Wednesday, May 7, 2008

How is HPV treated?

External genital warts
There is no cure or treatment that can eradicate HPV infection, so the only currently possible treatment is to remove the lesions caused by the virus. Unfortunately, even removal of the warts does not necessarily prevent the spread of the virus, and genital warts frequently recur. None of the available treatment options is ideal or clearly superior to others.

A treatment that can be administered by the patient is a 0.5% solution or gel of podofilox (Condylox). The medication is applied to the warts twice per day for 3 days followed by 4 days without treatment. Treatment should be continued up to 3-4 weeks or until the lesions are gone. Podofilox may also be applied every other day for a total of three weeks. Alternatively, a 5% cream of imiquimod [(Aldara) (a substance that stimulates the body's production of cytokines, chemicals that direct and strengthen the immune response)] is likewise applied by the patient three times a week at bedtime, and then washed off with mild soap and water 6-10 hours later. The applications are repeated for up to 16 weeks or until the lesions are gone.

Only an experienced physician can perform some of the treatments for genital warts. These include, for example, placing a small amount of a 10-25% solution of podophyllin resin on the lesions, and then, after a period of hours, washing off the podophyllin. The treatments are repeated weekly until the genital warts are gone. An 80-90% solution of trichloroacetic acid (TCA) or bichloracetic acid (BCA) can also be applied weekly by a physician to the lesions. Injection of 5-flurouracil epinephrine gel into the lesions has also been shown to be effective in treating genital warts.

Interferon alpha, a substance that stimulates the body's immune response, has also been used in the treatment of genital warts. Treatment regimens involve injections of interferon into the lesion every other day over a period of 8 to 12 weeks.

Alternative methods include cryotherapy (freezing the genital warts with liquid nitrogen) every 1 to 2 weeks, surgical removal of the lesions, or laser surgery. Laser surgery and surgical excision both require a local or general anesthetic, depending upon the extent of the lesions.