

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