HPV is causing a variety of benign, borderline and malignant disorders, with common anogenital signs. The association of various types of treatment is still the preferred method to eradicate HPV infection. This paper offers information about possible systemic treatments of HPV infection, based on the documentation from the PubMed databaseincluding immunomodulatory drugs, antiviral medications, therapeutic HPV vaccines and biological therapy.
Keywords HPV, HPV systemic treatment, therapeutic vaccines, systemic immunomodulators, systemic antiviral drugs Rezumat Infecţia umană cu diferite genotipuri ale virusului papiloma uman HPV este una dintre cele mai frecvente infecţii virale cu transmitere sexuală.
HPV provoacă o varietate de afecţiuni benigne, precanceroase şi maligne, cu semne anogenitale comune. HPV necesită tratament sistemic antiviral, dar în prezent nu există un medicament antiviral sistemic aprobat împotriva infecţiilor cu HPV.
Hpv vaccine genital warts diferitelor tipuri de tratament este încă metoda preferată pentru eradicarea infecţiei cu HPV. Această lucrare oferă detalii despre posibilele tratamente sistemice ale infecţiei cu HPV, pe baza documentaţiei din baza de date PubMedinclusiv medicamente imunomodulatoare, medicamente antivirale, vaccinuri HPV terapeutice şi terapie biologică.
Cuvinte cheie HPV tratament sistemic HPV vaccinuri terapeutice imunomodulatoare sistemice medicamente antivirale sistemice Genital infections with human papillomaviruses HPVamong the most common sexually transmitted diseases STDhpv vaccine genital warts alarming signals in human health, due to the prevalence and dissemination, as well as to various pathologies induced mostly at the level of the genital tract 1.
The virus has tropism for feminine genital tract. Discussion At this moment, there is no routine effective therapy to treat lesions induced by HPV. HPVshr infection with various clinical forms at various levels requires an early diagnosis and proper treatment 5.
The treatment improves symptoms, especially regarding evolutive flares, lowering the possibility of infection by HPV and possibly through other possible STD associated 6. It is recommended that all clinical and subclinical susceptible lesions at the level of epithelium and mucous membranes be tested for HPV 7. The possibility of identifying the genotype is useful, especially for infections with HPVshr, when the therapy must be prompt and targeted, and post-therapeutic follow-up must be done for hpv vaccine genital warts term in order to prevent the neoplastic transformation 8.
Taking into account the fact that many lesions hpv vaccine genital warts confirmed HPV etiology have a self-limiting evolution, it is recommended that before starting the treatment the patient should be kept under observation for several weeks, expecting the spontaneous healing 9. A multidisciplinary approach is required for optimal decision making, treatment planning, and post-treatment response assessment. The therapy of the dimensiunea helmint produced by HPV is local and systemic.
Topical treatment removes lesions, but the absence of infection is not guaranteed The absence of a sterilizing therapy diminishes the effectiveness of evaluation and monitorization of the sexual partners, but their testing can identify ignored lesions HPV is ubiquitous, especially in the lower genital tract, which makes the pharmacological treatment to be considered as the therapy of choice The treatment with interferon and immunomodulating agents inosine did not bring the presumed results many side effects which limited the therapeutic doses Figure 1.
Antiviral polyamide in HPV infection 18 Systemic antiviral treatment would be the treatment of choice, but at present there is no systemic antiviral drug approved for HPV This article details the progresses in the treatment of systemic infection with HPV, regardless of type, location and genotype Table 1.
HPV vaccines currently licensed in the United States of America 21 This hpv vaccine genital warts provides up-to-date scientific data on the possible systemic treatments of human infections with HPV confirmed etiology. Recurrences occur after all therapies.
All topical treatments are associated with local skin reactions including itching, burning, erosions and pain. A number of studies highlighted the role of HPV systemic treatment, from which the most prevalent are aromatic retinoids, interferon, inosine, while hpv vaccine genital warts studies have reported benefits after using hydroxicloroquine Antiviral medications like foscarnet, cidofovir and ribavirin were used as systemic HPV treatment with good results Figure 2. HPV by the numbers 30 A history of genital warts, a positive HPV test result, or abnormal cervical, vaginal, vulvar or anal cytology, all indicate a prior HPV infection, but not necessarily with the HPV types included in the vaccines.
The vaccination is still recommended in individuals within the recommended age range who have evidence of prior HPV infection, as it can still provide protection against infection with HPV vaccine types not already acquired.
However, these patients should be advised that vaccination will have no therapeutic effect on preexisting HPV infection or in HPV-associated diseases, and the potential benefit of HPV vaccination hpv vaccine genital warts not as great as hpv vaccine genital warts they were vaccinated before their sexual debut 24, The therapeutic anti-HPV vaccines are supposed to induce cell-mediated immunity and to prevent the development of benign and malignant lesions induced by this virus.
Cell-mediated rather than humoral immune responses are important for the clearance of established infections. The HPV E6 and E7 oncoproteins are essential for the onset and maintenance of malignancy; thus, they are unlikely to escape immune responses by mutation. They are also expressed constitutively and at high levels, and therefore represent near-ideal hpv vaccine genital warts for the development of therapeutic vaccines against established HPV infections and lesions.
Other proteins useful for targeting of early viral infections are E1 viral helicase and E2, which are expressed at higher levels than E6 and E7 at very early stages before viral genome gardasil vaccine injuries. An ideal therapeutic vaccine would target these proteins to induce strong tumor-specific T-cell type 1 and cytotoxic lymphocyte CTL responses able to kill infected and malignant cells The types of hpv vaccine genital warts vaccines, which are developed and evaluated at the moment, are vaccines with viral or bacterial vectors, vaccines based on dendritic cells and modified tumor cells, vaccines based on peptides, proteins or RNA replicons or DNA vaccines 27, Progress will likely come from clinical trials testing the treatment of low-grade lesions of the cervix, with the aim of accelerated and sustained resolution following either HPV immune response, or drug treatments as the stepping stone for wider therapeutic application The treatment is reserved for patients with visible warts.
The general treatment strategy is to eliminate as many of the visible lesions as possible until the host immune system can control the viral replication The treatment is not recommended for subclinical anogenital or mucosal human papillomavirus infection in the absence of coexistent dysplasia Recent research directions are promising to provide antiviral medications anti-HPV with the characteristics aforementioned 36, However, current therapeutic strategies remain expensive due to the systems of manufacture, meaning that even if a vaccine were to be commercialized, its cost would render it less accessible to populations in developing countries, where the burden of cervical cancer is condiloame bushke. To expand the impact of therapeutic vaccines in developing countries, plant-made products are a promising technology to offer inexpensive and effective pharmaceuticals Additionally, cold-chain vaccine delivery is necessary to maintain vaccine shelf life, and contributes to the inaccessibility of vaccine products in developing countries due to poor infrastructure Vaccination at a very large scale prior the sex life debut is for now the only tool we have in the battle against HPV infections.
Still, as several candidate vaccines are tested nowdays in clinical trials, it is likely that we will benefit from a therapeutic HPV vaccine in the near future. Conflict of interests: The authors declare no conflict of interests. Bibliografie 1.
J Acquir Immune Defic Syndr. Genital warts: a comprehensive review.
Hpv vaccine quadrivalent
J Clin Aesthet Dermatol. Association of antiretroviral therapy with high-risk human papillomavirus, cervical intraepithelial neoplasia, and invasive cervical cancer in women living with HIV: a systematic review and meta-analysis.
Lancet HIV. Role of inosine pranobex in management of HPV-associated diseases: problems and prospective. Obstetrics, Gynecology and Reproduction. Comparative study of systemic interferon alfa-NL and isotretinoin in the treatment of resistant condylomata acuminata.
J Am Acad Dermatol. Sexually transmitted diseases treatment guidelines, Adv Ther. An overview of early investigational drugs for hpv vaccine genital warts treatment of human papilloma virus infection and associated dysplasia.
Traducere "spus negi genitali" în engleză
Expert Opin Investig Drugs. Systemic α-interferon Wellferon treatment of genital human papillomavirus HPV type 6, 11, 16, and 18 infections: double-blind, placebo-controlled trial. Gynecol Oncol. Antiviral medication in sexually transmitted diseases. Mini Rev Med Chem. Butureanu S, Butureanu TA.
Obstetrica şi Ginecologia. Antivir Ther. HPV in men: an update. J Low Genit Tract Dis. Management of cervical dysplasia in the context of pregnancy. Cervical cancer during pregnancy. Diagnostic and treatment options. Immunomodulators in warts: Unexplored or ineffective?.
Pap and HPV Testing - Nucleus Health tratamentul paraziților sarcomului
Indian J Dermatol. Lopinavir up-regulates expression of the antiviral protein ribonuclease L in human papillomavirus-positive cervical carcinoma cells.
Treatment of condylomata acuminata with oral isotretinoin. J Urol.
Hpv vaccine genital warts cure
Oral isotretinoin in the treatment of recalcitrant condylomata acuminata of the cervix: a randomised placebo controlled trial.
Sex Transm Infect. Systemic Cidofovir in Papillomatosis. Clin Infect Dis. Drug Des Devel Ther. Ann Intern Med. Perspectives for therapeutic HPV vaccine development. J Biomed Sci. Rev Obstet Gynecol. Associations between highly active antiretroviral therapy and the presence of HPV, premalignant and malignant cervical lesions in sub-Saharan Africa, a systematic review: current evidence and directions for future research.
BMJ Open. Lacey CJN. Therapy for genital human papillomavirus-related disease.
J Clin Virol. Human Papilloma Virus — neonatal involvement.
Treatment of human papillomavirus with peg-interferon alfa-2b and ribavirin. Braz J Infect Dis.
Use of interferon-alpha in recurrent respiratory papillomatosis: year follow-up.