genital warts
Antibodies to human papillomavirus type 11 virus-like particles in sera of patients with genital warts and in control groups.

Eisemann C, Fisher SG, Gross G, Muller M, Gissmann L.

Deutsches Krebsforschungszentrum, Forschungsschwerpunkt Angewandte Tumorvirologie, Heidelberg, Germany.

We analysed by ELISA a total of 478 human sera for the presence of antibodies to HPV-11 virus-like particles. The sera were obtained from patients with current genital warts (group CO), from males attending the hospital for fertility disorders (group MA), from blood donors (group BD) and from patients hospitalized for reasons unrelated to HPV infections (group HO). Antibody prevalence was higher in male patients of group CO (23.0%) as compared to males of groups MA (3.2%; P < 0.0001), HO (5.3%; P = 0.01) and BD (16.7%; NS). In addition, there was a significant difference in antibody titre between the males of group CO compared to group MA. Within the whole sample the absorbance of sera from females was higher than in specimens from males (P < 0.0001). A small subset of the sera was also tested by radioimmunoprecipitation assay (RIPA). There was good agreement between the data obtained by ELISA and RIPA.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8760429&dopt=Abstract genital wart


genital warts
Patients with genital warts: how are they managed by general practitioners?

Estcourt CS, Higgins SP, Hall J, Hillier VF, Chandiok S, Woolley PD.

Department of Genitourinary Medicine, Manchester Royal Infirmary, UK.

This study was carried out to assess the management by general practitioners of patients with genital warts. An anonymized postal questionnaire was sent to 2060 general practitioners in the north west of England; 1260 (61.2%) completed questionnaires were returned. A total of 76.69% of GPs saw one or more cases per quarter. Of 468 (37.1%) GPs who managed patients in-house, 393 (83.9%) used podophyllin of concentration between 0.5 and 50%; 169 (43%) did not specify the podophyllin concentration and 112(23.9%) used podophyllotoxin. Of 395 GPs (31.3%) prescribing patient self-treatment, 259 (65.6%) prescribed podophyllin, but 60.23% did not specify the concentration; 134(33.9%) prescribed podophyllotoxin. Screening for selected sexually transmitted infections (STIs) was performed by 258/618 (41.7%) GPs. Only 74 (11.97%) screened for Chlamydia trachomatis and Neisseria gonorrhoeae and Trichomonas vaginalis. Partner notification was advised by 1138 (90.3%) and condom use by 1027 (81.5%). Only 333 (26.4%) referred all patients to GUM departments. Many GPs manage patients in-house, most using podophyllin solutions which vary in concentration, are non-standardized and potentially hazardous. Most GPs who instigate patient self-treatment prescribe podophyllin which is not licensed for this usage. Podophyllotoxin 0.5% is a safe, effective alternative. Few non-referring GPs screened for the 3 common STIs, thus putting patients at risk of complications such as pelvic inflammatory disease. Non-referral of patients with genital warts to GUM departments may have costly medical and financial consequences.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8799786&dopt=Abstract genital wart


genital warts
The lifetime occurrence of sexually transmitted diseases among a cohort aged 21.

Dickson N, Paul C, Herbison P, McNoe B, Silva P.

Department of Preventive and Social Medicine, Dunedin Multidisciplinary Health and Development Unit, University of Otago Medical School.

AIMS: To determine the lifetime occurrence of sexually transmitted diseases (STDs) among a cohort aged 21. METHODS: Participants were interviewed at aged 21 as part of a multidisciplinary health and development study. Questions on STDs and sexual behaviour were presented by computer. RESULTS: Of the cohort members known to be alive, 92% responded. Among the sexually experienced 8.6% of the men and 17.3% of the women reported ever having had an STD. Genital warts and chlamydial infection were the commonest STDs among the men, and chlamydial infection, genital warts, and genital herpes among the women. General practice was the commonest place for treatment, and only a minority of people were treated at sexual health clinics. The risk of having an STD increased steeply with the lifetime number of sexual partners. CONCLUSIONS: STDs are common problems among young New Zealanders, especially women. The rate was as high as the US. Prevention should be directed at increasing the use of condoms, but education aimed at reducing the number of sexual partners and delaying the onset of sexual involvement should be considered seriously. A more coordinated approach to treatment is required to take into account the diversity of settings where STDs are treated. Surveillance of STDs needs to be extended, as currently the only data are from sexual health clinics.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8816720&dopt=Abstract genital wart